Critical and Emergency Care Nursing
Winner
Southport and Ormskirk Hospital NHS Trust: Introducing the pause after a death on the critical care unit
During the Covid-19 pandemic, many measures were put in place to help staff with the aftermath of multiple deaths and trauma. The most powerful of these was pausing work and holding a minute’s silence at a set time to honour the deceased, so the concept was introduced for staff and families on the critical care unit. What this might look like in practice was explained to staff and a reference card was produced for them to read at the bedside. Putting such personal touches into end-of-life care helped staff to support each other and process what can be an emotionally difficult part of the job. Feedback from staff and families was very positive, and there is a desire for ‘The Pause’ to be rolled out to other departments.
Finalists
Blackpool Teaching Hospitals NHS Foundation Trust: Emergency department nurse navigators
Specialist safeguarding nurses with
training and experience in adverse
childhood experiences, trauma-informed
care, sexual and criminal exploitation,
and safeguarding were employed as
emergency department navigators.
Visiting hotspots to locate children
at risk of harm, they work to prevent
them from becoming victims of
violence. Expanding the service from
Blackpool to span Lancashire reduced
health inequalities, serious violence and
knife crime.
Blackpool Teaching Hospitals NHS Foundation Trust: The ED project: timely and responsive specialist palliative care assessment at the ‘front door’
Emergency department (ED)
admissions to hospital are known to
increase for people in their last year of
life, but early palliative care involvement
can reduce length of stay. This project
aimed to provide timely specialist
palliative care support in the ED to
reduce unnecessary admissions. A
dedicated bleep was used during
normal working hours and 78 bed days
were saved in one year.
Calderdale and Huddersfield NHS Foundation Trust: BLOSM: a trauma-informed approach to emergency care
After an audit of emergency
department presentations, a range of
interactive social pathways were developed – with the support of
partners from Calderdale and Kirklees
councils – to meet local people’s needs.
Published online, these ranged from
advice on dog bites to support for
people attending with issues relating to
homelessness, and drug and alcohol
misuse. Shaping service delivery based
on communities’ needs has led to
positive outcomes for service users.
Essex Partnership University Hospital NHS Foundation Trust: Mental health urgent care department
As mental health crisis assessment and support via an acute emergency department (ED) was far from desirable, a mental health urgent care department was opened in Basildon. With a diverse and highly skilled workforce, the service reduced the number of patients attending Basildon Hospital’s ED by an average of 67% in its fi rst six weeks. It also helped patients in crisis to return home safely when, previously, they may have been admitted. Feedback from patients and other professionals was excellent.
Kettering General Hospital NHS Foundation Trust: Call 4 Concern: implementation and one-year review
Call 4 Concern (C4C) was rolled out
trust wide in an attempt to give patients
and relatives direct access to critical
care outreach services to prevent
clinical deterioration and improve their
experience. Feedback from service
users was overwhelmingly positive and,
in one year, clinical deterioration was
prevented in at least three cases.
St Helens and Knowsley Teaching Hospitals NHS Trust: Specialist palliative care at the front door
Palliative care patients often present
to the emergency department (ED)
in crisis. As their needs can be complex,
a clinical nurse specialist (CNS) was
placed there fi ve days per week, 9-5pm.
Working with specialty coordinators,
the CNS prioritised patients for direct
moves out of ED. More than 500
patients were assessed, and a care plan
was devised for each on the same day.
Sta surveys showed the support was
greatly valued.
Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust: Electronic SBAR
This initiative aimed to reduce time that
beds were empty on the assessment
wards and make the patient handover
from the emergency department to
those wards easier. Handover was
changed from a telephone process to an
electronic SBAR (situation, background,
assessment, recommendation) format.
This freed up ED standrand coordinators’
time, beds were empty for shorter
periods and patient care improved,