MAY/JUNE 2004

FEATURE

Acibadem works to deepen the role of nurses

Harvard Medical International and its Turkish partner Acibadem Healthcare Group have launched a professional development program designed to help the nurses of Acibadem grow as members of the patient care team and establish a foundation for continual professional development. Acibadem is working to address a number of issues affecting the nursing profession in Turkey, such as high turnover rates, the lack of in-depth nurse specialty training programs, and a young workforce with few seasoned mentors.

Acibadem’s nurses are motivated to learn not only how to provide high-quality patient care, but also how to develop as leaders.

Nursing education is one of the top priorities of the HMI-Acibadem partnership, which also includes the creation of a state-of-the-art cancer and neuroscience center, continuing medical education for physicians, and quality improvement initiatives.

Although its nurses are of high caliber, Acibadem, like other health systems in Turkey and worldwide, is dealing with a nursing profession in transition. In recent years, turnover rates at Acibadem have reached 30 percent, a trend due in part to a traditional lack of attention to the educational and career needs of this vital workforce. More important than this high percentage is the lack of continuity it produces in the hospitals, where staff satisfaction and patient care depend on cohesive teams of professionals that understand each other’s capabilities and foster good communication.

“It is terrific that Acibadem recognizes the role of nursing in quality care and is working hard to encourage a small, stable group of young nurses to train and inspire others,” says Elizabeth Brown, RN, MSN, HMI director of clinical services. “The education program is part of Acibadem’s commitment to making the nursing staff feel valued as an integral part of the organization’s mission.”

Saliha Koc, RN, director of nursing for Acibadem Healthcare Group, believes that the nursing education program will result in the emergence of leaders within the nursing staff. “The program will not only deepen the clinical role of nurses, but also prepare nurses to function more effectively as managers and educators, as well as in more recently developed roles, such as quality improvement experts and outpatient multidisciplinary team members,” she said.

Creating a set of learning objectives
In February, Brown and Koc surveyed Acibadem’s senior nurse leaders and educators with the goal of identifying critical practice issues, needs, and priorities. Their findings, related to the areas of management, research, education, and patient care, will form the basis of a comprehensive nursing program moving forward.

The survey showed that most Acibadem nurses do not routinely perform physical assessments, because this type of evaluation has been the purview of physicians. It also demonstrated a need for in-depth training in specialty areas such as oncology and neurological nursing, along with an increased understanding and integration of evidence-based practice. A majority of Acibadem nurses called for further development of the leadership skills crucial to nursing management.

Also in February, Maryellen O’Sullivan, RN, BSN, of Memorial Sloan-Kettering Cancer Center, led Acibadem nurses through a series of workshops covering physical assessment, basic cancer biology, and safe administration of chemotherapy. “The objective was to establish a baseline of cancer care knowledge for these nurses,” said O’Sullivan.

Two nurses who visited Boston received certificates to commemorate their learning experience. From left to right: Elizabeth Brown, RN, MSN; Pelin Kocoolu, RN; Michael Kavanaugh, HMI-Acibadem program coordinator; Banu Saritas, RN; and Arlene Butler, RN, MSN, of INHL.

Bringing knowledge from Harvard to Istanbul
In March, HMI facilitated a 10-day program that brought two Acibadem nurses to Boston for a series of learning experiences in Harvard-affiliated hospitals. Pelin Kocoolu, RN, focused on the nurse’s role in neurological care, while Banu Saritas, RN, enhanced her knowledge of oncology nursing. Custom-designed by the Institute of Nursing Healthcare Leadership (INHL), a frequent HMI collaborator, the clinical observation programs took place at Massachusetts General Hospital, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Beth Israel Deaconess Medical Center. Kathleen Scoble, EdD, RN, director of INHL’s International Nursing Studies Collaborative, said that the program’s curricula were based on learning objectives identified by the nurses, their supervisors at Acibadem, and HMI, as well as on a professional project that INHL requires visiting nurses to identify as part of their educational program. “The project provides a structure for the nurses to apply their new knowledge once back at their home hospital,” said Scoble.

Pelin, a neurological intensive care unit (ICU) nurse, was impressed by the organization of the Harvard hospitals, and felt that Turkish hospitals could learn from the systems approach. Her experience in the Harvard-affiliated hospitals also helped to demonstrate the value of a competency-based, formalized orientation program. She plans to develop a unit-based training program for the neurology nurses who will work in Acibadem's new neurosurgery ICU.

Banu, a recent recruit to Acibadem, said the program presented a comprehensive overview of the safe administration of chemotherapy. She was also particularly intrigued by the emphasis on patient and family education, which is not as prevalent in Turkey. Her project is aimed at creating a patient and family education program for Acibadem’s new facility.

On the horizon
Acibadem Healthcare Group will mark International Nursing Day, which is May 14th, by hosting a panel on evidence-based nursing practice. Martha Curley, RN, PhD, a nurse researcher at Children’s Hospital in Boston, will join two Turkish nursing faculty on the panel. In addition, in June HMI will once again welcome two Turkish nurses to Boston, where they will take part in a management and education program. Finally, plans are underway for a management workshop this fall that, according to Brown, will help identify the core competencies required to develop strong nursing management.

Acibadem’s dedication to developing its nursing staff has it ahead of the learning curve, and poised to make team-based care a key component of health care delivery in the Acibadem hospitals. Dr. Harvey Makadon, HMI vice president for health systems, said, “Focusing on nursing shows great vision on the part of the Acibadem’s leaders. As we have seen throughout the world, the sense of being cared for is closely related to quality of care.”

 

 

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Dr. Steven Feske led discussions on caring for stroke patients.

Oncology and neuroscience highlighted at medical conference in Istanbul
More than 700 health care professionals, including nurses, gathered in April for a two-day conference hosted by Acibadem Healthcare Group (AHG) to hear about the latest advances in neuroscience and oncology. A multidisciplinary faculty made up of Turkish and Harvard-affiliated physicians presented lectures and led discussions on topics such as the use of magnetic resonance imaging (MRI) in the treatment of neurological conditions, recent advances in the treatment of a range of cancers, and best practices in the care of stroke and oncology patients.

Mehmet Ali Aydinlar, chairman of AHG, joined Dr. Harvey Makadon of HMI in welcoming the conference attendees for what proved to be a stimulating mixture of lectures and discussions. The first day of the program focused on neurology, which along with oncology is to be a focus of a new center being built by Acibadem. Dr. Peter Black, chief of neurosurgery at Brigham and Women’s Hospital (BWH), presented two lectures on the use of intraoperative MRI. Dr. Steven Feske, who directs the stroke division at BWH, led sessions on acute stroke therapy and the evaluation of stroke in an acute setting.

The conference’s second day was dedicated to current treatments of cancer. Dr. Lowell Schnipper, chief of the hematology/oncology division at Beth Israel Deaconess Medical Center, gave the keynote address, “Targeted Cancer Treatment,” and also lectured on current approaches to treating breast cancer. Dr. David Brooks, director of the minimally invasive surgery department at BWH, discussed surgical treatments of breast and lower gastrointestinal cancer.

The conference program also reflected Acibadem’s focus on making nurses an integral part of the care team. Mary Amantangelo, N.P., senior stroke researcher at Massachusetts General Hospital, presented approaches to caring for stroke victims, including ways to improve the quality of life of stroke victims and how to effectively communicate with family members. Prof. Dr. Saadet Ülker and Saliha Koc, Acibadem’s director of nursing, moderated a panel discussion featuring Turkish nursing professionals covered a range of issues related to the role of nurses in neurosurgery, from pre- and post-operative approaches to care, to helping patients transition to life at home. Georgie Cusack, RN, MSN, a clinical nurse specialist with the National Institutes of Health, lectured on the care of oncology patients. Finally, a panel of Turkish physicians led a discussion of how to nurture and maintain the psychological health of the oncology staff.