COUNTY DURHAM AND TEES VALLEY NURSING COLLABORATIVE

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COUNTY DURHAM AND TEES VALLEY NURSING
COLLABORATIVE

• KATH ELLIOTT

Photographs (c) D Robinson
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What is it?

• The CDTV Nursing Collaborative
• is a shared nursing practice development
  project,
• involving all the Trusts in the Strategic
  Health Authority, including all nurses, wherever
  they work and whatever they do

Photographs (c) D Robinson
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Background and structure

• 2003 project sponsorship by SHA Chief Executive
  and Nurse Director
• 2003 developed by Nursing Director Network
• December 2003 - Project chair Harry Cronin
• April 2004 -Steering group formed
• July 2004 - Project manager - Chris Stanbury
• University of Teesside support
• Patient involvement through local PPI leads
• Local representatives developing change teams
• External audit and research of impact and process

Photographs (c) D Robinson
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Why develop a collaborative?

• To identify and promote common values of nursing
  within this SHA
• To highlight the unique aspects of nursing care
  and good practice
• To support collaborative change across a range of
  nursing services
• To give added value to nursing practice
  developments

Photographs (c) D Robinson
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What will collaborative do?

• Identify and agree common standards of nursing
  behaviour for all 15 Trusts
• Support development of local change programmes
• Audit impact of change on nurse-patient
  relationships
• Share good practice and lessons learned
• Publicise the achievements of nursing staff

Photographs (c) D Robinson
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How does the project work?

• Ongoing initiative with annual targets
• Clear values, aims and standards for change
• Collaborative methodology small change cycles
  and local ownership
• Local programmes of change
• 15 local representatives forming steering group
• Audit programme
• Regular reporting
• Events and publicising

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Local progress

• AUDIT-PATIENTS
• -CARERS
• -DOCUMENTATION
• -OBSERVATION
• TWO TEAMS PHASE ONE
• TWO TEAMS PHASE TWO

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LOCAL PROGRESS

• TRUST STEERING GROUP
• ACTION PLANNING
• REAUDIT
• COMMUNICATING RESULTS
• INTERNAL
• SHA

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RESULTS

• Standard One
• Nurses will introduce themselves on first
  greeting by name and roles in relation to the
  person being greeted in a polite and helpful
  manner, genuine and welcoming.
• Target 100
• Range 65 - 90
• Actions being Developed
• -Raise awareness of staff around meeting and
  greeting people
• -Customer Care training
• -Explain role in ward booklets

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RESULTS

• Standard Two
• Nurses will involve the patient and where
  appropriate their carers at all times in the
  planning and discussions about the nursing care
  they will deliver
• Target 100
• Range 59 - 98
• Actions being Developed
• -Discuss plans at the bedside
• -Keep documentation at the bedside on some wards
• -Write evaluations at the bedside with the
  patient
• -Communication sheet to be kept at the bedside
  for patients and relatives

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RESULTS

• Standard Four
• Nurses will record the involvement of patient
  and carers in their care with appropriate entries
  into clinical records
• Target 100
• Range 2 - 48
• Actions being Developed
• -Discuss with staff at ward meetings
• -Update on NMC guidelines
• -Re-look at Pathways/Care Plans
• -Communication sheets being developed
• -Long term look at documentation
• - Mirrors Essence of Care
  results re documentation

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RESULTS

• Standard Five
• Nurses will approach patients and carers and
  initiate meaningful contact as a routine actively
  throughout their working shift
• Target 100
• Range 75 - 98
• Actions being Developed
• -Ensure all staff make time to speak to patients
  on every shift
• -Ensure all staff make themselves visible at
  visiting and introduce selves in the bays
• -Sisters clinics 3 days a week

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RESULTS

• Standard Six
• Nurses will hold discussions with patients and
  carers and give information and education to
  patients and carers in a private space where
  conversations cannot be overhead
• Target 100
• Range 63 - 100
• Actions being Developed
• -Highlight quiet areas of the ward to staff
• -Give patients and carers the choice to talk in
  private where possible

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RESULTS

• Standard Seven
• Nurses will ensure that patients are protected
  from physical exposure and public view at all
  times during intimate physical interventions
• Target 100
• Range 95 - 100
• Actions being Developed
• -Well done and congratulate staff

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RESULTS

• Standard Eight
• Nurses will ensure that all nursing
  interventions will minimise any sense of feelings
  that the patient may have of feeling helpless and
  powerless
• Target 80
• Range 85 - 97
• Actions being Developed
• -Remind staff to ask permission before giving
  care
• -Customer care training
• -Remind staff to leave call buttons with patients

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RESULTS

• Standard Nine
• Nurses will inform patients and carers about
  their availability and ensure maximum visibility
  in the clinical area
• Target 90
• Range 72 - 96
• Actions being Developed
• -Ensure staff are availability at visiting times

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RESULTS

• Standard Ten
• Patients and carers will experience being
  actively listened to by nursing staff and being
  given time and space to ask questions
• Target 100
• Range 83 - 100
• Actions being Developed
• -Sisters clinics
• -Staff rounds eg post ward round

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RESULTS

• Standard Eleven
• Patients and carers will experience staff as
  available and engaging providing opportunities
  for care
• Target 100
• Range 83 - 100
• Actions being Developed
• -Speak to each patient on an individual basis
• -Include patients in conversations

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RESULTS

• Standard Twelve
• Patients and carers will be given information by
  nursing staff that they find useful and helpful
  in a format they understand
• Target 100
• Range 87 - 100
• Actions being Developed
• -Review ward information
• -Go back and ask patients and carers if they
  understand the information

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RESULTS

• Standard Thirteen
• Patients will experience their physical care and
  handling from nurses as gentle and causing
  minimal distress
• Target 100
• Range 100
• Actions being Developed
• -Well done

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RESULTS

• Standard Fourteen
• Patients will experience their nursing care as
  individual and personalised and will have been
  addressed by nurses in the manner which they
  prefer
• Target 100
• Range 95 - 100
• Actions being Developed
• -Well done

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RESULTS

• Standard Fifteen
• Patients will feel that nurses have tried to
  make them feel comfortable and at ease at all
  times
• Target 100
• Range 95 - 100
• Actions being Developed
• -Well done

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RESULTS

• Standard Three
• Nurses will use the appropriate micro
  communication skills with patients, carers and
  the public
• - eye contact
• - facial expression
• - body language
• NEGATIVE Lack of expression
• Looking out of the window when talking to the
  patient
• Did not look at the patient whilst talking
• POSITIVE Smiling
• Reflective of conversation with patient
• Welcoming
• At same level as the patient
• Gentle, soft
• Held patients hand

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COMMENTS FROM PATIENTS AND CARERS

• NEGATIVE
• Not given the opportunity to digest what had been
  told and ask questions
• One nurse ignored me
• Nurses tend to stay away at visiting
• Abrupt manner in which the end of visiting was
  announced
• Nurses not visible
• POSITIVE
• Made to feel welcome
• Staff have been marvellous

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In Summary

• Four Wards
• 15 Standards
• Very positive results

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• LINK TO
• ESSENCE OF CARE
• PATIENT SURVEY
• HEALTH CARE STANDARDS
• NURSING STRATEGY
• STAFF MORALE

Photographs (c) D Robinson
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Where can I find out more?

• Project Chair Harry Cronin
• 0191 333 6270
• Harry.cronin_at_cddps.northy.nhs.uk
• Project manager Chris Stanbury
• 0191 333 6533
• Chris.stanbury_at_cddps.northy.nhs.uk
• Local representative details here

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• THANK YOU
• Any Questions?

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