Nurses and midwives can help break down boundaries across levels of care and settings

Several case studies demonstrate that nurses and midwives collaborate not only with other professions but also with informal care-givers and families, helping to improve health outcomes and reduce barriers to care. Nurses and midwives, with their long tradition of team work in care, are well positioned to facilitate the team work required to break down boundaries among levels of care and settings, provided they have the necessary institutional support, so that all health professionals can participate in collaboration.

Iceland (case study 14)

Overview: A physician and a nurse found that more health education and support were needed in managing diabetes. A new nursing service was organized, involving multidisciplinary ambulatory care for young people living with diabetes. The nursing service focused on providing information, education and support in response to the expressed needs of parents, children and adolescents. The skills and competence for this new role were instilled over time by training and continuing education, including academic degrees. As a part of multidisciplinary teams, nurses conducted scientific research and participated in conferences and workshops.

Outcomes: The enhanced nursing service provided many benefits for its clients, including greater satisfaction, better ability to deal with the disease and better treatment compliance. The better health outcomes of both clients and the health system confirmed the importance of this initiative. The improvements to the service included individual, group and family counselling and motivational interviewing sessions. This initiative was followed by other nursing services that were integrated into health care delivery.

Health 2020 goal: Tackling Europe's major health challenges: NCDs and communicable diseases