Applicability of the Accountancy Disciplines to Nursing

1
Applicability of the Accountancy Disciplines to
Nursing

• WTO Workshop on Domestic Regulation
• Geneva, 30 March 2004

2
Nursing is a good test of the general
applicability of the disciplines

• Complex
• Varying models/degrees of regulation
• Good support within the profession
• International tools
• Highly mobile

3
ICN

• Established in 1899, to promote high standards of
  nursing practice and education globally
• First and widest reaching international
  organisation for health professionals
• Speaks international for roughly 12 million
  nurses
• ICN works to ensure quality nursing care for all,
  sound health policies globally, and the
  advancement of nursing

4

• Nurses are on the move to pursue education, a
  better job, to escape a local situation, to send
  money home, to experience a new culture, etc.
• They want to move with ease and be treated
  equally with others

5
Interest in regulatory frameworks is highMRAs
are popular e.g. EU, NAFTA, Trans Tasmania,
Caribbean, ECSA
6
ICNs contributions to regulation

• Code of Ethics for Nurses
• Regulation Framework
• Standards and guidelines (practice, education,
  research)
• Competencies (generalist nurse, nurse
  practitioner, telenursing)
• Framework for standards development

7
ICNs contributions to regulation

• Ethical recruitment
• Policies on definition, scope, protection of
  title
• Credentialing Framework
• C/E Accreditation Guidelines
• National Licensure Database

8
Governance must provide

• High standards for personal/professional growth
  and performance
• Public sanction
• Participation of the profession in public policy
• Accountability to the public and
• Proper recognition and remuneration

9
According to ICN, regulation should

• Be designed to achieve the stated purpose
• Have standards based upon clear definitions of
  professional scope and accountability
• Promote the fullest development of the profession
  commensurate with its potential social
  contribution
• Recognise and incorporate the legitimate roles
  and responsibilities of interested parties in
  standard-setting and administration

10
According to ICN, regulation should

• Acknowledge and balance interdependent interests
• Provide and be limited to those controls and
  restrictions necessary to achieve their
  objectives
• Be sufficiently broad and flexible to achieve
  their objectives and permit freedom for
  innovation, growth, and change
• Operate in the most efficient manner, ensuring
  coherence and co-ordination among their parts

11
According to ICN, regulation should

• Promote universal standards of performance and
  foster professional identity and mobility to the
  fullest extent compatible with local needs and
  circumstances
• Provide honest and just treatment for those
  parties regulated
• Recognise the equality and interdependence of
  professions

12
Concerns relate to1. Interpretation of terms

• How are these to be interpreted
• What will be the impact?
• What constitutes quality service? Who decides?
• Are there other criteria that need to be in
  place?
• What will be the impact on care?

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Concerns relate to2. The necessity test

• What constitutes not more trade restrictive than
  necessary?
• Regulators worry about loss of autonomy
• Might a system that is not culturally appropriate
  be imposed?

14
Concerns relate to3. Fear that standards will
be lowered

• Standards have already fallen
• Private education institutions, hospitals, and
  nursing homes

15
Concerns relate to4. Loss of control5.
Impact of changes arising from dispute
resolution
16
Other issues

• Transparency difficult for poorer countries
• Qualification requirements what it means
• Poor countries/those with under-developed systems
• Need to communication

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• Regulation, which assures the public that nurses
  are competent to provide care and advice, is key.

18

• The nursing profession is interested in sound,
  transparent national regulatory systems and
  global standards, which are responsive to the
  evolution of nursing and patient care.

19

• It is important that governments undertake to
  support the strengthening of regulatory systems
  where they are weak or lacking.

20

• ICN advocates an approach sufficiently broad and
  flexible to permit freedom for innovation,
  growth, and change facilitating sound regulatory
  process principles that aim to protect the public
  and provide for just treatment of those
  regulated.