ENS4Care

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Evidence Based Guidelines for Nurses and Social Care Workers for the deployment of eHealth services

“Innovative, high quality, safe and cost-effective national healthcare systems are dependent upon policy-makers and stakeholders developing and implementing high-quality eHealth services.” (Sheikh et al., 2011)

Officially launched in December 2013, in Warsaw, in the context of the EU eHealth Action Plan, and coordinated by the EFN, this two-year EU project, funded by DG Connect and composed of 24 partners, from all over Europe, with a mix of professional associations in nursing and social care, nursing regulators and unions, informal carers, patients, researchers and research communities, civil society representatives and industry, this EFN EU project “ENS4Care” was aiming to share good nursing and social work practices in eHealth services and, through the evaluation and consensus building, create a set of guidelines focusing on: healthy lifestyle and prevention, early intervention and clinical practice, integrated care, skills development for advanced roles, and nurse ePrescribing; next to establish a sustainable mechanism to support nursing and social care research in the field of ICT enabled integrated care, and to create a sustainable and structured collaboration network, making key stakeholders able to promote innovation of nursing and social care services through the mutual sharing of good practices of telehealth and telecare services.

Best practices collected
Drawn from a total of 122 existing good practices collected in 2014 from the field and the daily practice, at national and regional levels, developed by nurses and social workers and including the use of eHealth tools for the benefit of the patient, these five Guidelines (prevention, clinical practice, advanced roles, integrated care and nurse ePrescribing), are aiming to inform the policy-makers in order to help them in the decisional process concerning healthcare systems, eHealth policies and delivery of care across the EU; inform nurses and social workers on the implementation steps of eHealth services; and promote a culture of evaluation of any service innovation.

1/ ICT enabled Health Coaching in Prevention (WP2)
ENS4Care supported the exchange of information and experiences among different partners and provided an overview of the range/type of eHealth services being used for prevention, in order to extract knowledge on the use of eHealth applications as tools to enhance healthy lifestyles that would boost prevention in healthcare from a life circle approach. There is evidence showing how to strengthen the role of nursing in the reshaping of the healthcare systems that, with the right knowledge, skills and opportunities, nurses and social care workers are uniquely placed to act as a health coach and to help prevent Non-Communicable Diseases (NCDs), by supporting healthy lifestyle. The guidelines are therefore looking into how nurses and social care workers could use eHealth services and technologies to boost prevention in healthcare.

2/ ICT enabled Integrated Care: Clinical Practice (WP3)
In line with the European Innovation Partnership on Active and Healthy Ageing, a major focus of the work was on strengthening Integrated Care as a system, as an efficient way to integrate primary and secondary care, and health and social care. Evidence based clinical practice guidelines for the implementation of eHealth services in ICT enabled integrated care systems were produced based on existing guidelines and experience within or accessible to the members of the Network. There are some examples of guidelines that have been developed along with the implementation of specific telehealth or telecare services at local level. Other examples on existing guidelines which the network took further focussed on overall aspects of telehealth and telecare services primarily addressing general concepts of telemonitoring, telephone advice, etc.

3/ ICT enabled Integrated Care: Advanced Practitioner in Nursing and Social Care (WP4)
One of the fundamental pillars to promote high quality healthcare is through a highly educated, dedicated and skilled workforce. Specifically, the promotion of advanced roles for nurses and social care workers in ICT enabled integrated is proven to boost quality, safety and cost-effectiveness of the healthcare delivered. These roles have made an enormous difference on the governance and management of healthcare, and improve efficiency, enhance patient care, improve health outcomes, contributing ultimately to the sustainability of health systems. Large part of the debate was then dedicated to the role of nurses and social care workers and to the education and competencies they must have in order to be able to take care of patients in the more efficient way with the use of ICT tools.

4/ ICT enabled Integrated Care: Nurse ePrescribing (WP5)
Nurse prescribing is an area of professional development which has made huge steps forward in the past few years and that is being fully implemented in several Member States (UK, Ireland, Finland, Sweden, Spain, etc.). Evidence suggests that this implementation is safe and clinically appropriate (West, 2011; University of Southampton, 2011; Latter et al, 2011, An Bord Altranais, 2008), and shows that nurse prescribing improves patient care by ensuring timely access to medicines and treatment, and increasing flexibility for patients (Carey N, Stenner K 2011; Drennan J et al 2009; National Prescribing Centre 2010). Nurse prescribing is first and foremost about making a difference for patients and service users. It is about enhancing professional capacity and developing new skills that lead to services that are more patient-focused thereby delivering better outcomes. The introduction of the concept is usually followed also by availability of eHealth platforms where nurse prescriptions are managed online allowing the communication with the communities, pharmacies, social services, and hospitals. Examples where its introduction has brought measurable benefits for the care systems were identified.

These 5 guidelines are now being taken forward by different stakeholders for further implementation in their countries, as in Poland, Romania, and Bulgaria.

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