05.11.16 By Sanofi Le Hub
It’s International Nurses Day! Time for Sanofi and Connecting Nurses to celebrate nurses around the world who EVERY DAY are making a difference in the lives of the patients and families they serve. And, time to reflect on the quality and impact of our nursing practice on patient behavioural change.
Sanofi’s Patient Centricity Unit supports Connecting Nurses, an international initiative that strives to drive innovation in healthcare by connecting the nursing community around the world.
Sanofi Le Hub sat down with Dr Sabina De Geest, Professor of Nursing at the University of Basel, and talked about the nurses role in behavior change, a critical step in chronic patient self-management.
Professor of Nursing and Director of the Institute of Nursing Science and Chair of the Department of Public Health of the Faculty of Medicine at the University of Basel (Switzerland)
Part time Professor of Nursing at Health Services and Nursing Research of the Department of Public Health at the KU Leuven (Belgium).
As a nurse, Professor of Nursing and member of our Behavioral Science Advisory Board, can you tell us about the nurses role in behavior change, a critical step in chronic patient self-management?
Nurses role in Behavioural Change is the “Business Case of the Future”. Management of chronic conditions represents the challenge of this Century: if patients are not empowered and do not receive the motivation to change, we as Healthcare Professionals will fail. We need to make the patient a true partner in healthcare, however this remains a challenge. Much still needs to be done to enable the Healthcare Systems optimally support nurse interventions.
Nurses are essential building block for chronic patient empowerment: they are extremely well positioned to support patients, due to the continuous and lasting relationships they’re building with them. Nurses have the comprehensive, holistic view of each patient’s medical and lifestyle needs and they’re also more cost-effective. Last but not least, nurses bring a substantial caring aspect into chronic condition management, to patients and their families.
To fully potentialize the role of nurses as fundamental part of the healthcare team, nurses need to acquire competencies in Communication and Behavioural science, which will help them to maximize the impact of their actions in clinical practice on patients’ health outcomes and quality of life.
Can you tell us about the different Healthcare Systems’ impact on the nurses roles and, as a consequence, on patient outcomes?
Nurses need to gain competencies in order to be able to empower patients. There are gaps between countries like EU states (France and Netherlands for instance) and a variability of investments made by countries on providing nurses alternative roles towards physicians and leveraging their know-how. More needs to be done to support implementation of Behavioural change strategies and Healthcare professional training.
Nurses’ ability to positively influence patient outcomes is a result of combination of 3 crucial factors: the right intervention in the right time and in the right Healthcare model. This combination has the power to unleash the value of nurses’ contribution at the maximum. As example, Diabetes Clinics’ investments on Behavioural change has shown good outcomes on patient adherence but there is still a long way to go, for example in CVD, and we see disparities in countries’ investment decisions.
From your clinical experience, can you provide us with examples about Behavioural Change techniques that seem to bring the biggest value?
Behavioural Change management goes far beyond patient information and education. The 3 key principles that bring value in clinical setting are:
- Building care plans with patients that are based on patient needs and barriers and understand, what is feasible for the patient.
- Taking time for feedback with patient to assess the progress made and update information about patient over the time.
- Continuous monitoring of patients’ efforts, with related action plan.
When those 3 principles will become standards in chronic patient care, it will be a great step forward! Depression symptomatology management represents a valuable addition to those 3 interventions. And group patient monitoring of patient represents a valuable means for extending the reach of nurses’ intervention.
In home care setting, leveraging peer-to-peer resources as new methods to deliver interventions appears to be very valuable. Using of video materials in addition to booklets and other written information resources has shown encouraging results as well.
We can act on patient adherence and prescription gaps by training Healthcare professionals on Behavioural Change techniques and help reengineering the whole system towards more optimal chronic patient support:
- Enable the shift from acute care to chronic care.
- Integrate all care partners into the care system, such as pharmacists, family members. This approach needs to be endorsed at the highest decision-making and scientific level as a golden standard in medicine, pharmacy, nursing.
- Elevate the care approach from individual patient to population level. Chronic care needs to become a systemic approach at population level. How can we organize the system of care with more electronic medical records which allow people self-management and empowerment? This is one of the questions for near future.
Finally, a more personal question: Why have you decided to become a nurse?
Being a nurse is an ongoing journey over time. I started studying nursing when I was 17 years old and very quickly understood, that nursing goes far beyond medicine. What I find fascinating is the impact we can make in person’s daily lives, you can really make this difference as a nurse by respecting the person you are helping to change her / his behaviour.
In collaboration with other Healthcare professionals, nurses are in the driving seat of change for chronic care patients. Being part of the Behavioural Change Expert panel is a unique experience to build value for patients within a care team and find ways to bring a positive and lasting change to patients’ lives.
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