Health Systems and Policy Monitor (HSPM)

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Analyses

Further expansion of the role and responsibilities of specialist nurses in the community

23 October 2018 | Policy Analysis

In May 2018, the MoH further expanded the role, responsibilities and autonomy of nurses in the community with incremental implementation. The objectives of these changes are to empower nurses, attract more people to the profession (as there is a shortage), improve continuity of care, and reduce work pressure on physicians.

The new responsibilities for specialist nurses include: ordering various diagnostic exams, referring patients to specialist care, performing additional clinical procedures, changing medication dosage, and becoming case managers for patients. In addition, three new specialization courses will be launched to enable nurses to provide enhanced care for specific types of patients:

1. From early 2019, nurses who undertake a “stroke course” can perform additional clinical procedures in order to shorten the time of treatment for stroke patients in an attempt to deter brain damage and improve treatment outcomes.

2. In 2019, nurses who undergo “rehabilitation training” will have extended responsibilities for making decisions about, and providing, rehabilitation and medical long-term care. This change will potentially better meet the needs of the ageing population, characterized by widespread chronic conditions and disabilities in activities of daily life.

3. Beginning in early 2020, nurses who undertake a “gastroenterology course” will be able to provide more care for patients with gastroenterological conditions, either chronic or acute. The objective if this change is to improve continuity of care between inpatient and outpatient care, and better integrate care for these patients.

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