Developing the role of HCAs in Critical Care

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Developing the role of HCAs in Critical Care
Joanna Hunter Senior Practice Development Nurse
Critical Care September 2009
2
Background

• HCA roles
• Staffing
• Critical care environment
• Assistant practitioners

3
Kings

• 16 Level 3 Beds
• 16 Level 2 beds
• 150 qualified staff
• 11 HCAs
• 18 staff per shift
• Level 2 nurse patient ratio 12
• Skill mix
• Workload

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11 HCAs

• 4 English is first language
• 6 Eastern European/1 Philippino
• Qualifications range from none to a degree in
  Biology
• 2 qualified nurses and 1 waiting to go to Medical
  school
• 2 never worked in healthcare previously
• 2 Band 3s and 9 Band 2s

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Development programme

• 2 week training programme on induction
• Trust/Unit competency document
• 3-4 x HCA days a year
• Team days
• Mandatory training annually
• EPR /IT training
• NVQ

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NVQ selection process

• Assessment centre
• 6 months employment
• Numeracy/literacy test
• Managers support
• Application form

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NVQ

• Level 2 and 3
• 5 candidates
• Health
• Units suitable for ICU
• Communication
• Health and safety
• Prepare and dress for work
• Prepare, support and assist with interventions
• Pressure area care
• Assessors

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Achieving Practice Outcomes

• MDT involvement
• Physio/OT/SALT
• PDNs
• Specialist Nurses
• TVN/Continence
• Staff
• Produce folders
• Teach one another

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HCA days

• Compliment learning
• Updates and Policies
• Competencies/Skills
• ECG
• ABGs
• BM monitoring
• Setting up equipment
• Wound care
• Requests

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Was it successful?

• 2 finished
• Positive feedback
• ? Knowledge, skills and confidence
• Benefits to nurse and patient
• Can help future career
• Less positive feedback
• Written work
• Time consuming

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The reality..

• NVQ assessors
• NVQ centre
• Time
• Cost
• Joint Investment Framework
• Train to gain
• Retention
• Supervision and accountability
• Professional regulation

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The Future

• ? Banding?
• Critical care assistants
• Nursing secondment

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Conclusion

• HCAs to support nurses not replace!
• Team work
• Tailor NVQ programme to meet Critical Care
  requirements
• Empowers and motivates HCAs
• Clear objectives and development plan of HCA role
  identify activities
• Patient care

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Further Information

• Jo Hunter
• Senior Practice Development Nurse
• NVQ Assessor
• Joanna.hunter_at_kch.nhs.uk
• Sandra Seed
• NVQ Centre Manager
• Kings College Hospital NHS Foundation Trust
• Sandra.seed_at_nhs.net

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References

• DH (2000) Comprehensive Critical Care. Department
  of Health 2000
• Hogan J and Playle JF (2000). The Utilization of
  the healthcare assistant role in intensive care.
  British Journal of Nursing 2000 Vol9 No 12 p
  794-801
• McGloin S and Knowles J (2005). An evaluation of
  the critical care assistant role within an acute
  NHS Trust Critical Care Unit. BACCN, Nursing in
  Critical care 2005 Vol 10 No 4 p210
• Nursing Times (2009) Whats new in Nursing? 9th
  June 2009 www.nursingtimes.net
• RCN (2003) Royal College of Nursing (2003)
  Guidance for nurse staffing in critical care.
  London RCN
• RCN (2008) Royal College of Nursing (2008).
  Healthcare Assistant Toolkit July 2008.
  RCNLondon