HCA training: making a difference to both staff and patients

10 May 2017

Nurse educator LYNLEY DAVIDSON outlines the impact a training framework for Waitemata District Health Board’s healthcare assistants has made on both HCAs and patient care.


waitemata hca

“It’s given me confidence in myself – I feel that I can advocate for my patients now.”

“Thanks so much for this opportunity – it’s changed my life.”

This is just a taster of feedback received from healthcare assistants (HCAs) after experiencing a variety of training opportunities offered through Waitemata District Health Board’s (WDHB) HCA education framework.

The unregulated HCA workforce provides a vital contribution to the frontline delivery of health care. While nationally there have been calls to standardise HCA education, employers still have a responsibility to ensure they are valued, have sufficient knowledge and skills to provide the highest standard of care and are supported to grow and develop. There is also an expectation that the workforce reflects the population.

This article outlines how WDHB addresses these responsibilities.

Waitemata employs over 500 HCAs. Over half are employed into adult medical/surgical and rehab patient care areas, a third in mental health and the rest in the community, internal bureau and child and family (including midwifery). Those involved in direct patient care delivery work within different models of care but always under the direction and delegation of a registered nurse or midwife.

Five years ago, WDHB had no formal structure or programme to educate and develop HCAs. Through a process of needs analysis and collaboration with charge nurses/midwives, managers, the nursing development service and Māori/Pacific Island workforce development and recruitment, a robust framework is now in place. This framework includes orientation, regular annual study days, a clear and easy to follow merit recognition programme (as per NZNO MECA), job descriptions and appraisals that encourage development, the opportunity to complete a Level 3 national qualification and a ‘New to HCA’ programme that targets Māori and Pacific peoples.

While ongoing development work is still happening in specific clinical areas, the framework is embedded and we are seeing a difference to both care delivery and in the lives of the HCAs themselves. Two aspects of our programme are highlighted to demonstrate this difference.

New Zealand Level 3 Certificate Programme

Gaining a healthcare qualification has two key positive outcomes. These are the impact that an increase in knowledge and skills has on patient care delivery, and the effect the attainment of the qualification has on the person who gains it.

A formal evaluation of the pilot certificate programme, completed in 2013, clearly indicated an improvement in patient care delivery and a sense of personal achievement for the participants. The programme, now offered yearly, is integrated and modulised – a collaborative development between Waitemata and Waikato DHBs and Careerforce. Yearly evaluation from the HCA participants continues to provide rich narrative about the difference the course is making to their care delivery and consequently to the patients’ experience.

Jeanne wrote:

“I used to limit my contact with prisoners. I learnt that we can’t discriminate and everyone should be treated with respect and dignity. Next time a prisoner came – I welcomed him and made sure he felt respected. The guard said later he had never seen the prisoner so calm”.

New to HCA Course

This course is offered to Māori and Pacific people who wish to enter the health workforce but have no formal work experience. While some have cared for whānau, with no formal work record the chance of being employed in an acute healthcare environment is often low.

Selection criteria are few, but include a passion to work in healthcare, reliability, and availability for full-time shift work. Once the participants have successfully completed the class work and three weeks of clinical placement with an experienced HCA, they can apply for vacancies within WDHB. In three years, 43 out of 47 have completed the course, with approximately 80 per cent then employed. While one outcome is employment, there are other benefits.

Naomi has now been employed in the DHB for three years. “Both the New to HCA course and the Level 3 qualification (completed in 2016) have made such a difference to me. Knowing someone was prepared to support me and encourage me to develop means I can see my worth and what I can contribute”. (Her sister completed the course last year and is also now employed.)

For 41-year-old Keileen, the New to HCA course and subsequent employment are a stepping stone to tertiary study as she is planning to begin a degree programme in nursing.

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