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
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
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
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’
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’
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?
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
Dementia – Improving Care at the Bedside
• 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:-
Dementia – Improving Care at the Bedside
Dementia – Improving Care at the BedsideThe Board Round – Pros and Cons
- Daily - MDT - Improved communication - Training - Safety - Drives discharge planning
- Time - Timing - Confidentiality - Attendance
Motto – “if we get it right for patients with Dementia – we get it right for everyone!”
Thank you!