Thesis for the Candidate of Sciences degree in Public Administration; Specialty 25.00.02 – Mechanisms of Public Administration. – Lviv Regional Institute for Public Administration of the National Academy for Public Administration under the President of Ukraine, Lviv, 2018.
The thesis is devoted to the complex research of mechanisms of public policy implementation in the field of nursing at the regional level and the development of practical recommendations for improving the legal, organizational, personnel and financial provision of nursing development in the conditions of systemic reform of public administration, healthcare and administrative-territorial organization of Ukraine.
In the thesis, on the basis of the generalization of scientific research on the issue of implementation mechanisms at the regional level of the public policy in the field of healthcare, there have been identified the main research directions and has been structurally specified the research task. The expediency of deepening the content of the definition of «public policy in the field of healthcare» is substantiated. The general structural and functional scheme of public policy in the sphere of healthcare has been developed. The expediency of separating public policy in the field of nursing as an integral part of the public policy in the field of healthcare has been substantiated, and also there was suggested the introduction into the scientific circulation of the concept of «public policy in the field of nursing». Theoretical foundations are defined and the general model of implementation mechanisms at the regional level of the public policy in the field of nursing is offered. The necessity of an integrated approach to the development, implementation, and correction of public policy in the sphere of healthcare is substantiated and the general model of the complex analysis of public policy in the sphere of healthcare concerning nursing has been developed.
As a result of the analysis of implementation mechanisms at the regional level of public policy in the field of nursing, the aspect is established: the expediency of distinguishing four stages of nursing development; the necessity for the co-ordination of elaboration processes and implementation mechanisms of the public policy in the sphere of healthcare concerning the development of nursing at the regional level with the processes of reforming public administration, administrative-territorial organization and local self-government; the condition of nursing development does not meet modern requirements and standards; the priority ways for improving the implementation mechanisms of public policy in the field of nursing at the regional level is to improve the legal, organizational, financial and personnel provision for the implementation of the above mentioned policy aimed at changing the role and place of nursing; the reforming of nursing in Ukraine needs to improve the regulatory and legal framework and the relevant regulatory documentation regarding the unified technological standards of the practical activity of a nurse, the expansion of powers of medical nurses in the medical-diagnostic process; among organizational factors hindering the development of nursing at the regional level there is important a lack of interaction and co-ordination of the activities of regional executive authorities, local self-government bodies, medical universities and civil society institutes; the absence of public concept of personnel policy in the sphere of healthcare, which has led to significant disadvantages of personnel provision for nursing development at the regional level, which made the lack of personnel and the effectiveness of their use, the significant aging of healthcare workers, regional and sectoral imbalances of HR provision; the reduction of the qualification level, etc.; inconsistency of the existing level of medical training of nurses with modern international standards; insufficiency of financial support for the development of nursing at the regional level.
A range of measures is suggested to improve the mechanisms for public policy implementation in the field of nursing at the regional level: in the regulatory and legal aspect, it is necessary to regulate and implement the legal and resource support of nursing through the creation of the appropriate payment and proper working conditions of nurses, improving the professional level and the status of nursing by adopting the law on nursing, making necessary changes to the relevant orders of the Ministry of Health of Ukraine, the development and introduction of professional public standards for the entire range of specialties and indicators for the expertise of the quality of nursing activities, developing the Code of Professional Ethics for nurses; to ensure the effectiveness of the organizational mechanism, it is necessary to increase the degree of interaction and coherence of the activity of public authorities of different levels
