The James Paget University Hospital has been shortlisted in four categories in the national Nursing Times Awards thanks to three innovative projects to save and improve lives.
The Trust’s ‘Kissing Goodbye to Sepsis’ campaign has been shortlisted in the Patient Safety Improvement category, while ‘A Modified Approach to Pulmonary Rehabilitation’, which aims to give people with lung disease new ways of coping with their condition, has been shortlisted in the Respiratory Nursing category.
A third project – the VIP Pathway ‘you are important to us’ – has been shortlisted in two categories, the Learning Disabilities Nursing section and Enhancing Patient Dignity field, as it provides a bespoke service to the most vulnerable patients admitted to the hospital.
Kissing Goodbye to Sepsis aims to raise awareness of this life-threatening condition to help identify and treat it quickly – which can be crucial to patient care and recovery.
Sepsis occurs when the body’s response to an infection injures its own tissues and organs. It can lead to shock, multiple organ failure and death if it not recognised early and treated promptly. Sepsis is one of the biggest killers. Every year there are 150,000 cases of Sepsis in the UK resulting in a staggering 44,000 deaths - more than bowel, breast and prostate cancer combined.
Since introducing the campaign the James Paget University Hospital has seen an increase in patients being treated promptly, thanks to a change of culture brought about by the campaign, which encourages all health professional within the hospital to be alert for the symptoms.
Transformation Nurse Joan Pons-Laplana is leading the drive to help staff identify patients with Sepsis quickly, as administering anti-biotics within 60 minutes can save lives.
He says; “To be short-listed for the awards is a fantastic achievement, but it has been the hard work of staff at the hospital over the course of the past year that has seen such a dramatic improvement, making the trust one of the best and most improved in the country.
“When we started the campaign the James Paget was average in national tables, but this was not good enough. We formed a group including doctors and A& E nurses to see what could be done to improve awareness. We wanted every front line professional – anybody who came into contact with a patient – to be able to identify symptoms and to ask ‘could this be Sepsis?’.
“When identifying Sepsis set observations are the key. We wanted to make it easy, so we created a new form on the back of the hospital’s observation chart with simple tick boxes to identify red flag symptoms and help recognise the condition – if any one of seven key factors are identified it is escalated. We also empowered nurses to be able to administer the anti-biotics if Sepsis was suspected, giving them the opportunity to intervene quickly.”
The James Paget University Hospital is now one of the most improved and best trusts in the country for treating Sepsis thanks to the campaign, with the hospital increasing the percentage of those treated within 60 minutes in A&E from 68% in July 2016 to 90% in July 2017. Those on wards treated within 90 minutes has increased from 58% to 86%.
Joan says; “There’s nothing better than knowing this work is saving lives and we’re now sharing this good practice with other trusts. By treating quickly we’re also reducing the length of patient stays in the hospital which has benefits for everyone.”
A Modified Approach to Pulmonary Rehabilitation also has care for patients at its heart – with the aim of finding new and innovative ways to make life better for those with lung disease. The nursing team have already won a prestigious national award – after being named national Respiratory Team of the Year 2016 by the Association of Respiratory Nurse Specialists – for their work with patients living with breathing problems and lung conditions, but this specifically recognises the programme of support and continuing care to encourage rehabilitation.
Respiratory Nurse Specialist Fiona Lang said they aim to improve the quality of life for those with breathing difficulties.
“Pulmonary Rehabilitation is a therapy offered to patients with chronic lung disease and it has been shown to be of significant patient benefit whilst being one of the most cost-effective treatments available.
“We offer pulmonary rehabilitation to patients with a confirmed diagnosis of lung disease who experience different levels of breathlessness and dysfunction. For those patients who experience the most severe level of breathlessness, we found that only 13% of patients would take up the offer of pulmonary rehabilitation. We recognise that it is difficult to come along if walking even a short distance makes you feel uncomfortably breathless, but we also know a lack of movement can lead to muscle weakness which increases breathlessness.
“We need to have a new approach to give patients confidence and designed the ‘Modified Pulmonary Rehabilitation Programme’ to help our patients with their breathing and the daily challenges this presents. We invite patients to attendthe gym to discuss these difficulties. We share with our patients breathing control techniques, improve posture and give them simple seated exercises to perform whilst coordinating their breathing. After two weeks of homework, our patients are invited back to the gym to explore whether they would like to undertake full pulmonary rehabilitation.
“This approach has seen us work more effectively with our partners at Body Wellness Ltd and we deliver sessions both in B’Well Gym Great Yarmouth and Water Lane Leisure Centre in Lowestoft. By combining activity and educational sessions we hope to improve the quality of our patients daily lives.”
The programme has seen significant results, with the latest figures from April 2016 to March 2017 showing that 47% of patients are now attending and, of those who do attend, 62% are completing at least part of the scheme. When compared to national figures, the programme appears to be performing well with better completion rates for patients attending.
As Fiona says; “We believe the service is needed, and it can be transferable and cascaded nationally, and this will form the basis for our presentation to the Nursing Times judging panel.”
The VIP Pathway ‘you are important to us’ project was designed to provide a seamless and personalised approach to ensure vulnerable adults admitted for theatre procedures are looked after at every stage. Staff at the hospital work closely with family carers and community colleagues to make the experience for those with learning disabilities and/ or autism and dementia as caring and comfortable as possible. Prior to the Pathway being put in place some theatre cases were cancelled at the anaesthetic phase due to patient anxiety. The project means family members and carers are invited into anaesthetic and recovery rooms as standard, that there is the opportunity to visit in advance of the appointment, and that packs are given to familiarise the patient with what they may see during their visit.
Rebecca Crossley, Learning Disabilities & Autism Specialist Nurse, said; “From the moment an individual is identified as needing hospital services the team will set up and plan every part of the person’s admission and treatment through to discharge.
“We discuss with the family, carers and patients what their requirements are, with a pre-operative planning meeting to meet staff involved in the operation. Staff are supported by the Trust’s Learning disability team and dementia team and the aim is to let family and carers know that there is extra support to prevent distressed or anxious moments.
“The feedback has consistently been that patients are more settled and family carers feel reassured as they are able to stay with their loved ones.”
Last year the VIP Pathway saw a saving of £56,000 through the reduction in theatre cancellations.
Julia Hunt, Director of Nursing said; “I’m incredibly proud that the James University Hospital has been shortlisted in four categories. It shows the excellent work that nurses are leading to drive innovation to improve our services for patients.”
The teams behind the four entries will now travel to London in September to present to the judging panel ahead of the awards being announced on November 2.