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The Scottish Patient Safety Programme. Improving HSMR in NHS Ayrshire and Arran. Improving HSMR in General Ward. Back to Basics programme designed to directly support the work of the Emergency Response Team, ensuring that staff are:

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the scottish patient safety programme

The Scottish Patient Safety Programme

Improving HSMR in NHS Ayrshire and Arran

improving hsmr in general ward
Improving HSMR in General Ward

Back to Basics programme designed to directly support the work of the Emergency Response Team, ensuring that staff are:

  • Aware of patient safety issues on a daily basis through safety brief ‘huddles’
  • Accurately measuring MEWS, identifying and responding to patient deterioration
  • Escalating patients effectively through SBAR communication at all times
improving hsmr in general ward3
Improving HSMR in General Ward
  • Achieving sustainability and spread
  • Measuring compliance with MEWS weekly, improvement methodology to drive improvements
  • Monitoring daily safety briefs to ensure effectiveness and compliance
  • Evaluating quality of exchange using SBAR for escalation of patient concern and for ward communication between staff e.g. handover/transfer
improving hsmr in general ward4
Improving HSMR in General Ward

Emergency Response Team

Managing the Acutely Unwell Patient

Barbara Cowley & Gaynor Campbell

ANP Clinical Managers

NHS Ayrshire & Arran

improving hsmr in general ward5
Improving HSMR in General Ward

Emergency Response Team

  • Team of Doctors and Nurses with advanced life skills
  • Respond to emergency calls following an acute deterioration in a patients condition
  • Aim to administer treatment and prevent unexpected ICU admission, cardiac arrest or death
improving hsmr in general ward6
Improving HSMR in General Ward

Prior to Pilot

  • Buy in of ANP team
  • Buy in of Ward team
  • Switchboard
improving hsmr leadership call out criteria
Improving HSMR – LeadershipCall Out Criteria

Emergency Response Team callout Criteria – General Ward Area

  • Airway
    • Any airway compromise
  • Breathing
    • Respiratory Distress/ progressive dyspnoea
  • Respirations less than 8/min or greater than 30 min(new, persistent)
  • Sa02 less than 88% on oxygen(new, persistent)
  • Increase in oxygen requirements to 50%
  • Circulation
    • HR >130 or HR< 40
  • Blood pressure less than 90mmHg (new, persistent)
  • Symptomatic dysrythmia
  • Disability
    • Acute change in mental state
  • Decreased responsiveness (new, persistent)
  • Seizure activity
  • Exposure
    • Uncontrolled pain despite treatment
  • Staff concern e.g. sustained chest pain despite nursing intervention
  • Uncontrolled bleeding
slide8

Patient in Cardiac Arrest?

Activate the Cardiac Arrest team via 2222

Does the Patient meet the ERT call out criteria or are they triggering a MEWS >4

Patients own team unavailable or unable to attend in 30 minsor request ERT activation

Contact Patients own team, develop a continuing plan of care

Activate

Emergency Response team*

ERT team Assess and initiate appropriate intervention

Documentation by ERT, follow up protocol activated

Contact Patients own team and develop a continuing plan of care

improving hsmr in general ward9
Improving HSMR in General Ward

During Pilot

3 full ERT activations:all appropriate

2 patients Sepsis

1 patient Acute Coronary Syndrome

improving hsmr in general ward10
Improving HSMR in General Ward

Post Pilot

  • Evaluation

“There is a feeling of comfort and support knowing there is a team available if we are in trouble.” Senior Charge Nurse

“it’s good to know we can get urgent help if things are going wrong”

Staff Nurse

“The fact you can get advice is great”. FY1

  • What could be improved?