Patient Safety Improvement

Winner

The Newcastle upon Tyne Hospitals NHS Foundation Trust: A collaborative model of meningococcal vaccination response monitoring for patients receiving complement inhibition

Some patients at the National Renal Complement Therapeutic Centre (NRCTC) receive eculizumab, a C5 inhibitor that increases the risk of meningococcal sepsis more than 600-fold. This is mitigated via vaccination and antibiotic prophylaxis but, as patients were geographically disparate, NRCTC specialist nurses noted a deficiency in local monitoring. Working with stakeholders, new service level agreements across all trusts were negotiated and implemented, resulting in an innovative system to increase monitoring of meningococcal titres and revaccination. The scheme’s success has resulted in a wider roll-out.

Finalists

Blackpool Teaching Hospitals NHS Foundation Trust: Operation Provide

NHS-employed independent domesticviolence advisers attended incidents ofdomestic abuse with the police to deliverrisk assessments, safety planning, andemotional and practical help. Havingsupported more than 3,000 people, theinitiative has been launched as a nationalhomicide prevention framework.

Bolton NHS Foundation Trust: Enhanced Care and Support Team

Innovative therapies were offered to patients at risk of harm due to cognitive decline, falls and challenging behaviors. Therapies offered included personal care assistance, haircuts, arts and crafts, and music therapy. Huge financial savings were made, and violent or aggressive incidents fell by more than 65%.

Dartford and Gravesham NHS Trust: Clinical nurse tutors

To combat a rise in medication errors and delayed care, clinical nurse tutors were introduced to educate and support more junior nurses. Inspiring them to upskill in their clinical environment proved successful in improving patient safety.

Kettering General Hospital NHS Foundation Trust: Call 4 Concern: implementation and one-year review

Call 4 Concern was rolled out trust wide 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 deterioration was reduced.

Kingston Hospital NHS Foundation Trust: Nasogastric feeding tube safety

An adult nasogastric feeding tube audit and competency assessment pathway was devised, comprising scenario-based training, ongoing education, routine reviews and spot-checks. There are now more competency-assessed nurses, better compliance audit data and improved reporting of near misses.

Lancashire and South Cumbria NHS Foundation Trust: The Bus Stop

To reduce self-harm and aggression/ violence on an acute mental health ward, the ‘bus stop’ – chairs strategically placed between communal areas and bedrooms – became an area where brief therapeutic interventions, such as relaxation activities, were delivered to aid mental wellbeing. Concerning incidents reduced and service users reported feeling supported.

Medway NHS Foundation Trust: Acute and emergency medicine collaboration to maximise community safety

This project to substantially reduce ambulance handovers and patient harm meant building inter-service trust where relationships had been fragile, or even hostile. Roles and procedures were amended, and same-day emergency care access improved, leading to fewer delays.

Nottingham University Hospitals NHS Trust: Advanced practice governance maturity matrix

A nursing advanced practice (AP) lead role was established to understand and implement AP governance to underpin patient safety across the trust. A maturity matrix was developed to ensure a positive, asset-based approach to building a patient safety culture around AP roles. It has been adopted by multiple employers.

The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust: Let’s Get Moving

This quality improvement initiative to prevent deconditioning in older patients on Feltwell Ward set out to get them out of bed and dressed, and enhance their wellbeing. Innovative methods resulted in significant improvements in their functional independence, optimized patient flow and happier staff.

Shropshire Community Health NHS Trust: Named nurse in community nursing

A new model of care was rolled out in the community nursing service so each patient had a named nurse responsible for their assessments, care plans and treatment reviews. Serious incidents and complaints reduced, patient feedback was positive and staff job satisfaction rose, improving retention.

Spire Healthcare: Reducing the incidence of post-operative hyponatraemia and improving care

Patient safety incident reports showed that hyponatraemia cases were higher than expected after major joint replacement surgery. A new team that was set up to address this developed a nurse training package, and created guidance and prompts for staff . Hyponatraemia cases dropped by 70%.