Northern Ireland Practice and Education Council for Nursing and Midwifery
Impact Measurement Project
Respiratory Competence Assessment Tool
Project Plan
December 2015
1.0Introduction
1.1In 2013 the Northern Ireland Practice and Education Council for Nursing and Midwifery (NIPEC) published its Impact Measurement Framework. This Framework enables NIPEC to review the resources it has developed in partnership with key stakeholders and assess the impact of the resources in relation to the intended outcomes. NIPEC Council agreed that it would conduct an impact measurement on the outcomes of at least two NIPEC projects/resources, per annum. The resource chosen for the business year 2015-2016 is the:
Respiratory Competence Assessment Tool (R-CAT)(revised 2014)
1.2The R-CATwas developedfor use by all those practitioners caring and providing services for patients diagnosed with asthma and Chronic Obstructive Pulmonary Disease (COPD).It was therefore agreed that the impact measurement should focuson the nurses and midwives who have a key responsibilityfor caring with patients with long term conditions, specifically asthma and COPD, in the acute, community and primary care settings.
1.3The following service areas were approved as a suitable target group for testing the impact of theR-CAT:
- General Practice,
- Acute and Community Respiratory Teams (paediatric and adult),
- Emergency Departments,
- Acute Respiratory Units,
- General Medical and Elderly Care Wards and
- Respiratory Outpatient Clinics.
1.4It was also agreed that it would also be useful to explore how the R-CAT has been incorporated into the planning of respiratory specific educationand training programmes, from the perspective of those planning, delivering and undertaking the programmes.
2.0Background
2.1In 2007Dr Carolyn Harper (Chair, Respiratory Wellbeing Service Framework (RWSF) Steering Group)commissioned NIPEC to facilitate a regional project to produce a learning and development strategy for respiratory care (nursing) to support the implementation of the RHWSF standards. An assessment tool wasdesigned to develop the competence ofnurses and midwives specifically in relation to asthma and COPD management and care. The Respiratory Competence Assessment Tool (R-CAT) was published in 2008 and distributed to all relevant stakeholders.
2.2The R-CATwas reviewed in 2012andupdated to includean additional small number of competence statements and a competence area related to adrenaline auto-injectors. The revised R-CAT was not reproduced in hard copy format however in 2014 it was added to NIPEC’s online competence assessment tool section
Purpose of the R-CAT
2.3The R-CAT was developed as a resource to:
- be adopted and supported by HSC Trusts, independent and voluntary organisations as a tool to develop competence within the nursing workforce in relation to asthma and COPD management and care.
- be used by education and development providers to guide programme development to support the implementation of the RHWSF
- have a positive impact on nursing care delivery of the RHWSF standards for patients with respiratory disorders and their carers.
2.4The RHWSF was the first Service Framework to be published in 2010, reflecting that respiratory disease is one of the biggest causes of death and disability in NI. Every three years the Service Framework is updated to ensure it references the most recent evidence and guidelines.
2.5The Service Framework sets standards in relation to the prevention, assessment, diagnosis , treatment, care, rehabilitation and palliative care of individuals/communities who currently have or are at a greater risk of developing respiratory disease.
3.0Impact Measurement Project
Aim
3.1The aim of the project is to examine the adoption of the R-CAT by nurses,who provide care and services for patients with asthma and COPD, to assess their competence and its usefulnessin relationtothe planning and delivery of post-registration education and training programmes.
Objectives
3.2Theobjectives of the Impact Measurement Project are as follows:
- establish if the original project objectives were linked to NIPEC’s business planning objectives
- determine if the objectives set out in the 2007 project plan were achieved by the end of the project
- scope how widely the R-CAT is used:
- by education providers in the curriculum design ofpost-graduate modules or programmes in respiratory care including long term conditions
- within the planning and delivery of HSC Trust in-house training programmes
- explore the adoption of the R-CAT including its online versionby nursesacross primary, community and acute care settings
- Make recommendations which will enhance the use of the R-CAT.
Methodology
3.3This project will be completed over a four month period. A small project group will be assembled; the members approved by NIPEC Business Team. The Impact Measurement project team will comprise aConsultant Nurse for Respiratory Care, employed by one of the HSC Trusts who will Chair the project; a Consultant Nurse responsible for Long Term Conditions in PHA;a NIPEC Senior Professional Officer and NIPEC Council member.
Method of Data collection
3.4Information will be gathered,via survey monkey, from:
- nurses who provide care and services for patients with asthma and COPD, in
the areas identified in para 1.3 and
- those planning, delivering and undertaking respiratory specific education and
training programmes.
Resources
3.5 NIPEC will project manage and provide administrative support to the Project.
Dissemination and Implementation
3.6Progress of the project will be communicated to key stakeholders using various mechanisms including the NIPEC website. On completion, the project will be summarised in a Final Report which will be available to view on NIPEC’s website. It will be presented to NIPEC Council and Chief Nursing Officer, DHSSPS.
Project Screening Assessment
3.7NIPEC undertook an equality screening process whichis detailed in Appendix One.
Evaluation
3.8 Ongoing evaluation of the management of the project will be conducted through
NIPEC and will ultimately feed into the progress and outcomes of the project. This evaluation will address the achievements of the objectives outlined in the project plan and the project management process.
References
(2008) The Respiratory Health and Well-Being Service Framework: Respiratory Competence Assessment Tool. Belfast:
Respiratory Competence Assessment Tool (R-CAT)(revised 2014) accessed on 7 December 2015 at
Department of Health, Personal and Social Services for Northern Ireland, (2010). Service Framework for Respiratory Health and Wellbeing. Belfast, DHSSPSNI.
Northern Ireland Practice and Education Council (NIPEC) (2013) Impact Measurement Framework. Belfast: NIPEC
Equality and Human Rights
Screening Template
for
Impact Measurement
Project Plan
October 2015
NIPEC is required to address the 4 questions below in relation to all its policies/projects. This template sets out a proforma to document consideration of each question.
- What is the likely impact on equality of opportunity for those affected by this policy/project, for each of the Section 75 equality categories (minor / major / none)?
- Are there opportunities to better promote equality of opportunity for people within the Section 75 equality categories?
- To what extent is the policy likely to impact on good relations between people of a different religious belief, political opinion or racial group (minor / major / none)?
- Are there opportunities to better promote good relations between people of a different religious belief, political opinion or racial group?
For advice and support on screening contact:
Sandra Rafferty / Anne Basten
Equality Unit
Business Services Organisation
2 Franklin Street
Belfast
BT2 8DQ
(028) 9536 3813 or (028) 9536 3814
Email: or
For information (evidence, data, research etc.) on the Section 75 equality groups see the Equality and Human Rights Information Bank on the BSO website –
(1)INFORMATION ABOUT THE POLICY OR DECISION
1.1Title of policy or decision
Impact Measurement of the Respiratory Competence Assessment Tool1.2Description of policy or decision
- what is it trying to achieve? (aims and objectives)
- how will this be achieved? (key elements)
- what are the key constraints? (for example financial, legislative or other)
The aim of the project is to examine the implementation of the R-CATin relation to the provision of education and training for and the assessment of competence of Nurses who provide care and services for patients with asthma and COPD. The objectives are to:
- establish if the original project objectives were linked to NIPEC’s business planning objectives
- determine if the objectives set out in the 2007 project plan were achieved by the end of the project
- scope how widely the R-CAT is used by education providers in the curriculum design of
- post-graduate modules or programmes in respiratory care
- specialist practice modules for district nursing teams, long term conditions, asthma and COPD
- explore the application of the R-CAT by nurses, in relation to assessing their learning and development needs and choosing relevant activities to develop competence and improve performance specifically in service areas which regularly and routinely care for patients with asthma and COPD across acute, community and outpatient settings.
- Review the use of the online assessment tool
- Make recommendations which will enhance the use of the R-CAT.
Data will be gathered via survey monkey from nurses caring for asthma and COPD patients/clients in HSC Trusts, Practice Nurses and Education Providers providing training/education for nurses caring for these patients/clients.
1.3Main stakeholders affected (internal and external)
For example staff, actual or potential service users, other public sector organisations, voluntary and community groups, trade unions or professional organisations or private sector organisations or others
- Nurse Registrants looking after patients/clients with COPD/asthma
- Nurse educators training/educating nurses looking after patients/clients with COPD/asthma
1.4Other policies or decisions with a bearing on this policy or decision
- what are they?
- who owns them?
- Respiratory Service Framework revised (2015)
- NIPEC Impact Measurement Framework (2013)
(2)CONSIDERATION OF EQUALITY AND GOOD RELATIONS ISSUES AND EVIDENCE USED
For information (evidence, data, research etc.) on the Section 75 equality groups see the Equality and Human Rights Information Bank on the BSO website –
2.1Data gathering
What information did you use to inform this equality screening? For example previous consultations, statistics, research, Equality Impact Assessments (EQIAs), complaints. Provide details of how you involved stakeholders, views of colleagues, service users, staff side or other stakeholders.
NMC Equality and Diversity Data 20112.2Quantitative Data
Who is affected by the policy or decision? Please provide a statistical profile. Note if policy affects both staff and service users, please provide profile for both.
Category / What is the makeup of the affected group? ( %) Are there any issues or problems? For example, a lower uptake that needs to be addressed or greater involvement of a particular group?Gender / NMC Diversity data for 2011 reports 6% of NI registrants are male, whilst 94% are female.
Age / NMC Diversity data for 2011 reports 4% of NI registrants are in their 70s, 23% are in their 60s, 34% are in their 50s, 23% are in their 40s and 15% are in their 20s.
Religion / Census 2011 figures for NI indicate:
•45.14% (817,424) are either Catholic or brought up as Catholic
•48.36% (875,733) are Protestant or brought up as Protestant
•0.92% (16,660) belong to or had been brought up in other religions and philosophies
•5.59% (101,220) neither belonged to, nor had been brought up in a religion.
•Catholic - 40.76% (738,108)
•Presbyterian Church in Ireland – 19.06% (345,150)
•Church of Ireland – 13.74% (248,813)
•Methodist Church in Ireland – 3% (54,326)
•Other Christina (including Christian related) – 5.76% (104,308)
•Other religions – 0.82% (14,849)
•No religion – 10.11% (183,078)
Did not state religion – 6.75% (122,233)
No NMC data
Political Opinion / Census 2011 figures for NI indicate:
•British only – 39.89% (722, 353)
•Irish only – 25.26% (457, 424)
•Northern Irish only – 20.94% (379, 195)
•British and Northern Irish only – 6.17% (111, 730)
•Irish and Northern Irish only – 1.06% (19, 195)
•British, Irish and Northern Irish – 1.02% (1847)
•British and Irish only – 0.66% (11, 952)
Other – 5.00% (90, 543)
No NMC data
Marital Status / Census 2011 figures for NI report:
•47.56% (680, 840) of those aged 16 or over were married
•36.14% (517, 359) were single
•0.09% (1288) were registered in same-sex civil partnerships
•9.43% (134, 994) were either divorced, separated or formerly in a same – sex partnership
6.78% (97, 058) were either widowed or a surviving partner
No NMC data
Dependent Status / Census 2011 figures for NI report :
•11.81% (213, 863) of the usually resident population provide unpaid care to family members, friends, neighbours or others because of long-term physical or mental ill – health/disabilities or problems related to old age
•3.11% (56, 318) provided 50 hours care or more
•33.86% (238, 129) of households contained dependent children
•40.29% (283, 350) contained a least one person with a long – term health problem or a disability.
No NMC data
Disability / Census 2011 figures for NI report:
•20.69% (374, 668) regard themselves as having a disability or long – term health problem, which has an impact on their day to day activities.
•68.57% (1, 241709) of residents did not have long – term health condition.
•Deafness or partial hearing loss – 5.14% (93, 078)
•Blindness or partial sight loss – 1.7% (30, 785)
•Communication Difficulty – 1.65% (29, 879)
•Mobility of Dexterity Difficulty – 11.44% (207, 163)
•A learning, intellectual, social or behavioural difficulty - 2.22% (40, 201)
•An emotional, psychological - 5.83% (105, 573)or mental health condition
•Long – term pain or discomfort – 10.10% (182, 897)
•Shortness of breath or difficulty breathing – 8.72% (157, 907)
•Frequent confusion or memory loss – 1.97% (35, 674)
•A chronic illness (such as cancer, HIV, diabetes, heart disease or epilepsy. – 6.55% (118, 612)
•Other condition – 5.22% (94, 527)
•No Condition – 68.57% (1, 241, 709)
No NMC data
Ethnicity / Census 2011 figures for NI report :
•White – 98.21% (1, 778, 449)
•Chinese – 0.35% (6, 338)
•Irish Traveller – 0.07% (1, 268)
•Indian – 0.34% (6, 157)
•Pakistani – 0.06% (1, 087)
•Bangladeshi – 0.03% (543)
•Other Asian – 0.28% (5, 070)
•Black Caribbean – 0.02% (362)
•Black African – 0.13% (2354)
•Black Other – 0.05% (905)
•Mixed – 0.33% (5976)
•Other – 0.13% (2354)
(1.8% 32,596 of the usual resident population belonged to minority ethnic groups)
NMC Diversity data for 2011 reports 55% of NI registrants identified themselves as white British, 39% as Other white, 5% as Asian, 0.4% black African and 0.6 as Other/mixed.
Sexual Orientation / There is variation in estimates of the size of the LGB&T population in Northern Ireland. Estimates are as high as 5-7% (65-90,000) of the adult population in Northern Ireland (based on the UK government estimate of between 5-7% LGB&T people in the population for the purposes of costing the Civil Partnerships Act). A similar proportion or more recently the Office of National Statistics estimate 1.5-2% which would be closer to 20-30,000 adults.This latter document is disputed by various LGB&T organisations.
NMC Diversity data for 2011 reports 98% of NI registrants stated they are heterosexual, 1.9% stated they were bi-sexual, and 0.5% stated they were gay/lesbian.
2.3Qualitative Data
What are the different needs, experiences and priorities of each of the categories in relation to this policy or decision and what equality issues emerge from this? Note if policy affects both staff and service users, please discuss issues for both.
Category / Needs and ExperiencesGender
Age
Religion
Political Opinion
Marital Status / Issues for those with dependents may be compounded for those who are single parents.
Dependent Status / Nurses who have dependents and/or caring responsibilities may require some flexibility in terms of timing and location of meetings or engagement events as well as access to training and learning opportunities.
Disability / Consideration may need to be given to access to buildings/venues for meetings and events for those with physical disability.
Some potential issues relating to use of internet and publication of electronic documents, and the need to ensure suitable alternative formats are developed and made available.
Particular needs of people with a learning disability may arise and need to be considered.
Likewise, particular needs of people with mental health difficulties may arise and need to be considered.
Ethnicity
Sexual Orientation
2.4Multiple Identities
Are there any potential impacts of the policy or decision on people with multiple identities? For example; disabled minority ethnic people; disabled women; young Protestant men; and young lesbians, gay and bisexual people.
None identified2.5Making Changes
Based on the equality issues you identified in 2.2 and 2.3, what changes did you make or do you intend to make in relation to the policy or decision in order to promote equality of opportunity?
In developing the policy or decision what did you do or change to address the equality issues you identified? / What do you intend to do in future to address the equality issues you identified?Access to information and communication with stakeholders is paramount in achieving the aims and objectives of the project. / As the project is taken forward, the lead officer will review any equality issues, including those identified in 2.3 and undertake the required screening.
2.6Good Relations
What changes to the policy or decision – if any – or what additional measures would you suggest to ensure that it promotes good relations? (refer to guidance notes for guidance on impact)
Group / Impact / SuggestionsReligion / None / None
Political Opinion / None / None
Ethnicity / None / None
(3)SHOULD THE POLICY OR DECISION BE SUBJECT TO A FULL EQUALITY IMPACT ASSESSMENT?
A full equality impact assessment (EQIA) is usually confined to those policies or decisions considered to have majorimplications for equality of opportunity.
How would you categorise the impacts of this decision or policy? (refer to guidance notes for guidance on impact)
Please tick:
Major impactMinor impact /
No further impact
Do you consider that this policy or decision needs to be subjected to a full equality impact assessment?
Please tick:
YesNo /
Please give reasons for your decisions:
This project is being undertaken to ensure it meets the needs of nurses in developing their competence in relation to caring for patients/clients with astma/COPD.NIPEC recognises the need to consider any impact on Section 75 groups, and that the needs, experiences and priorities of these groups may vary.
(4)CONSIDERATION OF DISABILITY DUTIES
4.1In what ways does the policy or decision encourage disabled people to participate in public life and what else could you do to do so?