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CNO Bulletin April 2023

 

A message from the CNO - Tracey Brigstock

Welcome to April’s edition of the CNO Bulletin.

I’m really excited to welcome two new Facilitators to our Shared Decision Making team, who will share their stories as we look to increase and enhance our growing network of more than 20 councils across UHCW.

This month we’ll also have special contributions relating to Cancer CNS Day and Maternity March, while we’ll also look ahead to the next steps of our exciting journey towards introducing our Electronic Patient Record (EPR) later this year.

And, of course, we’ll be celebrating our latest DAISY Award winner.

 

In This Issue

 

Shared Decision Making – Welcoming new Facilitators

Shared decision making, or shared governance, is about staff having collective ownership to develop and improve practice; ensuring patients receive caring, safe, and confident care. It places staff at the centre of the decision-making process and sees managers having a facilitative leadership role.

Since launching in early 2020, we now have over 20 councils across UHCW involving staff from all roles. Councils meet on a monthly basis and are given dedicated time to come together and work on positive improvements that matter most to them, in collaboration with their senior leaders.

 

Hi, I’m Matt

I’m excited to join as the new Shared Decision-Making Facilitator! I originally became involved in SDM over 6 years ago as a newly qualified nurse at Northampton General Hospital. Since then, I have facilitated the model at both Northampton and University Hospitals of Leicester and supported Trusts across the UK to set up their own SDM Councils.

I am deeply passionate about the Shared Decision-Making model, as I have witnessed first hand on numerous occasions the significant positive impact it can have on individuals, personally and professionally. It is so vital that we empower our frontline teams to have their voice heard and get them involved in the decision-making process across the organisation.

My role will now be to review the current model we have in place and look at how we can grow and sustain it moving forward. I can’t wait to meet our current 20+ councils and hear from them their experiences so far, as well as begin to set up new councils as we head further into 2023.

 

Hi, I’m Michelle

I’m excited to join as the new Practice Facilitator for Pathway to Excellence and Shared Decision-Making! I fell in love with shared decision-making two years ago as the Chair of our ReSPECT Council, and I believe in the power of shared decision-making as a vehicle to empower our staff. I have seen how it empowered my direct care colleagues, brought us together to work towards shared goals, and enabled us to innovate and drive change. I am so excited to now be in a role where I can support and develop others to grow using this approach.

My role is to facilitate projects within Pathway to Excellence® and Shared Decision-Making (SDM), and my focus is on equality, diversity, and inclusion within our nursing, midwifery, and allied health professional teams.

I will be facilitating our Trust-wide Internationally-Educated Staff SDM council. The council will be a support network for our internationally-educated nurses, midwives, allied health professionals, and health care support workers, and council projects will support their well-being and professional development. I also facilitate our Anti-Racism SDM council; the group is currently creating the UHCW anti-racism toolkit based on a national document from Ruth May, the Chief Nursing Officer for England. I am looking forward to supporting our council members’ development and am so excited to see all the wonderful ways our members will grow through shared decision-making!

If are interested in setting up a council of your own or a focused project group using the shared decision-making approach, please get in touch via Shareddecisionmaking@uhcw.nhs.uk

 

The Centre for Care Excellence (CfCE) strategy

We were so proud to launch the Centre for Care Excellence (CfCE) strategy at the end of March. Thank you to all those who attended and made the Grand Round such an energy filled event. It was inspiring to hear from all of the Professors and Associate Professors within the Centre as to the work that they are doing to improve patient care through Research, Innovation, Practice and Education (the ‘RIPE’ model).

The event was recorded on Teams, so please click to view it here: Microsoft Teams

More information on the CfCE and the new CfCE Strategy can be found here: Centre for Care Excellence - University Hospitals Coventry & Warwickshire (uhcw.nhs.uk)

 

Ward Accreditation- are you going for Gold?!

The annual accreditation assessments began 1st March this year and will be completed by the end of June. It is a great opportunity for teams to showcase and celebrate improvements undertaken following their last accreditation assessment and the high standards of care being delivered in ward areas. So far this year 4 wards have achieved a Silver Award:

  • Ward 33 Surgery (2nd Silver Award)
  • Ward 33 SDU/ Ward 10 ECU
  • Ward 22 Vascular
  • Ward 50

and Ward 31 has achieved a Bronze Award. Congratulations to all those areas!!!

Good luck to all wards who are awaiting their assessment and be sure to showcase the improvements you have been making whether it’s learning from incidents, piloting new ways of working or focussing on specific standards.

Top Tips

  • Focus on Essential standards
  • Ensure risk assessments are up to date & accurate
  • Ensure actions are implemented
  • Ensure documentation reflects care delivered & is evaluated

 

Tidy up and Declutter

  • Declutter patient tables and bedspaces & utilise bedside lockers
  • Ensure the patients’ bedspace is clear of hazards
  • Encourage the MDT to tidy notes away!
  • Ensure oxygen cylinders are not left in patient bays
  • All medications should be safely stored in the Omnicell or drug trolley

Grab a trolley and clear unwanted items/linen/rubbish from patient bays

 

Cleaning & IPC

  • Is the cleaning rota visible and up to date?
  • Is there evidence clinical equipment is clean ie. Green labelling
  • Is there alcohol gel available at every bed space?
  • Is PPE available & worn correctly
  • Is the correct signage in place for patients requiring isolation?

 

Cancer Clinical Nurse Specialist (CNS) Day: Macmillan Hepatobiliary and Pancreatic (HPB) CNS

We are a team of three nurses (Claire Pearce, Michelle Faupel and Jamie Bradley)

who have a specialist skill set to support HPB patients in the surgical team. We have a wealth of experience in Oncology, Chemotherapy, Surgery and Nutrition. Given the complexity of HPB, our extensive training and experience supports benign cases, suspected cancers and patients with a confirmed cancer diagnosis.

We meet and support patients through their treatment pathway. Treatment plans can vary for HPB patients which can include upfront surgery, neo-adjuvant surgery, specialist liver directed treatments (inclusive of trans-arterial chemoembolisation TACE or ablation), direct referral to Oncology for palliative chemotherapy or neo-adjuvant chemotherapy and best supportive care.

There is much variation within the HPB job role, we support consultant led clinics, assess patients on wards pre- and post-surgery. We update patients on the ward or in a clinic setting of investigations, results or diagnosis. We also manage and oversee nurse led surveillance clinics for cancer patients who have undergone HPB surgery. In addition, lead on clinics in the management of pancreatic cysts, Intraductal Papillary Mucinous Neoplasms and gallbladder polyps. We hold pre-MDT (Multidisciplinary Team meeting) alongside the HPB consultant lead and attend the weekly MDT meeting. The team are pivotal to all allied health care professionals because we communicate and coordinate HPB care/referrals.

We provide teaching sessions at trust level to ward based nurses to educate and impart knowledge of our role. This aims to support patients with HPB cancers who can encounter problems with nutrition, low muscle mass, pain, nausea, jaundice and pancreatic enzyme insufficiency. This in effect can improve psychological impact in the peri- and post operative setting for HPB patients. Sharing best practice aims to enhance and improve patient care.

More recently we presented at the Great Britain and Ireland Hepato Pancreatic Biliary Association Robotic meeting hosted at UHCW on ‘Patient reported outcomes After Robotic Surgery’. This meeting was attended by almost 200 people.

We are currently looking forward to joining the new national HPB CNS network COALESCE: creating a National CNS Pancreatic Cancer network to Standardise and improve care. This network will help the HPB CNS’s to share best practice in this specialist role on a national level.

Working in a specialist treatment centre for HPB we all love our job supporting this group of patients and strive to always provide a first-class service. We would recommend nurses to consider a role in the HPB cancer service, as well as rewarding, this speciality provides continuity of patient care and job satisfaction.

 

Changes made to Hospital@Home’s complex infection pathway

From Tuesday 2 May 2023, Hospital@Home's complex infection pathway is changing to a Complex Outpatient Antimicrobial Therapy (COpAT) service and will align to BSAC guidelines for outpatient parenteral antimicrobial therapy (OPAT) in adults in the UK.

This transformation has been made possible through a collaborative effort between our Infectious Diseases department, Microbiology department, pharmacy department and Integrated Care Service.

Changes have been made to the way in-patients are transferred:

  • Patients will no longer remain as Inpatients when accepted onto a COpAT pathway, they will be discharged by the referring ward on IPM and CRRS.
  • TTOs will need to be closed off by the referring ward doctors following acceptance onto the COpAT pathway.
  • Chronic medications will be managed by GP given that COpAT is an outpatient service; COpAT team will be responsible only for acute medication prescribing, supply, administration, and changes to the current regime (mostly antibiotics).
  • During COpAT treatment, patients will remain under an Infectious Diseases or microbiology Consultant to supervise the antibiotic treatment. All medical decisions will be addressed by this COpAT consultant, including the indication for COpAT type of antimicrobial, duration of therapy, site of administration, the type of intravenous catheter, and management of any possible complications. COpAT consultant will supervise the antimicrobial treatment, communicate any concerns with the discharge team, and liaise with other subspecialties when needed.
  • Other clinical issues that are specific to other specialty will remain with the specialism (e.g., joint concerns, chronic kidney disease on dialysis, etc)
  • There will be no changes to the referral process, all referrals will be made via CRRS Outpatient Hospital@Home referral form.
  • An admission and discharge letter will be available on CRRS for the GP and the referring team.
  • Patients discussed at COpAT MDT will all have a letter dictated which will be available on CRRS. The consultant responsible for the patient will inform the referring clinician of any changes if appropriate.
  • All those patients on the Hospital@Home current caseload (accepted prior to 2/05/23) will remain as Inpatients and under shared accountability between the referring and accepting consultant for the remainder of their treatment.

If you have any questions, please visit the 'Hospital@Home' TrustNav page.

 

Research showcased during Maternity March

Every year we welcome 6,000 new babies at UHCW, each one a joyous moment for staff and the proud parents.

For Paula McIlgrew and fiancé Jonny, the arrival of little Evelyn was extra special.

After three miscarriages, Paula was referred to Tommy’s and a research trial at UHCW in February 2020.

But there was further heartache when she suffered miscarriages in the October and in July 2021.

“You do have second thoughts when it keeps happening,” admitted Paula. “But it was something we wanted and I said I’d carry on until I physically and mentally couldn’t.”

That determination and perseverance paid off when she gave birth to Evelyn in November last year.

“She’s beautiful, it’s tiring but it’s been brilliant,” said Paula. “Every day is amazing, I’d do it all again.

“The help that we had at UHCW was amazing, we couldn’t have asked for anything better.”

For more details about research at UHCW, go to https://www.uhcw.nhs.uk/leading-research/about-us/

 

Research and Development showcase - Thursday, 18th May

Our Research and Development team will showcase unique exhibition stands for colleagues to learn more about how research can benefit their area on Thursday, 18th May.

This 2-hour drop-in session will be hosted on the first-floor atrium of the Clinical Sciences Building (CSB) from 11:30am, and will feature facts and examples from a range of different departments including Radiotherapy, Trauma and Orthopaedic, Vascular and more.

This is a fantastic opportunity to learn how our Research and Development team can work with your department, or about the different pathways available and exciting specialisms within Research.

There is no need to pre-book on to this event.

 

EPR Skills Training Begins in June

Please visit our ‘EPR Skills Training’ page on TrustNav. Here you will learn how staff will access E-Learning modules and register for classroom sessions.

  • E-Learning modules are available in June
  • Classroom training begins 24th July
  • Learn how much training different role groups need
  • Learn how to book training

Please note line managers and ward managers will need to register their staff into the classroom sessions. Once the session calendars are available, managers can align classroom sessions with staff rotas and availability.

Sessions calendars and information will be available very soon.

 

We need EPR Super Users!

The Trust are currently looking to recruit EPR Super Users to have in place to support others prior to, and during go-live. EPR Super Users should be technically savvy with strong computer skills and a good understanding of our existing applications and workflows.

EPR Super Users need to be able to invest extra time in additional training before helping and supporting their peers at go-live.

Please note that special EPR Super User training will be offered between 5th June and 10th July. Please plan accordingly and booking information will be shared with EPR Super Users as soon as possible.

To register to be an EPR Super User, complete this form as soon as possible. Line managers or ward managers can also put forward their colleagues using the same form. Once staff members are verified their line manager or ward manager will receive a confirmation.

For general questions, contact EPR.Programme@uhcw.nhs.uk

 

 

'Our daughter was in the absolute best hands' - Jenny Morris becomes our latest DAISY Award honouree

Our DAISY Award honour roll is shining brighter than ever following the addition of our latest honouree, Clinical Sister Jenny Morris.

The awards, funded by UHCW Charity, celebrate the skilful and compassionate care our nurses and midwives provide on a daily basis.

Jenny’s exceptional care was highlighted by the parent of a patient admitted to the Major Trauma Enhanced Care Unit after sustaining serious injuries.

The nomination read: “Jenny's calm, caring, non-judgmental approach made such a difference to a traumatic time in our lives.

“She cared for my daughter with so much patience, keeping us involved as much as she could and made sure I was able to stay with my daughter throughout her 12 days in hospital.

“All of this gave us such reassurance and we knew our daughter was in the absolute best hands. When she showed signs of improvement, Jenny treated her with respect, care and dignity.

“At the worst time of our lives, Jenny and her two colleagues Katy and Jess were the only reason we didn't collapse and even on the night I did fall apart, she allowed a HCA to take me outside for some fresh air.

“I won’t ever be able to repay her above and beyond kindness.”

Many congratulations Jenny.

 

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