Strengthening the competences of nurses and new forms of cooperation are crucial to ensuring the future availability of general outpatient care. The projected increase in the demand for health care due to the ageing population, while the expected decrease in the number of medical places due to the high average age of doctors, put emphasis on the efficient use of personnel capacities in outpatient care. Extending the competences of nurses, practical nurses of -- assistants, the presence of an administrative assistant in office is one of the main prerequisites for ensuring the availability of general outpatient care in the future.
Implemented actions:
The measures implemented include extending the competences of practical nurses. Competences of sisters were incorporated into the new decree according to the proposals of the Slovaknurse chambersand midwives presented in the process of creationGeneral outpatient care strategies by 2030.
The Ministry of Health is ready to implement further adjustments and extensions of competences which can help to better adapt to current needs and challenges in the field of health care with the cooperation of the Slovaknurse chambersand midwives as well as the Slovak Chamber of Medical Technical Officers.
From 1 July 2023, following the amendment of Decree No. 321/2005 Coll. on the scope of practice in certain health professions, they added to practical nurses - assistants of competence. A practical nurse-assistant got the chanceseparatelyperform selected activities based on the indication of the doctor, nurse or midwife, for example:
- administrationsubcutaneous except opiate personfrom 6 years of age (previously 18 years old),
- draw capillary blood personexcept the pathological newborn(previously 18 years old),
- withdraw venous bloodfor examination from the peripheral vascular system through a single injectionfrom 6 years of ageexcept blood for blood for blood culture and blood for transfusions and forensic tests(previously 18 years old),
- administer a diet with a nasogastric probe or percutaneous endoscopic gastrostomy to a person from 6 years of age if conscious(previously 18 years old),
- prepare milk formula, doses of breast milk from the mother's milk bank and appetizers in the milk kitchen,
- make a 12-leather EKG record to the person except the newborn.
From 1 August 2024 on the basis of the new Decree No 208/2024 MZ SR Z. z, which determines the extent of nursing experience provided by the nurse separately, on the basis of the doctor's indication and in cooperation with the physician, and the extent of the midwife's experience provided by the midwife alone, on the basis of the doctor's indication and in cooperation with the physician, adjusted the competences of nurses and nurses with advanced experience according to the competence diagrams provided in the general outpatient care reform strategy until 2030.
A sister with advanced experience has been given the opportunity to carry out activities separately, such as:
- indicatedand administerpain relief treatment and lower body temperature(except opioid analgesics), for diarrhoea, constipation and evaluation of the efficacy within the dose range and pharmacological composition based on the advice of a physician recorded in the person's medical documentation,
- indicate collection of biological materialfor baseline laboratory examinations within the specified indicative range for the standardized procedure,
- indicate and perform sewing of a small surgical woundand remove the stitches from the primary healing wound (formerly indicate the treatment of the primary healing wound),
- monitor andassess the ECG recordin the range of quality, heart rate and heart rhythm; if she has identified pathological values or changes, inform the doctor.
The nurse has been given the opportunity to carry out activities separately, such as:
- carry out the sorting of personsaccording to the urgency of their condition, based on physical examination, evaluation of vital functions and results of anamnestic data collection,
- to indicate and introduce a cannula into the peripheral vein, disrupting peripheral vein cannula, controlling, recording and evaluating the function and condition of the cannula,
- perform basic skin tests for allergies based on the doctor's indication and prepare the doctor's results for evaluation,
- prepare a prescription and a medical voucherfor doctor approvalbased on physician indication, ensure and coordinate administration related to the prescription of medicinal products, medical devices and dietetic foods.