COVID-19 Sürecinde Sağlık Sistemlerinin Zorlukların Üstesinden Gelebilme Kapasitesinin Geliştirilmesi ve Hemşireler ile Diğer Sağlık Profesyonellerinin Güçlendirilmesi

Yıl 2020, COVID-19, 76 - 83, 24.07.2020

Füsun Terzioğlu

https://doi.org/10.12956/tchd.733123

Cited By: 5

Öz

Sağlık sistemi, ana amacı sağlığı iyileştirmek ve geliştirmek olan tüm organizasyonlar, kurumlar, kaynaklar ve insanlardan oluşur. Bu tanım sağlık sistemini iyileştirme aktivitelerinin yanı sıra sağlığın belirleyenlerini nüfuz altına almak için sarfedilen eforu da içermektedir. Sağlık sistemi, kamusal sağlık çalışmaları ve hem devlet hem de sivil aktörler aracılığı ile kişisel sağlık hizmeti sağlayan sağlık kurumları piramidinin birlikteliği ile insanlara koruyucu, önleyici, teşvik edici, tedavi edici ve rehabilite edici müdahaleleri sağlar. Sağlık sisteminin çalışmaları, insanlara saygı çerçevesi içinde gerçekleşirken, aynı zamanda duyarlı ve maliyet açısından adil olmalıdır. Sağlık sistemi, çalışanlara, bilgiye, malzemeye, ulaşıma, iletişime ve çalışabilmesi için genel bir yönergeye ve yöne sahip olmalıdır. Sağlık sistemi içerisinde çalışanların en fazla işgücünü oluşturan hemşirelik mesleği toplumun değişen ihtiyaçlarına cevap verme, toplumsal sağlık zorluklarını yenmek ve yüksek kalite sağlık hizmetinin sağlanmasını garanti altına almak için uygulamalarını geliştirmiştir. 20.yüzyıl boyunca ve 21.yüzyılın içinde de beklenen yaşam süresini arttırmada ve bebek-anne ölümleriyle ilgili risk faktörlerinin azaltılmasında ciddi kazanımlar elde edilmiştir. Hemşireler çocukların sağ kalımının gelişmesine önemli katkılarda bulundular ve katkıları iyi bir şekilde kanıtlanarak belgelenmiştir. Temiz suya ulaşılabilirlikte, besin güvenliğinin (hıfzıssıhhanın) gelişmesinde, sıtmanın, tüberkülozun, ve çocuk felcinin azaltılmasında, ve de HIV virüsünün yayılışını azaltma gibi pek çok toplumsal kriz ve pandemi yaratabilen durumlarda ciddi ilerlemeler sağlamıştır. Günümüzde de sağlık sorunlarının en önde gelenleri olan antimikrobiyal direnç, yeni salgınlar, üreyen enfeksiyonlar, doğal felaketler, küresel iklim değişimi, silahlı çatışmalar ve göçler gibi tehditler ile karşı karşıyayız. Hemşirelerin tüm bu kriz süreçlerinde çözüm üretebilme yeteneği ve sağlık hizmetlerine olan katkısı tartışılmaz bir gerçektir ve nitekim DSÖ 2020 yılını dünya hemşireler yılı olarak ilan etmiştir. Bu derleme tarzında hazırlanmış olan makalede COVID 19 sürecinde sağlık sistemlerinin zorlukların üstesinden gelebilme kapasitesinin geliştirilmesi, bu süreçte hemşirelerin rolü ve önemi ile hemşirelerin ve diğer sağlık profesyonellerinin bu kriz döneminde güçlendirilmesine yönelik stratejiler tartışılacaktır.

Anahtar Kelimeler

COVID-19, hemşirelik, sağlık profesyonellerinin güçlendirilmesi

Enhancing the Capacity of Health Systems to Overcome Challenges and Strengthening Nurses and other Healthcare Professionals in COVID-19 Process

Öz

Nowadays, leaders and executives are faced with a complex set of problems that do not have a complete solution, threaten their career and the future of their institutions, and that the parties are harmed. When evaluating ambiguous information that contradicts each other, the priority of the manager and leader should be to implement the solution that gives the least harm to the majority. When a process such as COVID-19, which caused a pandemic and left our lives under uncertainty, more than one crisis situation emerged, which we had to manage both personally and as healthcare professionals. The important point here is related to how we manage and lead these extraordinary situations we encountered in the Quantum era.
How we keep pace with change and how we can lead this planning process is an important issue. Because people faced a risk in the context of the most important human right and constitutional right “right to live”. Therefore, how to protect ourselves and stay healthy during this process have been our top priorities. The first thing that comes to mind when it comes to protecting and strengthening health is undoubtedly the health professionals who have adopted this issue as a professional principle. Health professionals have important responsibilities in planning this crisis in terms of planning, speed, compliance and trust. This article, prepared in a compilation style, discusses what can be done within the scope of the COVID-19 process, by improving the capacity of managers and leaders to overcome difficulties in the health system they are in and strengthening nurses and health professionals.

Anahtar Kelimeler

COVID-19, Empowerment, Nurses, Leadership, Management

Kaynakça

• 1. Baumann A (2007) International Council of Nurses (ICN) positive practice environments: Quality workplaces = quality patient care, information and action tool kit [Electronic version]. Retrieved September 13, 2009, from http://www.icn.ch/indkit2007.pdf.
• 2. Benton D (2012). Advocating Globally to Shape Policy and Strengthen Nursing's Influence. The Online Journal of Issues in Nursing, Vol. 17 No. 1
• 3. Buchan J & Aiken L (2008). Solving nursing shortages: a common priority, Journal of Clinical Nursing, Vol. 17 No. 24), 3262-3268.
• 4. Campbell J et al. (2015). Improving the resilience and workforce of health systems for women’s, children’s, and adolescents’ health. BMJ 2015;351:h4148,
• 5. Canadian Nurses Association (2009). Ethics In Practice Social Justice in Practice, April 2009.
• 6. Cooper A (2013). Paperless In the United Kingdom. American Nurses Today, Special Issue, vol 8, no 11, p11.
• 7. David KE et al. (2015). Health-care worker mortality and the legacy of the Ebola epidemic, Lancet Global Health Volume 3, No. 8, e439–e440, August 2015. Available at: www.thelancet.com/journals/langlo/article/PIIS2214-109X%2815%2900065-0/fulltext). Department of Health (2009). NHS Health and Wellbeing Review, Leeds, UK.
• 8. Dick J, Clarke M, Van Zyl H & Daniels K (2007). Primary health care nurses implement and evaluate a community outreach approach to health care in the South African agricultural sector. International Nursing Review, 54(4), 383-390.
• 9. Duffield CM, Diers D, O'Brien Pallas L, Aisbett C, Roche MA, King MT & Aisbett K (2011). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, vol.24, issue 4 pp. 244-255.
• 10. Fillingham D & Weir B (2014). Systems leadership, Kings Fund, London, UK. Fineberg HV (2012). A successful and sustainable health system—how to get there from here. New England Journal of Medicine, Vol. 366 No.11, pp 1020-1027.
• 11. Global Health Workforce Alliance (2015) Synthesis paper of the thematic working groups. Towards a global strategy on human resources for health. Available at: www.who.int/hrh/documents/synthesis_paper_them2015/en/).
• 12. Institute of Health Equity (2013). Working for Health Equity: The Role of Health Professionals Available at: www.instituteofhealthequity.org/projects/working-for-health-equity-the-role-of-healthprofessionals. Accessed 20 April 2020
• 13. International Council of Nurses (2002) Definition of Nursing. Available at: www.icn.ch/who-we-are/icndefinition-of-nursing/. Accessed 20 April 2020 .
• 14. International Council of Nurses (2008), “Position statement: Participation of nurses I health services decision making and policy development”. Available at: www.icn.ch/images/stories/documents/publications/position_statements/D04_Participation_Decision_ Making_Policy_Development.pdf. Accessed 20 April 2020.
• 15. International Council of Nurses (2011). Closing the Gap: Increasing Access and Equity. International Nurses Day toolkit. Available at: www.icn.ch/publications/2011-closing-the-gap-increasing-access-andequity/. Accessed 30 April 2020
• 16. International Council of Nurses (2015a). Nurses a Force for Change: Care Effective, Cost Effective. International Nurses Day toolkit. Available at: www.icn.ch/publications/2015-nurses-a-force-for-changecare-effective-cost-effective/. Accessed 30 April 2020.
• 17. International Council of Nurses (2015b), International Council of Nurses Statement on the joint ICNWHO consultation on Global Strategy on Human Resources for Health, 20 April 2020 .
• 18. International Council of Nurses (2015c). Consultation on HRH global strategy. Available at: www.icn.ch/what-we-do/the-global-strategy-on-human-resources-for-health-workforce-2030. Accessed 20 April 2020
• 19. Jackson, D., Firtko, A. and Edenborough, M. (2007) Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: A literature review. Journal of Advanced Nursing, 60; 1-9 .
• 20. Jamison, Dean T et al.(2013) Global health 2035: a world converging within a generation, The Lancet, Volume 382 , Issue 9908 , 1898 – 1955. Available at http://dx.doi.org/10.1016/S0140-6736(13)62105-4.
• 21. Kruk ME,et al.(2015). What is a resilient health system? Lessons from Ebola, The Lancet, Vol. 385 No. 9980: pp 1910-1912.
• 22. McAlister, M. and McKinnon, J. (2009) The importance of teaching and learning resilience in the health disciplines: A critical review of the literature. Nurse Education Today, 29; 371-379
• 23. McDavid, D (2013) Mental health: A key challenge for Europe in the 21st century, Eurohealth, Vol 19 no 3 p14-17
• 24. NHS Direct (2007). Healthcare risk assessment made easy. Available at: www.nrls.npsa.nhs.uk/resources/?EntryId45=59825. Accessed 20 April 2020 25. NHS Leadership Academy (2015). Systems leadership. Available at: www.leadershipacademy.nhs.uk/about/systems-leadership/. Accessed 20 April 2020
• 26. Oxfam (2015). Never Again Building resilient health systems and learning from the Ebola Crisis, 203, Briefing paper.
• 27. Shamian J et al, (2015) No global health without human resources for health (HRH): The nursing lens, Canadian Journal of Nursing Leadership Vol. 28 No. 1. 28. http://www.robertsoncooper.com/blog/entry/how-non-psychologists-build-personalresilience
• 29. Sheridan N et al, (2011) Health equity in the New Zealand health care system: a national survey. International journal for equity in health, Vol. 10.No. 1: pp 1-14.
• 30. Sull, A Harland, N and Moore, A (2015) Resilience of health-care workers in the UK; a cross-sectional survey Journal of Occupational Medicine and Toxicology 2015, 10:20.
• 31. Sullivan, M, Kiovksy, RD, Mason, DJ, Hill, CD & Dukes, C 2015, “Interprofessional collaboration and education”, American Journal of Nursing, vol.115, no.3, pp.47-54. Available at: http://journals.lww.com/ajnonline/Fulltext/2015/03000/Interprofessional_Collaboration_and_Educati n.26.aspx. Accessed 20 April 2020
• 32. Tangcharoensathien V, Mills A, Palu T (2015). Accelerating health equity : the key role of universal health coverage in the Sustainable Development Goals. BMC Med. 2015; 13: 101. Published online 2015 April 29. doi: 10.1186/s12916-015-0342-3.
• 33. Tomblin-MurphyG & Rose A (2015). Nursing Leadership in Primary Health Care for the achievement of SDGs and HRH Global Strategies Geneva ICN Internal Working Paper
• 34. Panter-Brick C (2014). Health, Risk, and Resilience: Interdisciplinary Concepts and Applications∗Annu. Rev. Anthropol. 2014. 43:431–48.
• 35. United Nations (2015). The Millennium Development Goals Report. Available at: www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf. Accessed 20 March 2020
• 36. USAID (n.d.). What is Health Systems Strengthening? Available at: www.hfgproject.org/abouthfg/about-health-systems-strengthening/. Accessed 20 April 2020
• 37. Ventura CA, Mendes IC, et al. ( 2015), The Evolution of World Health Organization's Initiatives for the Strengthening of Nursing and Midwifery, Journal Of Nursing Scholarship, Vol. 47 No. 5, pp 435-445.
• 38. Wilson S & Langford K (2015). 10 ideas for 21st century healthcare, Innovation Unit London. Available at: www.innovationunit.org/sites/default/files/DIGITAL%20VERSION10%20Ideas%20Final.pdf.
• 39. World Health Organization(2003). Fifty-Sixth World Health Assembly, Strengthening Nursing and Midwifery, Report by the Secretariat: A56/19: Provisional Agenda Item, Available at: http://apps.who.int/gb/archive/pdf fles/.
• 40. World Health Organization (2006).The World Health Report 2006: Working Together for Health, Geneva.
• 41. World Health Organization (2007). Everybody’s business: strengthening health systems to improve health outcomes: WHO’s framework for action. Available at: www.who.int/healthsystems/strategy/everybodys_business.pdf
• 42. World Health Organization (2008). Primary Health Care. Now More than Ever. Retrieved from: http://www.who.int/whr/2008/en/
• 43. World Health Organization (2010a) Monitoring the building blocks of health systems. A handbook of indicators and their measurement strategies. WHO Geneva Switzerland
• 44. World Health Organization (2010b). “Framework for action on interprofessional education & collaborative practice”, viewed on January 13 2016, http://apps.who.int/iris/bitstream/10665/70185/1/WHO_HRH_HPN_10.3_eng.pdf?ua=1
• 45. World Health Organization (2010a). Health systems financing: the path to universal coverage. Available at: http://www.who.int/whr/2010/en/. Accessed 18 March 2020
• 46. World Health Organization (2014). Health-system resilience: reflections on the Ebola crisis in western Africa.by Kieny MP, Evans DB, Schmets G, Kadandale S. 2014 - Bull World Health Organ2014;92:850 – http://www.who.int/bulletin/volumes/92/12/14-149278/en/#). CN
• 47. World Health Organization (2015a). Health in 2015: from MDGs to SDGs. Geneva: WHO. Available at www.who.int/gho/publications/mdgs-sdgs/en/).
• 48. World Health Organization (2015b). Health workforce density per 1000 population, Global Health Observatory data repository. Available at: http://apps.who.int/gho/data/node.main.A1444?lang=en).