Thanks for your feedback, we have started to go paperless as a trust over the last year. We do have electronic observations and more recently careflow connect. It is currently being used for ward handovers and team referrals as the first stage. I am led to believe escalation referrals will be introduced at some point but not aware of our trusts timeline. The wards will need to complete the referral using SBAR format electronically. We will be able to edit what specific information we are looking for to reflect the current deteriorating patient SBAR tool.
Common models used for critical reflection in healthcare are Driscoll's model (what, so what, now what) or STARS technique ( situation, task, action, result, self-reflection).
Hope this is helpful 🙂
I have attached a copy of the collated results from the survey I conducted within my trust at the end of last year. The results were surprising to us, given our experience. The response was pretty unanimous that staff knew what SBAR was and why it would be used, they mostly all reported using the tool and stated that they would not change the tool.
As a team, we could only put the lack of SBAR referrals down to staff education and encourage them to use it more.
So I proceeded with the relaunch by revamping the old SBAR form into a pre-printed sticker that could be directly applied
I would be interested to know, if overnight, patients who score 0-2 on NEWS which has not changed with no concerns since the last set of observations, what your trust policy is on observation frequency?
Does your trust require observations to be carried out 4 hourly minimum regardless of patients NEWS score and stability?
Or if there are no concerns and the patient is clinically stable with consecutive NEWS 0-2 that they do not have observations taken overnight?
Looking forward to hearing what other trust practices are.
Hi @Rob Tomlinson, yes the 'Dragons Den' is just for staff at Kettering General for funding in order to implement new idea/ innovation for the trust.
I'm not sure what there rules are with potential out of trust applicants, but I'm happy to provide the contact email to you if you wanted to enquire further?
@Alex Entwisle Thank you for sharing your essay and your experiences, I am glad that you have been able to implement this within your department.
@Viranga I am more than happy to share the survey question and findings. I will be looking at collating the project into an article, i am currently in the stages of implementing SBAR stickers and am hoping to evaluate the effectiveness of them and whether the addition training and resources have made an impact.
I will be measuring the outcomes through a repeat survey and through our critical care outreach database, looking at wheth
We are looking into introducing a new device to deliver CPAP at ward level into our trust.
Currently we use NIPPY machines which can deliver some PEEP when in a selected mode, however the downfall to this is, it can only produce an oxygen concentration of around 50%. Often, the patient groups that require this intervention are on high oxygen requirements and so particularly in the early stages would benefit from a device that could deliver both.
I have previously worked with Pulmodyne 02-Max trio which allows up to 90% oxygen and PEEP up to 7.5cmH20. Majority of patients responded ve
I agree Claire, it becomes extremely difficult to screen those patients that have high NEWS but are stable with a plan and those that may not fit into certain categories that are at great risk of deterioration.
Part of the reason, I think, is because of the high quantity of patients that score NEWS throughout the day, and nursing staff feel they need to alert CCOT for majority of them, not because they are worried necessarily but because it says in the policy and they are worried that if they don't they will be held responsible.
In turn, we are conditioning the nursing population to
Thanks for your response @Danielle Haupt
The survey, through surveymonkey, has gone out to staff members direct to their emails and on our shared facebook page for the trust. Fingers crossed I get a decent amount of responses.
It is an interesting though putting it on twitter and finding out what the wider audience think, at this point I would need to gather data from my trust in particular, but after that could be an interesting option.
As a Critical Care Outreach nurse of many years, one of my greatest bugbears is SBAR handover, or there lack of!
Within my trust, there is an SBAR proforma attached to the NEWS2 chart, which appears to be fit for purpose currently. (We are still on paper obs charts, moving to e-obs by the end of the year)
SBAR is taught and embedding in all our teaching and training, the candidates at the time of the courses are all able to giver perfect SBAR handovers in simulation but as soon as they walk out the door all of that seems to disappear.
It is all too often we re
As Dani has already mentioned, the CCOT team at KGH are undertaking many QI projects and have been truly inspired both on this forum and through twitter.
It is providing us with great insight and most of all inspiration to push through. As we all know, spearheading change and QI is not an easy task!
We definitely need all the help we can get, and so will lap up all of the invaluable experiences other trusts have.
And hopefully, in turn can use this forum to share our experiences.
All the best, and looking forward to seeing more posts.