QUALITY AND QUANTITY IN NURSING CARE IN PRIMARY CARE IN SLOVENIA July 1999 June 2002

1. QUALITY AND QUANTITY IN NURSING CARE IN PRIMARY CARE IN SLOVENIA July 1999 � June 2002 Slovenian participating organisations: Ministry of Health Nursing Association Health Centre Maribor College of Nursing Studies at the University of Maribor WHO Collaborative Center for PHC nursing Participating organisation from the Netherlands: Catholic University of Nijmegen (KUN)

4. Overall objectives of the project Optimize the nursing system in primary care Contribution policy making on quantity and quality in nursing care Project goal: To meet standards and criteria for good nursing practice and rational nursing management

5. Main results achieved Instruments to manage and monitor the quantity and quality in nursing care Obtaining concrete insight to the required quantity and quality of care Ministry of Health use the methodology to find out if there is enough nursing staff The methodology was also used as one of the criteria for nursing staff projection for the period of 20 years Nurses and nurse managers know how to plan, realize, evaluate and adjust the nursing process and number of nurses needed in a systematic way Working climate that allows development on policy proposal in nursing care for other health centres Results are incorporated in nursing education and they are applied in health centres in their daily practice

6. Main obstacles during the implementation of the project  Expected Resistance from nurses at the begining Time limitation to execute the proposed activities Unexpected More tasks were requested than was planned to be carried out by the project team (the classification of the family, repeated measurements in quantity and quality as a learning process, repeated 16-weeks of patient classification in community nursing care). Also the dissemination of the project results, writing articles, textbook, readers, organise and hold meetings with all involved in the nursing care system in Slovenia required more time

7. The concept of primary care in SLO Accessibility Availability Continuity of care Comprehensiveness As part of former Yugoslavia health care system used to be a "parading horse" of socialist philosophy. Several laws implemented Andrija Stampar's ideas on PHC in service to all the people and using active approach in primary care in searching for health problems among disadvantaged and risk groups (children, women in generative period, workers, TBC patients etc.).

8. In the public sektor, PHC, both preventive and curative, is provided in 128 health care facilities. Most PHC professionals work independently, and their gate-keepig function is further strengthened. There have been attempts to delegate the responsibility for planing PHC to local goverments and today municpalities manage most centers, which are still owned by the state. There are also dispansaries for various types of care aimed at children, youth, tuberculosis, gynecology, occupation medicine. One of important structural changes in our country in general practice is new Department of family medicine.

9. The strong defenders of primary care Ministry of Health Institute for Health Protetction GP and Nursing Association

10. Further development of primary care One essential challenge that needs to be adderess is how to develop more efficient communication between PHC and secondary/tertiary care Long term care � changes in health inssurance Slovenia will need to re-evaluate some of the approaches that were the cornerstones of the reform in 1992. One of them is the level of decentralisation and deregulation and their sustainability related to the development of PHC. Bigger accent on regional and local level Institute for Health Protection with health promotion and education programs

11. Helpful international support To educate and to train new profile of RN �case manager� for preparing progams on first level in the concept of long term care