Page 788 - ACCCN's Critical Care Nursing

A P P E N D I X A W O R L D F E D E R AT I O N O F C R I T I C A L C A R E N U R S E S P O S I T I O N S TAT E M E N T S 765

APPENDIX A2 Governments, hospital boards and professional bodies
DECLARATION OF BUENOS AIRES: that inform and support the provision of critical care
services must recognise the importance of providing ade-
WORKFORCE quately skilled, educated and available critical care nurses,
POSITION STATEMENT ON THE PROVISION doctors and other support staff to assure the health and
OF CRITICAL CARE NURSING WORKFORCE safety of some of the most vulnerable patients in the
healthcare system.
– AUGUST 2005
Introduction This declaration presents guidelines universally
accepted by critical care professionals, which may be
In May 2003 the World Federation of Critical Care adapted to meet the critical care nursing workforce
Nurses undertook a review of available national critical and system requirements of a particular country or
care nursing associations’ position statements on critical jurisdiction.
care nursing workforce requirements. The current posi-
tion statement aims to inform and assist critical care II. Central Principles
nursing associations, health services, governments and
other interested stakeholders in the development and 1. Every patient must be cared for in an environment
provision of appropriate critical care nursing workforce that best meets his or her individual needs. It is the
requirements. right of patients whose condition requires admis-
sion to a critical care unit to be cared for by regis-
The first draft of this position statement was distributed tered nurses. In addition the patient must have
to member societies of the WFCCN between February immediate access to a registered nurse with a post-
2004 and September 2004 and changes made following registration critical care nursing qualification
discussion and meeting of the WFCCN in Cambridge (see Appendix A1).
September 2004. 2. There should be congruence between the needs of
the patient and the skills, knowledge and attributes
The second draft of this position statement was
distributed to a wider audience including member of the nurse caring for the patient.
societies of WFCCN, other international nursing and 3. Unconscious and ventilated patients should have
medicine organisations and individuals with an interest a minimum of one nurse to one patient. High-
in critical care nursing between October 2004 and dependency patients in a critical care unit may
April 2005. have a lesser nurse : patient ratio. Some patients
receiving complex therapies in certain critical care
The third draft of this position statement was distributed environments may require more than one nurse to
to an ever-wider audience, again including member soci- one patient.
eties of WFCCN, other international nursing and medi- 4. When calculating nurse-to-patient ratios and roster
cine organisations and individuals with an interest in requirements in critical care, consideration and
critical care nursing between May 2005 and August 2005. care must be given to the skill sets and attributes
of nursing and support colleagues within the
A full meeting of the World Federation of Critical Care
Nurses on Saturday 27 August 2005 at the Sheraton nursing shift team, as they vary and require
Hotel, Buenos Aires, Argentina, ratified this position re-evaluation with fluctuations in patient care
statement. requirements.
5. Adequate nursing staff positions must also be in
I. Preamble place to assist with nursing education, in-service
training, quality assurance and research programs,
Critical or intensive care is a complex specialty developed management and leadership activities and, where
to serve the diverse healthcare needs of patients (and institutionally required, external liaison and
their families) with actual or potential life-threatening support services beyond the confines of the critical
conditions. care unit.
6. Critical care nurses should focus their labour on
Development of the nursing workforce within critical
care units requires careful planning and execution to roles and tasks that require advanced skill, exper-
ensure an appropriate balance and mix of staff skills and tise and knowledge of best practice in patient care.
attributes that allow for safe and effective care. In parallel Therefore, adequate numbers of support staff
is the provision of a learning environment for novice should be employed to preserve the talents of criti-
critical care nurses, a flexibility to respond to changes in cal care nurses for patient care and professional
demand and efficiencies to ensure economic sustain- responsibilities wherever possible.
ability without clinical compromise. 7. Flexible workforce strategies and incentives should
be employed by management to recruit, retain and
Critical care nursing workforce planning must be consid- remunerate expert critical care nurses at the patient
ered in the context of the total hospital requirement for bedside, and to ensure appropriate succession
access to critical care beds in addition to the regional planning for future leadership needs. Additionally,
requirement for integrated and accessible critical care ser- contingencies should be in place to respond to
vices across a number of hospitals and institutions in a fluctuating and unexpected demands on the criti-
population-defined health service. cal care service.