IPCHS. Integrated People-Centred Health Services

Practices

 
Sept. 6, 2016 Leading practice Europe

Advancing the role of nurses in Finland to improve patients’ access to care

Summary

The Ministry of Social Affairs and Health promoted the shift of responsibilities from physicians to nurses through implementing supportive policies, legislation and incentives; partnerships and international networks facilitated information exchanges and offered inspiration for activities during the initiative’s design; national legislation provided the necessary framework for aligning changes in the professional scope of practice for nurses; the development of postgraduate advanced nursing programmes in partnership with universities supported the sustainability of the initiative and ensured the continuing development of nursing skills; advancing nursing roles contributed to professional empowerment and improved workplace well-being for both nurses and physicians.

Description of practice
City: Helsinki Country: Finland
The problem

In 2000, Finland faced a shortage of physicians with only 241 per 100 000 population, compared to a WHO European Regional average of 302 per 100 000 population. This shortage made responding to patient demands challenging and contributed to geographic inequities in care access. In contrast, Finland had an above-average volume of nurses with 954 per 100 000 population, compared to a WHO European Regional average of 666 per 100 000 population. However, the relatively limited scope of practice and autonomy for nurses compromised the extent to which nurses could support service provision in underserved areas. 

The solution

Based on an analysis of 31 pilot projects conducted between 2003 and 2004, the Ministry of Social Affairs and Health recommended shifting responsibilities from physicians to nurses to address the problems caused by physician shortages. The Ministry backed this recommendation with incentives for municipalities to further encourage the restructuring of health providers. To ensure nurses had the necessary skills to take on additional responsibilities, Finnish universities developed various postgraduate advanced nursing programmes. Subsequent government policies provided further support for the advancement of nursing roles. In 2010, legislation was enacted to allow nurse prescribing for a defined list of medications and a new postgraduate programme was developed to support this. As a result of these combined efforts, advanced practice nurses have been positioned to autonomously deliver a range of health services to patients. Supported by evidence-based guidelines, advanced practice nurses perform consultations, order and carry out diagnostic tests, manage patients with chronic disease and treat minor acute conditions, among other responsibilities.

Implementation of practice
What stage is the practice currently in?

Completed

Who was/is responsible for the implementation of the practice?

The Ministry of Social Affairs and Health led the initiative through issuing official recommendations to support the advancement of nursing roles and encouraged municipal uptake of recommendations with complementary policies, legislation and incentives. Cooperation between national and municipal governments was important and municipal councils were invited, along with other stakeholders, to participate in planning discussions. The majority of stakeholders were supportive of the initiative, with the exception of medical associations. However, as providers were largely in favour of the proposed changes, the Ministry was able to work with medical association executives to overcome resistance. International nursing recommendations and models provided inspiration for activities and the Thematic European Nursing Network offered Finnish universities exposure to advanced nursing programmes being implemented abroad. Finnish universities played a key role in developing new higher-education programmes to train advanced practice nurses to take on the additional responsibilities being advocated for by the Ministry.

Impact

Several small-scale evaluations have recorded the impact of the initiative and reported positive outcomes. Advanced practice nurses now manage approximately half of all patient visits in health centres. Furthermore, according to a study carried out at a rural health station, advanced practice nurses met patients’ care needs without a physician up to 70% of the time. Early studies indicate both physicians and nurses have reported improved workplace well-being as a result of changes under the initiative. Patients also appear satisfied with the care they receive from advanced practice nurses. A national-scale evaluation on nurse prescribing is currently underway. The results of this evaluation, which are expected by the end of 2015, will be used to inform future directions for nurse prescribing in Finland. 

Additional information

This case was prepared as part of a larger effort by the WHO Regional Office for Europe and published (2016) in the document, "Lessons from transforming health services delivery: Compendium of initiatives in the WHO European Region".

© Copyright World Health Organization (WHO), 2016

The methodology used for the development of this case is slightly different from the templates used on the IntegratedCare4People web platform, in particular in the analysis of enabling factors and barriers to change.

 

Please click on the link below for more information about this practice. 

Contact information
Name:
Marjukka Vallimies-Patomäki
Organization:
Ministry of Social Affairs and Health
Email:
info@integratedcare4people.org
Phone:
Role:
None
Comments
 

Andrew Naomi 17/04/2022 02:22

I was infected with Herpes (HSV) two years ago and I was devastated. I visited different hospitals but they only gave me drugs to treat the symptoms. One day I was browsing through Dr. SEBI then I found a lady who introduced me to an Herbal Doctor called Dr. OJAMO. She explained to me how Dr. OJAMO cured her from herpes with natural herbs and root products, she gave me the doctor Email:: dr.ojamoherbalhome@gmail.com I contacted him and asked him questions about his product. He explained to me how the product works and also showed me those he has cured with his product. He told me he would prepare the product and shipped it to me, the product got delivered after 5 days of delivery. I took the product as instructed by Dr. OJAMO and after 21 days I was having diarrhea and constantly urinating. I went for a test and I was tested for Herpes Negative. The product worked exactly the way Dr. OJAMO instructed and now I am free from HSV. I am very happy, I will recommend this great testimony to save a lot of people suffering from Herpes. Contact: Dr. OJAMO Whats-app:: https://wa.me/2349077406037 also Email dr.ojamoherbalhome@gmail.com His website https://drojamoherbalhome.wixsite.com/welcometodrojamoherb

Monica Raymond 18/04/2022 09:39

One day I was reading an article online we’re I found about Dr. Ojamo and how people have been cured using his herbs and roots so I message Dr. Ojamo on WhatsApp  https://wa.me/2349077406037   and I got a reply. He told me with God everything is possible. Dr. Ojamo told me about plants/herbs and it’s purpose that when he told me no matter the situation you found yourself in there is always a solution. I decided to try Dr. Ojamo Healing Herbs. He made a fresh herb and told me the plant and root because his product is 100% plants and root cooked and packaged inside a container and he shipped it through UPS. I received it and finished the product exactly 21 days ago and before then I was having diabetes and difficulties in breathing, I went to the hospital and my doctor was surprised how I got cured from all these diseases then I said praise to God .  Share Dr. Ojamo email: dr.ojamoherbalhome@gmail.com or you can call and WhAtsapp him on  https://wa.me/2349077406037   if you are infected with HERPES virus or having any health problems contact Dr. Ojamo and he will help you. Share his email so that everyone will know there are herbs and roots that cures every diseases because there can never be a smoke without a fire; dr.ojamoherbalhome@gmail.com   Check his Website https://drojamoherbalhome.wixsite.com/welcometodrojamoherb

Add your comment


Sign in to add your comment.