World Health World Health Organization (WHO) Organization (WHO)

Nursing StandardsNursing StandardsJoan E. Edwards, RNC, MN, CNSJoan E. Edwards, RNC, MN, CNS

Associate Clinical ProfessorAssociate Clinical ProfessorTexas Woman’s UniversityTexas Woman’s University

jedwards3@twu.edujedwards3@twu.edu

ObjectivesObjectives• Describe world events that have Describe world events that have

contributed to the release of the 2009 contributed to the release of the 2009 WHO standards document WHO standards document

• Explain at least two of the WHO standards Explain at least two of the WHO standards

• Compare at least one of the WHO Compare at least one of the WHO standards to a current Indonesian nursing standards to a current Indonesian nursing programprogram

Millennium Development Goals Millennium Development Goals Target → Year 2015Target → Year 2015

• Halve extreme poverty and hungerHalve extreme poverty and hunger• Achieve universal primary educationAchieve universal primary education• Empower women and promote equality between women Empower women and promote equality between women

and menand men• Reduce under-five mortality by 2/3Reduce under-five mortality by 2/3• Reduce maternal mortality by ¾Reduce maternal mortality by ¾• Reverse the spread of diseases, especially HIV/AIDS Reverse the spread of diseases, especially HIV/AIDS

and malariaand malaria• Ensure environmental sustainabilityEnsure environmental sustainability• Create global partnership for developmentCreate global partnership for development United Nations Dept of Public Information - 2002United Nations Dept of Public Information - 2002

Global Health DisparityGlobal Health Disparity

Maternal MortalityMaternal Mortality United States – 15.1 deaths/100,000United States – 15.1 deaths/100,000 live birthslive births Sierra Leone – 2100 deaths/100,000Sierra Leone – 2100 deaths/100,000 live birthslive births Centers for Disease Control, 2008Centers for Disease Control, 2008

BioterrorismBioterrorism

Natural DisastersNatural Disasters

Mobility of the Global PopulationMobility of the Global Population

Global Melting PotGlobal Melting Pot

WHO Global WHO Global StandardsStandards

Initial EducationInitial EducationProfessionalProfessionalNurses and Nurses and MidwivesMidwives

March 2009March 2009

2121stst Century: Century: 35 million nurses in the world35 million nurses in the world

Why do we need global Why do we need global standards? standards?

• Health care is becoming more complexHealth care is becoming more complex

• Increased number of health care providers Increased number of health care providers at different levels at different levels

• Need for more equitable access to health Need for more equitable access to health carecare

Research has indicated that a Research has indicated that a more highly educated nursing more highly educated nursing workforce not only improves workforce not only improves patient safety and quality of patient safety and quality of care, but also saves livescare, but also saves lives

WHO. World Health Statistics, 2007. Geneva, World Health Organization,WHO. World Health Statistics, 2007. Geneva, World Health Organization,

2007.2007.

Intended Use of StandardsIntended Use of Standards

• Benchmark (to provide a more Benchmark (to provide a more competency-based outcomes in an age of competency-based outcomes in an age of increasing globalization)increasing globalization)

Potential usePotential use• Establish global approach to evidence-Establish global approach to evidence-

based educational programsbased educational programs• Apply established competencies to provide Apply established competencies to provide

a guide for curriculum developmenta guide for curriculum development• Stimulate creation of programs that meet Stimulate creation of programs that meet

national, regional and societal needs and national, regional and societal needs and expectationsexpectations

• Establish benchmarks for continuous quality Establish benchmarks for continuous quality improvementimprovement

Additional usesAdditional uses• Catalyst in asking for education change, Catalyst in asking for education change,

reform, and quality improvement.reform, and quality improvement.

• Leverage in building capacity for adequate Leverage in building capacity for adequate number of nurses, in addition to highly number of nurses, in addition to highly qualified nurses to strengthen the qualified nurses to strengthen the workforce. workforce.

• Basis for development of global standards Basis for development of global standards for advanced nursing educationfor advanced nursing education

Problem addressed by Problem addressed by standardizationstandardization

• Huge variation in initial education level of Huge variation in initial education level of nursesnurses

- High school training- High school training

- Associate degree- Associate degree

- Diploma degree- Diploma degree

- Baccalaureate degree- Baccalaureate degree

Goal of WHO StandardsGoal of WHO Standards

• Establish educational criteria and assure Establish educational criteria and assure outcomes that:outcomes that:

- are based on evidence- are based on evidence

- promote the progressive nature of - promote the progressive nature of education and lifelong learning education and lifelong learning

- ensure the employment of - ensure the employment of practitioners who are competent; practitioners who are competent; and who, by providing quality care, and who, by providing quality care, promote positive health outcomes promote positive health outcomes in the populations they serve in the populations they serve

Differences in Achievement Differences in Achievement of Goalsof Goals

• Some countries have already achieved Some countries have already achieved goalsgoals

• Some countries have much work to do Some countries have much work to do (timeline to be determined by each (timeline to be determined by each country)country)

Development Task ForceDevelopment Task Force• Dr Fariba Al-Darazi (WHODr Fariba Al-Darazi (WHO

Regional Office for the Eastern Mediterranean)Regional Office for the Eastern Mediterranean)• Dr Sawsan Al-Majali Dr Sawsan Al-Majali (Nursing(Nursing

Programme, Dar Al-Hekma College)Programme, Dar Al-Hekma College)• Ms Nancy Dickenson-HazardMs Nancy Dickenson-Hazard

(Sigma Theta Tau International)(Sigma Theta Tau International)• Dr Valerie Fleming Dr Valerie Fleming (Glasgow Caledonian(Glasgow Caledonian

University)University)

Dr Karen Morin Dr Karen Morin (University of Wisconsin, Milwaukee)(University of Wisconsin, Milwaukee)• Dr Jean Yan Dr Jean Yan (World Health Organization)(World Health Organization)

Development Task Force (cont)Development Task Force (cont)

• 2006 – Bangkok, Thailand2006 – Bangkok, Thailand

• 2007 – Glasgow, Scotland2007 – Glasgow, Scotland

• SEARO contributor: SEARO contributor:

Dr. Prakin SuchaxayaDr. Prakin Suchaxaya

Steps of Task ForceSteps of Task Force

• Gather evidence and dataGather evidence and data

• Secure expert consensusSecure expert consensus

• Collect and assimilate public commentsCollect and assimilate public comments

• Analysis and synthesisAnalysis and synthesis

• Document launch and global Document launch and global disseminationdissemination

Underlying Principles of Underlying Principles of StandardsStandards

• Competencies provide sound basis to Competencies provide sound basis to build curriculum and meet health needs of build curriculum and meet health needs of populationspopulations

• Interaction between the nurse and the Interaction between the nurse and the client is the primary focus of quality client is the primary focus of quality education and careeducation and care

• An inter-professional approach to An inter-professional approach to education and practice is essentialeducation and practice is essential