The benefits of introducing the PAs have been measured using the trust's annual audit of ward administration, which showed an overall improvement of 14.3 per cent in the pilot area. Senior nurses on these wards are now spending an average of only six hours a week on administrative tasks.
A study commissioned by the Departartment of Health in October 2005 showed that senior nurses spent a considerable amount of time on clerical and administrative tasks. The resulting reduction in time spent on delivering patient care was shown to reduce job satisfaction.
With the increasing emphasis the trust has placed on structured systems and processes, there is a need to provide nursing teams with the support to develop, collate and report performance data. Results from the annual nursing review and human resources file checks showed that some areas did not have the information infrastructure needed to easily demonstrate how the area was being managed.
The senior nurse PA role was designed to provide a first point contact for all non-clinical activities and assist with the reporting and analysis of performance data. This means senior nurses have been able to increase their presence on the ward to focus on patient care. The post was advertised at band 4, Agenda for Change, to ensure suitably experienced and professional people were attracted to the post.
Aspects of the senior sister's role now managed by the PA:
- diary management;
- personal files;
- creating and maintaining a staff database;
- authorising annual leave, within set guidelines;
- monitoring staff sickness, booking review meetings and generating the appropriate documentation;
- monitoring PIN registration and reminders;
- analysing incident reports;
- establishing an audit programme and reporting system;
- administrative tasks, such as redesign of documents and development of electronic versions;
- organising office space with accessible archiving.
The immediate effect of the PA role has been to allow the senior nurse to have more clinical time and be available in the ward. This has given a more visible form of leadership for staff and patients. Quality of care has improved as the senior nurse is able to lead by example, tackling complex discharges and improving length of stay statistics.
Additionally, the senior nurse is more able to act as a role model to junior staff, sharing knowledge and skills, and has been able to recommence local training plans and clinical supervision sessions, resulting in the team feeling more valued.
There have been more opportunities for face-to-face discussions to identify and resolve issues as they arise, preventing complaints. Patients' confidence in the service has also been enhanced. This has been reflected in a reduction in patient complaints.
The quality of documentation, such as reports and letters, has greatly improved and is now done in a timely fashion. The new staff database set up and maintained by the PAs gives easily accessible, up-to-date information ranging from staff training needs to sickness records. This has allowed for better planning and service development.
Improvements seen in standards of administration, annual audits, the clinical time regained by the senior nurses have enabled other senior nurses to have business cases approved to recruit senior nurse PAs.
Thanks go to Liz Lees and Sue Winwood. For more information call 0121 424 1345 or e-mail firstname.lastname@example.org