Modernizing Nursing Education in Kazakhstan Through Evidence-Based Clinical Guidelines
The Kazakhstan Social Health Insurance Project (SHIP) aims to improve healthcare by modernizing the education system for nurses. This involves implementing evidence-based nursing clinical guidelines to enhance the quality and safety of nursing practice in the country. The project focuses on the development of guidelines, guideline adaptation, and the progress of nursing education in Kazakhstan.
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Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES Evidence based nursing clinical guidelines to ensure Evidence based nursing clinical guidelines to ensure the quality and safety in nursing practice the quality and safety in nursing practice The progress of development work in the Republic of Kazakhstan The progress of development work in the Republic of Kazakhstan Eveliina Kivinen, Doctoral student, MSc (Ed), RN, Senior Lecturer Lahti University of Applied Sciences Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Background Background Clinical practice guidelines (CPG) are effective tools in delivering optimal, quality-focused, patient-centric, safe care and improving the quality and cost of healthcare. Research has been carried out on the methods underpinning CPGs Increasing number of terms, tools and acronyms Guideline development processes vary, some guidelines have not undergone rigorous development. (IOM 2011, JCI 2016, Kredo et al 2016) Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Definitions Definitions Nursing clinical guidelines - are documents that synthesize current evidence and recommendations for nursing professionals about the care of patients with specific conditions. It uses preventive, diagnostic, therapeutic and rehabilitation activities in the management of patients based on evidence-based medicine and nursing. Nursing clinical guidelines are systematically developed statements of recommended best practice in a specific clinical area, designed to provide direction for nursing professionals in their practice. (Kivinen et al 2018) Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Definitions Definitions Guideline adaptation - is a systematic approach to consider the use and/or modification of an existing guideline produced in one cultural and organizational setting for application in a different context. Adaptation can be used as an alternative to developing a new (de nuovo) guideline. It reduces duplication of effort and the validity of recommendation is maintained. Adaptation is a participative process. It involves local key stakeholders and the guideline is customized to be suitable for local context. (ADAPTE collaboration 2009.) Process improves guideline quality and ensures that recommendations are relevant in nursing practice in the Republic of Kazakhstan. (Kivinen et al 2018) Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Nursing Nursing clinical Republic Republic of clinical guideline guideline development of Kazakhstan Kazakhstan (2018 (2018- -2020) development in 2020) in the the The comprehensive nursing development plan for 2020 [ 2020, 2014] "Social Health Insurance Project: increasing the availability, quality, cost-effectiveness and financial protection" activities concerning Modernization of Education System for Nurses. Research committee training Manuals Nursing clinical guideline development (5+5+5) Implementation materials and national trainer education Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Research committee Research committee Training Working groups in nursing clinical guideline development in the Republic of Kazakhstan 1. Coordination group 2. Steering group 3. Development group 4. Guideline methodologist 5. External review group and consultants Finalizes the scope and clinical question Searches existing guidelines/evidence Conducts systematic reviews Assesses the evidence/guidelines Formulates the recommendations Prepares a plan for dissemination Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES (Kivinen et al 2018)
Methodological Methodological recommendations recommendations - -The The manuals manuals Development process Stepwise instruction on the technical and procedural aspects of developing and adapting nursing clinical guidelines Manual Nro 1,Methodological recommendation how to develop nursing clinical guidelines Manual Nro 2,Methodological recommendation how to adapt international nursing clinical guidelines Increase the confidence guideline recommendations to be internally and externally valid, and feasible for the clinical nursing practice. Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Nursing Nursing clinical the the Republic Republic of clinical guideline guideline development of Kazakhstan Kazakhstan development process process in in STAGE 1. STAGE 2. STAGE 3. STAGE 4. STAGE 5. STAGE 6. Preparation of a new guideline process Subjecting the adapted guideline to external review Approving and publishing the adapted guideline Proposing a new guideline development Finding and assessing the evidence Writing the guideline Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES (Kivinen et al 2018)
The The guideline guideline adaptation of of Kazakhstan Kazakhstan adaptation process process in in the the Republic Republic STAGE 1. STAGE 2. STAGE 3. STAGE 4. STAGE 5. STAGE 6. Approving and publishing the adapted guideline Preparation of a guideline adaptation process Subjecting the adapted guideline to external review Proposing a guideline development or adaptation Finding and assessing international guidelines Adapting guideline recommen- dations Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES (Kivinen et al 2018)
First First nursing nursing clinical clinical guidelines guidelines Development groups (4) are adapting international guidelines Hypertension Heart failure Diabetes Asthma Review process (July 2018) Publication (September 2018) Implementation material (September-December 2018) National trainer education Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Conclusions Conclusions Evidence based nursing The purpose and challenges in guideline development Republic of Kazakhstan now has a research committee with invited specialist developing nursing clinical guidelines The Manuals on how to develop nursing clinical guidelines has been developed The first nursing clinical guidelines will be published in September 2018 Research indicates multiple barriers in clinical guideline implementation and adequate strategies needs to be developed to overcome them. (Melnyk 2015, Fisher et al 2016, Wieringa et al 2018) Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
References References Fisher, F., Lange, K., Klose, K., Geiner, W. & Kramer, A. 2016. Barriers and Strategies in Guideline Implementation A Scoping Review. Healthcare 4(3), 36. Retrieved 11.6.2018. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5041037/pdf/healthcare-04-00036.pdf IOM. 2011. Consensus report, Institute of Medicine. Clinical practice guidelines we can trust. JCI. 2016. Clinical Practice Guidelines: Closing the Gap Between Theory and Practice. A White Paper by Joint Commission International. Retrieved 27.5.2018. Available: https://www.elsevier.com/__data/assets/pdf_file/0007/190177/JCI-Whitepaper_cpgs-closing-the-gap.pdf Kredo, T., Bernhardsson, Machingaidze, S., Young, T., Louw, Q., Ochodo, E. & Grimmer, K. 2016. Guide to clinical practice guidelines: the current state of play. International journal for quality in health care 28(1), 122 128. Retrieved 27.5.2018. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767049/ Kivinen, E., Hopia, H., J rvinen, S., & V n nen, I. 2018. Manual Nro 1,Methodological recommendation how to develop nursing clinical guidelines. SHIP - Modernization of Education System for Nurses. Kivinen, E., Hopia, H., J rvinen, S., & V n nen, I. 2018. Manual Nro 2,Methodological recommendation how to adapt international nursing clinical guidelines. SHIP - Modernization of Education System for Nurses. Melnyk, B. 2015. Important Information About Clinical Practice Guidelines: Key Tools for Improving Quality of Care and Patient Outcomes. World wiews on evidence based nursing 12(1). Retrieved 27.5.2018. Available: https://sigmapubs.onlinelibrary.wiley.com/doi/full/10.1111/wvn.12079 Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Wieringa, S., Dreesens, D., Forland, F., Hulshof, C., Lukersmith, S., Macbeth, F., Shaw, B., van Vliet, A. & Zuiderent-Jerak, T. 2018. Different knowledge, different styles of reasoning: a challenge for guideline development. BMJ Evidence-Based Medicine. Retrieved 27.5.2018. Available: http://ebm.bmj.com/content/ebmed/early/2018/04/03/bmjebm-2017- 110844.full.pdf 2020. Ministry of labour and social protection of population of the Republic of Kazakhstan official website. 2014. Retrieved 30.5.2018. Available: http://www.enbek.gov.kz/sites/default/files/kompleksnyy_plan.pdf Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES Thank you Thank you Eveliina Kivinen MSc (Ed), RN Nursing Degree Programme Coordinator E-mail: eveliina.kivinen@lamk.fi Lahti University of Applied Science Hoitajankatu 3, 15850 LAHTI Kazakhstan Social Health Insurance Project - SHIP - Journey to a better Healthcare MODERNIZATION OF EDUCATION SYSTEM FOR NURSES
