a view from the bedside. getting it right for vulnerable patients
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A View from the Bedside. Getting it Right for Vulnerable Patients. Ms E Childs Director of Nursing and Governance Executive Lead for Safeguarding Adults. Dr G. Kendall Consultant Care of the Elderly Clinical Lead for Dementia . About Us - PowerPoint PPT PresentationTRANSCRIPT
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A View from the Bedside. Getting it Right for Vulnerable Patients
Ms E ChildsDirector of Nursing and GovernanceExecutive Lead for Safeguarding Adults
Dr G. KendallConsultant Care of the ElderlyClinical Lead for Dementia
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About Us• Medium sized District General Hospital with
world class aspirations. Positive benchmarked performance
• Work positively with partners – Torbay and South Devon NHS Trust, Local Authorities, 3rd Sector
We Serve• Diverse area, coastal and moor = 300+sq miles• Large % of older people, 23% over 65 and
highest number of over 85’s• Significant deprivation in many parts of local
population
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Our Key Priorities: Safest care, No Delay, Best Patient Experience
Continuing to improve safety, reducing overall
hospital mortality
Eliminating unnecessary
waits for patients in all
aspects of their care
Aspiring to achieve a
‘positive and ??’ experience for
all parents / carers
Improving quality through
greater partnership
working CQUIN Scheme 2010/11
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Dementia - Improving Care at the BedsideWho:-
Executive Lead:Director of Nursing
linking into local Safeguarding Adults Board
Executive Lead:Director of Nursing
linking into local Safeguarding Adults Board
Operational Lead: Associate Director of Nursingmember of Torbay Learning Disability
Partnership Board
Medical Champion: Consultant Physician
Care of the Elderly
Clinical Nurse SpecialistDementia Care
Mental Capacity Act/Safeguarding Adults post
Supported by increasing ‘dementia champions’
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Dementia – Improving Care at the Bedside What have we implemented?
• Board to Ward awareness – patient stories told ahead of each meeting• Dementia Policy – underpinned by principles which include minimizing
ward moves. • Use of ‘forget me not’ symbol (flagging PAS)• Development of local ‘dementia champions’ underpinned with
education / coaching• Embedding patient profiles for dementia and learning disabilities (similar
to ‘this is me’).• Mealtime companions (Wards) Dementia befriender (A&E)• Laminated card – prompts for staff – fits into ID badge holder• Observations of care• Multi disciplinary ‘Board Rounds’
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Dementia - Improving Care at the Bedside
• Observations of care – replacing ‘real time’ patient feedback questionnaires
oWeekly processo Trained staff (all disciplines) and external – presently
Foundation Trust member ‘Working With Us Panel’• Immediate feedback to staff observed in delivery of care• Record then filed with actions for evidence (CQC)• 30 minutes observation
oWhat do I see?oWhat do I hear?oWhat do I smell?oWhat do I feel?
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Dementia – Improving Care at the Bedside
• Each patient discussed – ‘forget me not’ icon for dementia / special needs
• Outcomes – daily update on care plan, involvement of carer, improved communication, speedier discharge home/transfer increasingly nurse led
• Multidisciplinary Board Rounds• Swift Plus – Interactive White Board
(Linked to PAS)• Led by consultant• Involving – Junior Medical Staff, Ward
Nursing Staff, OT, Physio, Discharge Co-ordinator, EoL Co-ordinator
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Dementia – Improving Care at the Bedside
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• Safety• risk factors• Ill patients• Infection control issues
• Improved Communication• Whole team involvement• Plan updated daily
• Discharge Planning• Day 1• Destination and EDD• Paperwork• Nurse led Discharge
Dementia – Improving Care at the BedsideThe Board Round – Benefits:-
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Dementia – Improving Care at the Bedside
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Dementia – Improving Care at the BedsideThe Board Round – Pros and Cons
- Daily - MDT - Improved communication - Training - Safety - Drives discharge planning
- Time - Timing - Confidentiality - Attendance
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Motto – “if we get it right for patients with Dementia – we get it right for everyone!”
Thank you!