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Fundamental care

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It is important that patients receive the most uptodate technical investigations and treatments, such as MRI scans and the latest innovative drugs, but equally important is that they receive a good standard of personal care, in terms of such issues as staff attitude, nutrition and hygiene.
Essence of Care’ was an initiative launched across the NHS in 2001 with the aim of increasing the quality of such care. It is made up of a set of 12 benchmarks, each of which underpin the best practice all of our patients should receive while receiving our services. The 12 benchmarks are:
  • Respect and Dignity
  • Communication
  • Food and Drink
  • Bowel and Continence Care
  • Care Enviroment
  • Pain Managment
  • Personal Hygiene
  • Managment of Pressure Ulcers
  • Promoting Health and Wellbeing
  • Record  Keeping
  • Safety
  • Self-Care
We have implemented various initiatives within the Trust on the above themes and undertake regular audits and reviews to establish standards which support continuous improvements in patient care.  The two latest initiatives occurring are:
Nursing care indicators (NCI) Every month 10 nursing charts and other documents are checked at random on all general wards and departments at the Trust (in effect, 200 charts are audited in total per month) to ensure that nurses are undertaking activities that patients require and documenting that activity.
The themes looked at are:
  •  Patient observations (temperature, pulse, respirations etc)
  •  Pain management
  •  Manual handling and falls risk assessment
  •  Tissue viability – prevention of pressure ulcers
  •  Nutrition assessment and monitoring
  •  Medications
  •  Prevention of infection
  •  ‘Think Glucose’ (Monitoring Diabetes)
  •  Bowel Assessment
The system was expanded into the maternity, neonatal and paediatric units from 1st January 2012.
 The completion rates of each ward are fed back to the matrons and ward managers for action where necessary. Each ward and the whole Trust is RAG (Red/Amber/Green) rated with previously a ‘Green’ given for a 90 per cent or greater score, an ‘Amber’ for 89-70 per cent scores and a ‘Red’ for scores 69 per cent or less although due to improvements these have now changed to a ‘Green’ given for a 93 per cent or greater score, an ‘Amber’ for 92-76 per cent scores and a ‘Red’ for scores 75 per cent or less.
In the last year all aspects of care have improved across the Trust as shown below.

 

Harm Free care and NHS safety thermometer
In 2011-12 the Trust signed up to ‘Harm Free’ care, a project being rolled out nationally to help teams eliminate four types of harm:
  • Pressure ulcers
  • Falls 
  • Urinary tract infections (in patients with a catheter) 
  • Venous thromboembolism
Building on our existing improvements, ‘Harm Free’ care (meaning the absence of the above harms) can be measured using the NHS Safety Thermometer, so called as it provides a ‘temperature check’ on harm.