Nursing Licence Degree Tallinn Health College Nursing School

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Nursing Licence Degree Tallinn Health College Nursing School of Lisbon Authors: Andreia Machado Cláudia

Nursing Licence Degree Tallinn Health College Nursing School of Lisbon Authors: Andreia Machado Cláudia Pedro Margarida Lança Nádia Cardoso 1

Summary ü ü ü ü Cultural and Geographic Context Portugal Lisbon Higher School of

Summary ü ü ü ü Cultural and Geographic Context Portugal Lisbon Higher School of Nursing of Lisbon (ESEL) Pole MFR Nursing Licence Degree Length Structure Health and Demography Indicators Statistical Data Foreign Nurses in Portugal Etary Piramid Aging Index Portuguese Health Care Sistem National Health System Nursing in Portugal Ordem dos Enfermeiros Skills of nurses in general care Quality standards of nursing care National Health Plan Tallinn, January 2009 2

Cultural and Geographic Context - Portugal ü Portugal has been a country since 1143

Cultural and Geographic Context - Portugal ü Portugal has been a country since 1143 ü Almost 11 million people (in 2004) ü Official Language: Portuguese (6 th most spoken in the world) ü Official Secondary Languages: English and French ü Immigration Country: African Countries of Portuguese Official Language (Angola, Cape Verde, Mozambique, Guine, etc. ), some east European countries (Ukraine, Russia, Moldova, etc. ) Tallinn, January 2009 3

Landscapes Tallinn, January 2009 4

Landscapes Tallinn, January 2009 4

National Futebol Team Tallinn, January 2009 5

National Futebol Team Tallinn, January 2009 5

Cultural and Geographic Context Lisbon ü ü Capital of Portugal About 500 000 people

Cultural and Geographic Context Lisbon ü ü Capital of Portugal About 500 000 people live in Lisbon ü 3 million people live in the metropolitan area of Lisbon ü Traditional type of music: Fado (Faith, destiny) ü Cosmopolitan and globalising city, which still has been able to renew and keep old costumes Tallinn, January 2009 6

LISBOA Tallinn, January 2009 7

LISBOA Tallinn, January 2009 7

Nursing School in Lisbon (ESEL) üFounded in 24 th September 2007, it is within

Nursing School in Lisbon (ESEL) üFounded in 24 th September 2007, it is within the polytechnic education. ü The four Higher Nursing Schools became one, so as to have more power to fight for nursing and nursing students rights. ü There are now four poles in ESEL. We belong to the Maria Fernanda Resende Pole. ü There will be a unique building in the future. üThere are 6 other schools of Nursing in the city of Lisbon, but they are private schools. Tallinn, January 2009 8 8

Tallinn, January 2009 9

Tallinn, January 2009 9

Nádia Andreia Cláudia Margarida Tallinn, January 2009 10

Nádia Andreia Cláudia Margarida Tallinn, January 2009 10

Nursing Licence Degree - Length ü The course gives a scientific training, technical, human

Nursing Licence Degree - Length ü The course gives a scientific training, technical, human and cultural, of the highest quality, in the provision, research and management of general nursing care to the person throughout its cycle of life, family, community groups and, given the different levels of prevention. ü Students who completed the course in Nursing Licence are able to provide general nursing to the individual, family and community; and can develop their practice into three distinct sectors: public sector, private sector (Health Centers, Hospitals, Clinics , Companies, Schools, Senior Centers, among others) or on a liberal exercise. ü Duration: 4 years ü 4665 total hours ü 2110 hours to theoretical classes ü 2555 hours to practical classes Tallinn, January 2009 11

Nursing Licence Degree - Structure 1 st Year: Nursing Basic Principles p Basic concepts

Nursing Licence Degree - Structure 1 st Year: Nursing Basic Principles p Basic concepts in Nursing I and II p History and Science of Nursing I p Microbiology and Parasitology p Anthropology and Sociology I p Anatomy, Physiology and Physiological Chemistry I and II p Psychology I p Systems and Policies on Health p Ethics of nursing I p Analysis of situations of nursing I p Option I p Clinical Teaching (CT) - Development of basic concepts in nursing (162 hours) q Total of ECTS – 60 (ESCT – European System for Credit Transference) Tallinn, January 2009 12

Nursing Licence Degree - Structure 2 nd Year: Nursing in Adult and Older Adults

Nursing Licence Degree - Structure 2 nd Year: Nursing in Adult and Older Adults p Adult Nursing p Aged People Nursing p Ethics in Nursing II p Health Education p Pathology p Pharmacology p Research in Nursing I p Anthropology and Sociology II p Psychology II p Analysis of situations of nursing II p Options II and III p Clinical nursing to adult and Older Adults (459 hours) - Rendering of care to the adult and the elderly in acute illness situation, and in chirurgical and emergency situations p Total of ECTS – 60 Tallinn, January 2009 13

Nursing Licence Degree - Structure 3 rd Year: Nursing in Psychiatric and Mental Health;

Nursing Licence Degree - Structure 3 rd Year: Nursing in Psychiatric and Mental Health; Nursing in Sexual and Reproductive Health; Nursing in Childhood and Youth p Nursing Women's health p Nursing in Childhood and Youth p Nursing in Psychiatric and Mental Health p Relationship of Aid p Management in Nursing p History and Science of Nursing II p Research in Nursing II p Option IV and V p Analysis of situations of nursing II q CT V – Rendering of care to the adult and the elderly in mental and chronic situation (216 hours) q CT VI – Rendering of care during the maternal cycle (216 hours) q CT VII – Rendering of care to the children and the youth in crisis situation (216 hours) Tallinn, January 2009 14

Nursing Licence Degree - Structure 4 th Year: Nursing in Community; Development of Thesis;

Nursing Licence Degree - Structure 4 th Year: Nursing in Community; Development of Thesis; Transition from student to Nurse • Community Health and Family Nursing • Training in the Employment Context • Nursing in Intensive Care • Personal Project in Clinical Nursing I and II • Analysis of Situations of Nursing IV • CT VIII – Rendering of care to the individual, family and group in the community (324 hours) • CT IX – Rendering of care in hospital/community institutions (data collection for thesis – Personal Project in Nursing) (648 hours) • Total of ECTS - 60 Tallinn, January 2009 15

Health and Demography Indicators Population (2005): 10. 569. 600 Birth rate (2005): 10. 4

Health and Demography Indicators Population (2005): 10. 569. 600 Birth rate (2005): 10. 4 birth/1000 Ratio: 4. 02 nurses/1000 habitants Tallinn, January 2009 16 OE, 2007

Etary Piramid Tallinn, January 2009 17 INE, 2008

Etary Piramid Tallinn, January 2009 17 INE, 2008

Portuguese Health Care System Three Co-existing Systems National Health Service (NHS) Special Public and

Portuguese Health Care System Three Co-existing Systems National Health Service (NHS) Special Public and Private Insurances Schemes for certain professions Tallinn, January 2009 Voluntary private Health insurance 18

National Health System The main health care provider is the State, througt the public

National Health System The main health care provider is the State, througt the public insitutions that constitute the NHS; NHS is mainly financed througt taxes and provides health promotion, treatment and desease surveilance and prevention; Tallinn, January 2009 19

Nursing in Portugal p There are references to nurses in Portugal as early as

Nursing in Portugal p There are references to nurses in Portugal as early as 1120 and, as other parts of the world nursing care was provided by monks and nuns. . . Some historic facts about Nursing in Portugal: Tallinn, January 2009 20

Nursing in Portugal Present status: In April 2007, there were 51. 167 nurses registered

Nursing in Portugal Present status: In April 2007, there were 51. 167 nurses registered in Ordem dos Enfermeiros, whose average was of 39 years. Since 1998, the initial education has been comprised of four school years and has awarded a higher education degree. Portugal is among the 27 European Countries that sign the Bologna Declaration: This declaration sets the original objectives in order to establish, by 2010, the “European Area of Higher Education”. Tallinn, January 2009 21

Nursing in Portugal Specialised training may be achieved at the post-graduation level in six

Nursing in Portugal Specialised training may be achieved at the post-graduation level in six areas: - Community nursing specialist; - Medical and surgical specialist; - Rehabilitation nursing specialist; - Infant health nursing and paediatrics specialist; - Maternal health nursing and midwifery specialist; - Mental health nursing and psyquiatrics specialist Tallinn, January 2009 22

Nursing in Portugal 81% 96% 19% 4% 14% 23 Tallinn, January 2009 OE, 2007

Nursing in Portugal 81% 96% 19% 4% 14% 23 Tallinn, January 2009 OE, 2007

Foreign Nurses in Portugal § On the 31 st of December 2007 2135 foreign

Foreign Nurses in Portugal § On the 31 st of December 2007 2135 foreign nurses worked in Portugal. Gender distribution, OE (Dec. 07) Tem most representative nationalities – OE (Dec. 07) Distribution of foreign nurses by activity sector, OE (Dec. 07) Tallinn, January 2009 24 OE, 2007

Nursing in Portugal 68% 15% Tallinn, January 2009 25 OE, 2007

Nursing in Portugal 68% 15% Tallinn, January 2009 25 OE, 2007

Ordem dos Enfermeiros (OE) Is a public association, free and autonomous in the scope

Ordem dos Enfermeiros (OE) Is a public association, free and autonomous in the scope of its attributions with juridical personality, independent of the state and representative of nursing graduates who practice nursing in Portugal, in complience with the principles of their constitution and the applicable legislation. Main aim: - Promote the defence of the quality of nursing care rendered to the population; - Develop, regulate and control the practice of nursing, guaranteeing that ethical and professional deontology rules are respected Tallinn, January 2009 26

Ordem dos Enfermeiros (OE) - Deontology and Ethics The nurses Deontological Code is included

Ordem dos Enfermeiros (OE) - Deontology and Ethics The nurses Deontological Code is included in the Constitution of the OE and states that nursing interventions have to guarantee the defense of the fredon and dignity of the human being and of the nurse. The activity of Portuguese nurses must be guided by: - The responsabilitys inherent to the role played by nurses in society; - The respect for human ritghs in the relationship with clients; - Excellence in the practice of the profession in general and the relationship with other professionals in particular. Tallinn, January 2009 27

Ordem dos Enfermeiros (OE) Some documents that regulate nursing practice: - Skills of nursing

Ordem dos Enfermeiros (OE) Some documents that regulate nursing practice: - Skills of nursing in general care; - Quality Standards of Nursing Care. Note: In 2004 OE became the representative of Portuguese nursing at the ICN (International Council of Nursing). Tallinn, January 2009 28

Skills of nurses in general care Article 8 Exercise training of nurses 1 -

Skills of nurses in general care Article 8 Exercise training of nurses 1 - Nurses should adopt a responsible and ethical conduct and act with respect for the rights and interests of the citizens. 2 - The exercise of professional nurses have some fundamental objectives: health promotion, disease prevention, treatment, rehabilitation and social reintegration. 3 - Nurses have a complementary role of functional relation to other health professionals, but given the same level of dignity and autonomy of professional practice. Tallinn, January 2009 29

Skills of nurses in general care Article 9 Interventions of nurses 1 – Are

Skills of nurses in general care Article 9 Interventions of nurses 1 – Are autonomous and interdependent. 2 – Is considered autonomous actions when they are taken by nurses under its sole and exclusive responsibility and initiative, according to their skills, whether in the provision of care, management, education, training or advice, with contributions in research on nursing. 3 - Is considered interdependent actions when they are taken by nurses according to their skills, together with other experts, to achieve a common goal, resulting from action plans set by multidisciplinary teams in which they are integrated and regulations 30 or guidelines previously formalized. Tallinn, January 2009

Skills of nurses in general care 4 – Nurses according to their qualifications: a)

Skills of nurses in general care 4 – Nurses according to their qualifications: a) Organize, coordinate, implement, evaluate and supervise the assistance of nursing in three levels of prevention; b) Decide on techniques and methods to be used for the provision of nursing care, and enhance existing resources, creating the trust and active participation of individual, family, community groups; c) Use their own techniques of the nursing profession for the maintenance and restoration of vital functions. Tallinn, January 2009 31

Skills of nurses in general care d) Participate in the coordination and promotion of

Skills of nurses in general care d) Participate in the coordination and promotion of activities inherent in the situation of health/disease, whether the client is followed in hospital, clinic or home; e) Carry out the administration of therapy prescribed, detecting their effects and acting accordingly, should, in an emergency situation, act in accordance with the qualifications and knowledge they hold, with the aim to maintain or restoration of vital functions; f) Participate in the drafting and implementation of protocols for standards and criteria for administration of medicines and treatments; g) Promote the education of the client on the administration and use of drugs or treatments. 5 - Nurses design, promote and carry on research aimed to the advancement of nursing in particular and health in general. Tallinn, January 2009 32

Skills of nurses in general care 6 - Nurses help in carrying out their

Skills of nurses in general care 6 - Nurses help in carrying out their activity in the area of management, research; teaching, training and advice for the improvement and development of the provision of nursing care, including: a) Organizing, coordinating, executing, monitoring and evaluating the training of nurses b) Evaluating and providing human resources needed to provide the nursing care, setting standards and criteria for action and to evaluate the performance of nurses; c) Proposing protocols and information systems for adequate provision of care; d) Giving technical advice on facilities, materials and equipment used in providing nursing care; Tallinn, January 2009 33

Skills of nurses in general care e) Collaborating in the development of protocols between

Skills of nurses in general care e) Collaborating in the development of protocols between health institutions and schools, drivers and facilitators of the learning of the trainees; f) Participating in the evaluation of needs of the population and resources in the field of nursing and proposing the general policy for professional practice, teaching and training in nursing; g) Promoting and participating in the studies needed to restructure, upgrade and enhancement of the nursing profession. Article 10 Delegation of tasks § The nurses may delegate tasks to staff witch are functionally dependent of them, when this have the necessary preparations for run then, combining always the nature of the tasks with the degree of dependence of the patient in nursing care. Tallinn, January 2009 34

Quality Standards of Nursing Care Conceptual framework The Health The Person The Environment The

Quality Standards of Nursing Care Conceptual framework The Health The Person The Environment The Nursing Care Good care means different things to different people!! Tallinn, January 2009 35

Quality Standards of Nursing Care In the permanent search for excellence in professional practice,

Quality Standards of Nursing Care In the permanent search for excellence in professional practice, the nurse: DESCRIPTIVE SET OUT Aim: clarify the nature and gather the various aspects of the social mandate of professional nursing • Pursues the highest levels of clients’ satisfaction; • Helps clients to achieve the maximum potential for health - Health Promotion; • Ensure the prevention of complications for clients’ health; • Maximizes the well being and the self-care; • With the client develops processes to adapt effectively to health problems - The functional upgrading; • Contribute for maximum efficiency in the organization of nursing care. Tallinn, January 2009 36

National Health Plan - Portugal - Main Strategies n n n Priority to poor

National Health Plan - Portugal - Main Strategies n n n Priority to poor people Programmatic approaches Approach base in settings (School, work places and prisons) Strategies to acquire health to everyone n n Central approach in family and on the life cycle Integrated Approach to the disease (leave with more functionality, client empowerment, self-control and self-vigilance) Tallinn, January 2009 37

- Portugal - National Health Plan Strategies to change management n n p Central

- Portugal - National Health Plan Strategies to change management n n p Central changes in citizens (more chose options, citizen voice) Accessibility and rational of medicines Reorientation of health system Empowerment the health system to innovation Strategies to guarantee the plan execution – Development a communication plan – Development an information system – Focuses in priority areas – Development of national programs – Mobilise the principal actors – Mobilise the recourses – Professional training – Investigation and development – Following and assessment 38 Tallinn, January 2009

Erasmus Experience - What it means for us! - Tallinn, January 2009 39

Erasmus Experience - What it means for us! - Tallinn, January 2009 39

Bibliography INE- Estimativas de população residente, Portugal, Nuts III e Municípios 2005, in www.

Bibliography INE- Estimativas de população residente, Portugal, Nuts III e Municípios 2005, in www. ine. pt, consultado a 15 January 2009 www. esel. pt – Nursing school in Lisbon official site http: //www. ordemenfermeiros. pt/index. php? page=463 - Nursing in Portugal http: //www. ordemenfermeiros. pt/index. php? page=470 - Foreign Nurses in Portugal http: //www. ordemenfermeiros. pt/index. php? page=8#article 60 – Skills of Nursing in General Care http: //www. ordemenfermeiros. pt/index. php? page=8#article 62 – Quality Standards of Nursing Care Tallinn, January 2009 40

Questions, Doubts? 41 Tallinn, January 2009

Questions, Doubts? 41 Tallinn, January 2009