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The InSieMe Project: Developing the role of the MS Nurse in Italy

The InSieMe Project: Developing the role of the MS Nurse in Italy. R. Motta, RN Social and Health Services and Research, Italian MS Society, ITALY. InSieMe: Infermieri per la Sclerosi Multipla. Together: Nurses for Multiple Sclerosis. Background. Approximately 52,000 affected with MS

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The InSieMe Project: Developing the role of the MS Nurse in Italy

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  1. The InSieMe Project:Developing the role of the MS Nurse in Italy R. Motta, RN Social and Health Services and Research, Italian MS Society, ITALY

  2. InSieMe: Infermieri per la Sclerosi Multipla Together: Nurses for Multiple Sclerosis

  3. Background • Approximately 52,000 affected with MS • Socialized health system • Inadequate distribution of human resources in hospitals and out-patient services (ie. patient:neurologist ratio - northern Italy 57:1 vs 34:1 in southern) • No special training/education in MS for allied healthcare professionals

  4. AIM:Create, develop, formalize role of MS nurse in Italy GOALS: • Develop nurses specialized in MS • Standardize healthcare practices in MS nursing • Mechanism for exchange and professional growth • Peer support network

  5. Phases of InSieMe:- develop curriculum- choose 1st 10 centres/nurses- intensive, comprehensive training on MS- regional courses - national conference- develop a permanente organization or group

  6. Phase 1Develop curriculumTopics chosen based on: -IOMSN Core Curriculum -Canadian MS Care Plan -Focus groups of professionals and persons with MS

  7. MODULES PROGRAM.

  8. Phase 2Choose core group of 10 nursesQuestionnaire to 200 neurology department ● MS clinic exists? ● Dedicated nurse?● HoursCriteria: - dedicated nurse following MS pts.- MS clinic open > 3 days/week- geographical distribution

  9. Course teaching methods • Lecture • Question and answer • “Quiz the audience” • Small group tasks • Role-playing • Case studies and case presentations • Practice visits with patients • Demonstrations • Discussion

  10. Phase 3Training- 5 day course on MS (with 10 nurses)- 2 day/session for revising curriculum- 3 day course for learning speaker skills

  11. Phase 4 Regional course- 10 courses offered in 10 sites- neurologist were invited to identify nurse to attend- 1 nurse for each neurology department in Italy- project covered all costs except for participants’ travel

  12. Centres involved in InSieMe 8 1 5 23 23 25 9 11 14 8 3 6 13 1 4 8 5 1 8 10

  13. Key to success - 1CHOOSE THE RIGHT PEOPLE!- motivated- dedicated- energetic- organized- open to new experiences- open to challenges

  14. Key to success - 2- vary teaching methods- involve partecipants throughout course

  15. Phase 5National Conference● 1st conference dedicated to nurses working in MS● Speakers are nurses!● Program does not exclude nurses who did not attend regional course● Opportunity for starting a support network

  16. 1st Annual MS Nurse Conference 25-26 October, 2003 Bologna, Italy● 240 registrants so far● Launch of new society for Italian MS Nurses- registration fee includes 1 year membership in new society

  17. Conference program MS nurse: Defining a new role Results of the InSieMe project The impact of InSieMe on MS patients Improving quality in MS centres The Cagliari MS Centre as a model The role of the MS nurse in teaching autonomy The meaning of autonomy in chronic illness Legislation regarding patient rights Self-management of fatigue Sexuality: let’s start talking about it Confronting bladder problems The future of MS nurses in Italy The IOMSN experience Creating and applying guidelines in MS nursing A new dialogue between nurse and neurologist Looking toward the future: SISM

  18. Phase 6SISM- Italian MS Nurse Society● Founded by a group of MS nurses and Italian MS Society● Goals for 1st year:- continuing education - guideline development - 2nd annual conference● Official affiliate of IOMSN

  19. In countries where no MS Nurse exists people (nurses, pwMS, other health care professionals) have to convinced of importance of MS Nurse: - give materials that support and promote project to put in hospitals and MSS branches - write a final exam that is reasonably challenging (with possibility for failing) - give certificates: ▪ for completing course ▪ for passing exam - offer CE credits, if possible

  20. Challenges● cultural barriers● cost● time/personnel

  21. Challengescultural barriers - nurses themselves inflexible to change, unwilling to take on active role and more responsabilities- patients, families accustomed to “communicating” only with neurologist - physician unwilling to acknowledge a non-physician can be responsible for management and decision-making

  22. Challengescost (hotel and catering for regional courses and printed materials very expensive)- smaller-scale (start small) - use MS Society/hospital structures rather than hotels - promote project in materials already produced by MS Society (i.e. magazine, newsletter, etc.)

  23. Challenges time/personnel (we used 2 full-time people for 3 years)- use a person with/in MS Society who is able to organize the project and is knowledgable about MS- involve MS experts and others who will collaborate for free

  24. Conclusions▪ where the MS nurse does not exist – MS Societies must act▪ creating MS Nurse experts is a long-term commitment▪ MS Nurse has the possibility to improve the quality of life for people with MS

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