Theatre and Surgical Nursing
Winner
The Christie NHS Foundation Trust: Dignifying surgery for a person with dementia and skin cancer
Patients with dementia and skin cancer were given an option of no treatment or treatment under general anaesthetic. Local anaesthetic was not considered in case they became distressed during surgery. Due to the increased, but avoidable, risk of a person with dementia developing delirium under general anaesthetic, a pilot was conducted in which a nurse accompanied the patient into theatre and delivered distraction therapy during surgery. The pilot was successful and this way of working has now become standard practice for the trust’s frailer patients. Financial savings have been significant, patient risk of delirium has been reduced and one patient even left theatre and told their carer “I’ve had a lovely day”.
Finalists
King’s College Hospital NHS Foundation Trust: Nurse-led discharge pathways for elective surgery
Perioperative nursing teams developed discharge pathways for elective surgeries to address patients occupying inpatient beds due to delays in clinician review before discharge. Transforming the culture and working methods of the multidisciplinary teams, and appointing a surgical pathway coordinator to supervise and support frontline staff and patients, resulted in reduced demand for inpatient beds, and positive progress in elective recovery.
Leeds Teaching Hospitals NHS Trust: Enhanced care unit
This four-bed enhanced care unit was
opened to ensure patient safety
following more-complex procedures or
procedures completed on patients with
more-complex needs. Nurse training
comprised a skills passport and criteria
to follow. There was an 80% success rate
in deliverance and completion of the
nursing skills enhanced care passport,
and feedback from both patients and
staff was excellent.
Leeds Teaching Hospitals NHS Trust: Utilisation of National Emergency Laparotomy Audit coordinator and launch of nurse-led clinic
The National Emergency Laparotomy Audit (NELA) coordinator role was developed, and a NELA telephone helpline and a weekly face-to-face clinic launched to improve the patient experience. Patients were able to contact the coordinator for advice after discharge, which acted as a safetynetting programme for them. This initiative also resulted in hospital readmissions being avoided.
South Tees Hospitals NHS Foundation Trust: Personal perioperative pathway for adult patients with additional needs
Staff telephoned patients with additional
needs, or their relatives, and asked
pertinent questions so any necessary
reasonable adjustments could be made
for patients due to have surgery. Bespoke
personal perioperative plans were
created, which led to positive feedback
from anaesthetists, who could better
prepare for the surgery, and patients’
relatives, who felt reassured that care
would be adapated as necessary.
Torbay and South Devon NHS Foundation Trust: Acuity based patient allocation
The volume of patients being operated on using the day-case pathway had increased, but estate capacity and staffing had not. Staff defined five categories of acuity and assessed individual patients to ascertain the nursing interventions required. By doing this, they moved from the traditional nursing model of one-to-one care to one based on acuity. No serious patient safety issues have occurred, patient handover has been faster and the number of late list finishes has reduced.