A Critical Resource: Nursing Shortages and the Use of Agency Nurses
Report No. 3- August 2002
Background
Nurses are a vital element in the provision of an effective health care
system for the State. Yet, an ongoing shortage of nurses has raised concerns
with the quality and cost of nursing care and use of agency nurses to
address nurse shortages.
This report examines the prevalence and management of nurse shortages
and risks to service delivery and health care within the Western Australian
public health system. The examination also reviewed the use and cost of
agency nurses during 2001.
The period of this examination, October 2001 to March 2002, coincided
with the Department of Health initiating a range of fundamental reforms
affecting the issues examined. Therefore, this report provides a broad
assessment of the management of nursing shortages in the period to March
2002 and a benchmark on which to evaluate the reforms.
What the examination found...
The examination found that over the period examined:
- The Department of Health did not have the system-wide information
available for a clear understanding of the extent and implications of
the nurse shortages in the public health system, nor a clear understanding
of the extent of the use of options such as private agency nurses.
- There is a shortage of nurses as evidenced during 2001 by reported
vacancies of up to 780 nurses over a total workforce of 8 947 full time
equivalent (FTE) nurses. This situation is compounded by high turnover
and mitigated by the use of overtime equating to 107 FTE nurses and
agency nurses representing 374 FTE staff.
- Strategies to attract and retain nurses in the public health system
generally had not been well co-ordinated and had been undertaken without
adequate workforce information and planning.
- In 2001, agency nurses, who are mostly Level 1 Registered Nurses (RNs),
represented eight per cent (374 FTEs) of the State's public health system
Level 1 RNs. For the six health services examined, the proportion ranged
from three per cent to 38 per cent in 2001.
- Limited orientation and pre-employment checks of agency nurses by
health services is putting service delivery and the quality of health
care at risk, particularly where agency nurses represent a high proportion
of staffing.
- There are significant differences in the cost of the nursing resource
options, for example in 2001, agency nurses cost 31 per cent more per
hour worked than Level 1 RN employees.
- The approach to hiring agency nurses is administratively inefficient
and puts health services at unnecessary risk of inadvertently breaching
a contract.
Since the examination commenced, the Department of Health has moved
towards greater co-ordination of nurses including collecting more centralised
workforce information, more co-ordinated recruitment of nurses and developing
a generic contract for hiring agency nurses.
What the examination recommended...
The recommendations in the report provide a firm basis for the Department
to implement its reforms. The major recommendations are that the Department
of Health should:
To help address nurse shortages:
undertake purposeful workforce planning, plan and evaluate strategies
to attract and retain nurses and develop indicators to monitor the impacts
of shortages on quality of care.
To ensure that quality of care is maintained while contracting agency
nurses:
- develop a framework for undertaking pre-engagement checks on agency
nurses and ensuring that they receive appropriate orientation and feedback
on performance; and
- monitor and evaluate the effectiveness of the framework.
To ensure value for money in contracting agency nurses:
- progress the proposed 'generic contract';
- ensure that financial evaluations are undertaken of the use of agency
nurses; and
- monitor the cost and effective use of agency nurses compared with
other options.
Right mouse click here and chose
"save target as" to download the complete report (235kb
PDF)
Problems downloading this report? Email our webmaster
|
