Marie Curie & SASH Hospital Palliative Care Team

58% terminally ill patients die in an acute Hospital.

Many people’s preferred place of death is their

own home, a Nursing home or Hospice.

Discharge Barriers Time

Co-ordinating discharge

Applying for funding

Packages of care

Nursing home availability

Equipment

Marie Curie and SASH joint project.

Two year pilot –

1.6 WTE Discharge Liaison 9:00-5:00 7 days a week

1 WTE Project Co-ordinator 9:00-5:00 Monday to Friday

8 WTE Healthcare Assistants 8:00-22:00 7 days a week Available to bridge gaps of care

support

All of these will actively work together to reduce the amount of bed days within an acute Hospital and enable

people to get to their preferred place of care in an organised and timely manner.

Capel Ward

Informing the public who's

who

Communicating with Multi disciplinary

team

A quiet place to talk to relatives

Meeting trust targets and

informing the public

Capel Ward Communication

• With our improved communication we have found our complaints have reduced.

• Dec 13 – April 14 – 3 complaints • Dec 14 – April 15 – 1 complaint

• Friends and family feedback has increased from 10% (May 14) to 55% (April 15)

• Feedback from relatives and patients is that they like the appointment system and that it ensures them some 1:1 time with the medical team

• Results discussed with the team at meetings and feedback via staff newsletters

Printing:HOLMWOOD WARD & CCU Promoting Excellence Through Staff Development.

About the Department

Holmwood Ward and the Coronary Care Unit (CCU),

provides acute medical care to those patients

suffering from a range of acute and chronic cardiac

conditions. Our nursing team is committed to

providing patient centered evidence based care,

combining care and compassion with clinical

expertise to ensure that patients receive a first class

service and a positive in patient experience at East

Surrey Hospital.

Staff Development

Fundamental to achieving this goal is supporting a nursing team who

understand the importance of best practice in the provision of holistic

care.

A journey begins when joining our department where basic and

fundamental nursing skills are developed under supervision to build a

sound foundation for future development.

Standards of practice are monitored, clinical strengths are homed in

upon to drive up our clinical standards and where high standards are

not achieved a positive learning process is implemented to address

and overcome weaknesses identified either on a departmental or

individual basis.

Once fundamental nursing skills are attained and maintained we

promote the development of our staff to extend their skills. We

strongly believe that continuity in care is essential to patient

experience and that for our nursing team to be able to deliver care

efficiently whilst having the expertise so that patients have confidence

and feel safe under our care.

New Staff Induction

All new nursing staff, regardless of grade, receive a structured induction period

where the focus is on becoming familiar with the units ethos of care.

This time is utilised to ensure that a strong base of core nursing skills are

established under the supervision of an mentor. An induction booklet has been

developed so that each new member of staff has a clear guide of the skills they

are to acquire and the competencies to be achieved which are signed off once

established.

Mandatory training will be attended during this time. This period of supervised

practice also allows any specific learning needs to be identified and addressed

with individual action plans put into place, if required, to support the new staff

member to achieve the units required standards of care. During this period staff

new to their role will be enrolled on the Trust programmes for Staff Nurse or

Health Care Assistant development to further support their learning.

V

a

r

i

a

b

l

e

s

/

R

e

s

e

a

r

Structured introduction to

the department, establishing

strong foundation nursing skills.

Induction

Development of extended skills promoting high quality care with technical skills

enhancing continuity of care.

Extended Skills

Development of specialist

advanced skills under supervision

and with full support of senior

nursing staff.

Advanced Skills

Practice of advanced and

specialist nursing skills in

cardiology.

Expertise

As our nurses become more specialised we further support continuing education and professional development. They now will undertake the Resuscitation Council's Advanced Life Support training course attaining a qualification which is utilised across the Trust in providing advanced resuscitation skills.

Registered nurses have the opportunity to undertake a Cardiology Acute Clinical Pathway at degree level facilitating their journey to nursing expertise in cardiology. Mentorship qualification is actively encouraged to support the promotion of an effective learning environment and allowing their increasing knowledge to positively influence the department.

In terms of practical support we are providing on going supervisory support by senior nurses to those who are gaining advanced skills in leading the nursing team in a critical care environment. They are able to gain confidence in their advance practice whilst knowing they always have senior support or advice available if required. In addition to this we are now introducing a practice development nurse role within the department to provide educational and practical support across the nursing team.

By the nursing staff being fully supported patient safety is fully maintained whilst confidence in independent practice is achieved.

Expertise is achieved through time, through experiences and a strong theoretical knowledge.

It is more than academic qualification. It is acquiring a true understanding of a condition, the risks, the treatment and most importantly what it means to the individual patients that we nurse.

Expertise is demonstrated when our nurses understand truly the impact of being in hospital, the risks patients are exposed to, the difficulties that can be encountered, the fear and the vulnerability that is experienced and can provide care that addresses all these issues in the planning and provision of care along side specialist cardiac nursing skills.

To help develop such a deeper understanding of patient care our senior nurses are involved in investigating complaints and clinical incidents. In performing personal development reviews for junior staff and participating in on the ongoing education of colleagues in the workplace.

Commendations and positive feedback is also relayed to the nursing team again enhancing understanding of what really matters to our patients when in hospital and what they expect from us.

Moving Forward

Holmwood Ward and CCU will continue to develop the training and

support it gives to its nurses in response to the evolving needs of the

patients that we care for, listening closely to patient experience and

continually reviewing our achievement against quality standards.

We will continue to work at maintaining a professional and friendly

environment where patients are safe and compassionately cared for

whilst benefiting from nursing expertise specific to their needs.

Supprting nurses through structured induction, formal learning and clinical supervision

Confident and competent staff

providing evidence

based patient centred care

Positive patient experience, continuity in

care. Patients feel safe and trust in the

nursing staff.

Advanced Skills

Extended Skills

Once all core skills and competencies have been achieved the

nursing staff are given opportunity to develop skills further. The

timescale for this will vary for each staff member but usually happens

from 6mths to a year in post.

For registered nurses and healthcare assistants there is opportunity to

develop skills in phlebotomy and cannulation. For registered nurses

Intermediate Life Support and Intravenous Additives certification also

enhance their practice as well as supporting a safe and efficient

caring environment where patients are familiar and confident in the

professionals around them.

In addition to practical skills it is now that the nurses begin to build

knowledge of cardiac conditions and start to enrich patient care and

experience by sharing knowledge, improving patients understanding

of their condition and helping patients to be empowered in their care

planning. In support of this opportunity is given to undertake

beginners courses specifically focused to cardiology.

Expertise

Dignity and Respect

We value each person as an individual and will challenge

disrespectful and inappropriate behaviour.

Compassion

We respond with humanity and kindness and search for things we can do, however small; we don’t wait to be asked because

we care.

One Team

We work together and have a ‘can do’ approach to all that we do recognising that we all add

value with equal worth.

Safety and Quality

We take responsibility for our actions, decisions and

behaviours in delivering safe, high quality care.

Our Values

Respiratory

Cardiology

Radiology

Acute Medical Unit

Emergency Care

Stroke

Haematology

Maternity

Theatres

Recovery

Endocrinology

General Medicine

Elderly Care

Critical Care

Paediatrics

Orthopaedics

Intensive Care

Outpatients

Women’s Health

Education

Day Surgery

Our specialities include:

What you can expect • Comprehensive induction to the ward

• Ward based teaching and mentoring

• Preceptorship programme and support

• Catalogue of training courses – both

internal and external

• Annual achievement review

• OSCE support (if applicable)

• Library membership

• NHS Discounts

• Pension

Why Us

Based at East Surrey Hospital (Redhill) and

Crawley Hospital, Surrey and Sussex Healthcare

NHS Trust is one of the top performing trusts in the country

We are one of the safest hospitals in the country

We have the best ‘Friends and Family’ score in the region

We achieved 100% for cleanliness in a recent inspection

Our staff are among the most motivated in the country and are

proud to recommend our Trust as a place to work and be

treated according to the latest staff survey

We achieved a ‘good’ rating from the Care Quality

Commission in our 2014 inspection

We are one of the top 100 NHS

employers according to the Health Service Journal

Are

you the

senSASHion

we’ve been

waiting

for?

Come

and join

one of the

top performing

trusts in England

For more information visit us at: www.surreyandsussex.nhs.uk

The

DAILY SASH Bucking the Trend: SASH

Nursing Numbers to RISE!

Thursday 7th May 2015

Following a very successful

recruitment campaign in the

Philippines, 158 nurses have been

selected to join SASH over the

summer months.

Seven members of staff from SASH

conducted over 200 interviews in

one week to select the right

candidates to help us care for our

patients more effectively.

These nurses will work across the

Trust, and following a period of

education and assessment, will

achieve their recognised UK

registration with the Nursing and

Midwifery Council (NMC).

In addition to the 18 Continental

Travel Nurses currently undergoing

their Overseas

their Overseas Nurses Programme

at the Trust, we can be assured that

qualified nursing numbers are on

the increase.

The Trust is counting on you to

welcome the new recruits and make

them feel part of the team.

Any questions or comment should

be directed to Sue Carr (Matron for

Workforce) by email or phone

(x2098).

Coming soon to a department near you:

Are you in your

Preceptorship

year?

We need your feedback!!!

Have you recently

completed your

Preceptorship?

We are in the process of

revising the Preceptorship

Programme; we will use agreed

standards (HENCEL, 2014) to

identify areas which could be

improved and ensure we

support the newly qualified

nurses in their first year after

university and onwards into their

career.

Are you a Nursing Assistant?

Are you new to care?

Have you worked at SASH for a while?

INTRODUCING THE

The Standards:

1. Your Role

2. Personal Development

3. Duty of Care

4. Equality and Diversity

5. Person Centred

6. Communication

7. Privacy and Dignity

8. Fluids and Nutrition

9. Mental health

10. Safeguarding Adults

11. Safeguarding Children

12. Basic Life Support

13. Health and Safety

14. Handling Information

15. Infection Control

ARE CERTIFICATE

The Care Certificate can help Nursing Assistants at

the start of their career, or those who have worked in

care roles for a while.

It is a set of national standards; it helps assure Trusts

that their Nursing Assistants deliver quality and

individualised patient centred care.

It offers the Nursing Assistant a structured approach

to their induction. It complements the specific

induction requirements for individual departments.

Completion takes place within the department, and is

supported by a mentor. It takes about 12 weeks and

is rewarded with a certificate.

Resources will be provided to all wards and

departments to support learning and assessment.

For any questions, contact Rebecca Maslin (Matron

for Practice Development) on ext. 2678 or by email.

Electronic Prescriptions and Medicines Administrations (EPMA)-

is the utilisation of electronic systems to facilitate and enhance

communication on prescribing and administration of medicines. It

provides a robust audit trail for the entire medicine use process.

BACKGROUND: In December 2014, EPMA was piloted for 10 weeks on the Ward with the main aim of improving patient safety through reduction of prescribing and administration errors that could result to medication errors and adverse drug events. It was funded by the National Programme for IT.

ORGANISATIONAL BENEFITS: • Wider improvements in Clinical

Practice. • Robust audit trail for the entire

medicine process. • Reduction in paper-based process

problems.

Welcome to Capel Annexe

RESULT: The pilot study done on Capel Annexe was a huge success. The used of the EPMA was proven to be safe and had reduced the medication errors. Nurses have shown more accountability and transparency of care to patients.

CLINICAL BENEFITS: • Reduction in medication errors. • More drugs are given on time. • Safety alerts noted when drugs

need reviewing or wrong doses/ timing

• Fully legible prescriptions • Alerts duplications or drug-drug

interactions. • Alerts for overdose warnings,

allergy and contraindications • Clarity when a drug is changed. • Documentation is more robust. • Guides inexperienced prescribers.

The overall result was overwhelming. The biggest benefits are less medication errors

and NO hunting for drug charts which means a more productive time with patients however; there are some generic limitations to EPMA

e.g. hardware, networks, training and support issues and errors still occur. EPMA can be

more appreciated if it can be rolled out Trust wide.

BACKGROUND: In December 2014, EPMA was piloted for 10 weeks on the Ward with the main aim of improving patient safety through reduction of prescribing and administration errors that could result to medication errors and adverse drug events. It was funded by the National Programme for IT.

BACKGROUND: In December 2014, EPMA was piloted for 10 weeks on the Ward with the main aim of improving patient safety through reduction of prescribing and administration errors that could result to medication errors and adverse drug events. It was funded by the National Programme for IT.

Overseas Nurses Programme

Care Certificate

Clinical Skills Training

Preceptorship

Role Development

e-Prescribing

Clinical hardware

Electronic documentation

Vital signs

Whiteboards

15 Steps

PREVENT

Recruitment

Bank / Agency Advisor

International recruitment

Safer Staffing

eRostering

Workforce Planning

Beccy Maslin Practice Development

Sue Carr Workforce

Lynn Sanders Clinical Informatics

Ward Accreditation

Ward Dashboard

Workforce Development

Career Progression

IELTS / ESL

Nursing Projects

Acuity Study

The Role of the Corporate Matrons

Setting up a New Service:

The Genetic Diabetes Nurse Led Clinic

I am taking a key role in a Health Education England / Scottish Executive funded project to look at the integration of

molecular genetic testing into diabetes care. There have been considerable scientific advances in the study of the

molecular genetics of monogenic diabetes, particularly the sub-group Maturity Onset Diabetes of the Young (MODY).

However, it is uncertain the best way for this information to be disseminated and, where appropriate, integrated into

clinical practice. Discussing genetic testing with patients involves numerous novel skills and it is our belief that it is

best to teach diabetes professionals about the small number of patients where genetic testing is important, rather than

referring large numbers to Clinical Geneticists, especially as the main issues for patients often relate to their diabetes.

MODY is a rare form of diabetes which is different from both Type

1 & Type 2 diabetes, and runs strongly in families. MODY is

caused by a mutation in a single gene. If a parent has this gene

mutation, any child they have, has a 50% chance of inheriting it

from them.

It’s important to know if you’ve got MODY, for the following

reasons:

• To make sure you get the right treatment and advice for your

type of diabetes (e.g. stopping insulin).

• As there is a 50% chance of a parent passing on MODY to

their child, you can consider and discuss the risk to any

children you have/plan to have.

• Genetic testing can be offered to other family members.

Aims & Objectives:

• To provide a new service for patients which will allow them to

be seen closer to home, in their own community

• To increase knowledge about the genetic types of MODY and

testing for these patients so that only appropriate patients are

referred for genetic testing.

This has been a great opportunity to extend my knowledge and provide a completely new service for my patients & Trust.

I would like to take the opportunity to thank my manager in supporting me in this project.

Susan Stockley

Lead Diabetes Specialist Nurse

Results:

• I have received specific training about genetic testing in

diabetes from Exeter University; this will be ongoing three times

per year.

• The Genetic Diabetes clinic is now set up and running monthly.

• I am already investigating 3 family’s genetics and have adapted

their medications accordingly.

• All aspects of this new initiative are being evaluated not only

locally but by Exeter University and Health Education England /

Scottish Executive.

IBD SERVICE SURREY & SUSSEX

IBD Nurse

Stoma Nurse

Dietician Pathologist

Surgeon

PATIENT IT Support

GP

Psychologist Radiologist

Consultant

IBD SERVICE

DON'T DELAY THINK DISCHARGE EVERYDAY

• Discuss patients expected date of

discharge and medically fit for

discharge date everyday at bed

board

• Liaise with OT/ Physio/SALT for any

assessments required for safe

discharge

• Ensure all relevant

referrals and documents

are complete once EDD

agreed

• Request residential home

assessments when MFFD without

delay

• Complete checklist if required

without delay

• Ensure Electronic Discharge

Summary is completed

• Ask pharmacy to screen TTOs

• Discuss with relatives if they are

able to collect

• Book transport if required

• Check patient has key/key safe

number

• Complete District nurse

• referral if required

• Complete nurse transfer

letter if required

• Ensure patient has food/heating at

home

• Liaise with care agency, safe

timing of discharge

• If required prepare supply of

wound care dressing

• Remove cannula

• Discuss planned discharge with

site manager daily

• Appropriately assessed patients to

be sent to discharge lounge

overnight

• Complete patient property

• Check TTOs

• Print out EDS/MAR chart

• Ask patient/ friends/ family to

complete friends family test

• Upon discharge update bed board

• Document in Bed Returns

Lisa Hollis

Junior Sister

Bletchingly Ward

READY STEADY GO

Mouth Care Matters is an HEKSS funded initiative to improve mouth care for hospitalised patients. It has been developed at East Surrey Hospital and aims to empower hospital staff with the knowledge and tools to improve

mouth care on the wards.

Inpatient Care

Doctors

Nurses

SALT team

Dieticians Occupational

therapists

Pharmacy

Mouth Care team

Oral health and our aging population • Our population is getting older, over 20% of the UK

population will be older than 65 in 2020 • We keep our teeth for longer • Older patients have more complex dental treatment

which requires more care • Older patients have more medical conditions that

affect their ability to look after their mouths

1968 = 37% No teeth 2008 = 6% No teeth

East Surrey CQC Report 2014 ‘We saw that some patients on wards appeared to have dry mouths. There was no record of mouth care being given. There was no consensus on the medical wards of how and where episodes of mouth care should be recorded, and it was rare to find it had been.’

Impact of hospitalisation on oral health • Increase in hospital acquired infections • Poor nutritional intake • Longer hospital stays • Increased care costs

Terezakis et al, 2011

Training • Interactive teaching sessions on mouth care for nursing staff

and other health care professionals involved in mouth care • Ward based training and support by the mouth care team

Findings at East Surrey Hospital 2015 • An audit found in seven medical wards there were oral

health assessments, in 0% of notes • A survey found less than 50% of nursing staff have had any

training in mouth care • More than 90% of nursing staff would like mouth care

training • 100% of the nurses who attended a mouth care matters pilot

session said this training should be mandatory • Current mouth care practice is not up-to-date and wards do

not have the equipment to provide good mouth care • There were 11 dentures reported as lost at East Surrey

Hospital

Evidence shows a link between oral health and: • Hospital acquired pneumonia • Ventilator assisted pneumonia • Heart disease • Stroke • Diabetes • And more…

Mouth Care Matters – A New Model of Care

We will provide you with the skills to deal with these mouth conditions that develop in inpatients at East Surrey Hospital

We are introducing: • Mouth Care bundles • An alternative to foam swabs which have been shown to be unsafe

& not effective • Dry mouth care • Toothbrushes and toothpastes more suitable for hospitalised

patients

Why do we need Mouth Care Matters?

Electrocardiograph-based PICC tip verification system Intravenous Nurse Specialist – Jill Clarke

331

374

119

69

226255

4860

50

100

150

200

250

300

350

400

2007 2008 2009 2010 2011 2012 2013 2014

When the nurse led Peripherally Inserted Central Catheter (PICC)

service introduced an upper arm, ultrasound guided insertion

technique the success rate increased to 99% and the service

expanded to include parenteral nutrition, haematology/oncology and

difficult to cannulate patients.

This change resulted in a very significant increase in the demand

for PICC’s, saving valuable anaesthetic and theatre time.

In 2014 the Intravenous Nurse Specialist (INS) changed to an

electrocardiograph (ECG) PICC tip verification system.

The correct positioning of the PICC tip at the cava-atrial junction is

essential to avoid serious complications.

The INS inserts PICCs at the bedside as a single-handed procedure.

Historically, a chest x-ray was ordered post PICC insertion to check

for satisfactory PICC tip position adding time, cost, radiation

exposure and treatment delay. Malposition could require post-

procedural adjustment or even reinsertion.

The ECG system gives real-time, accurate confirmation that the

PICC tip is in the correct position allowing immediate

commencement of intravenous therapy and improved patient care

and confidence with the procedure.

The change to ECG tip verification

• Allows the INS to work more efficiently

• Reduces the number of CXR’s ordered

• Reduces patient exposure to ionizing radiation

• Reduces delays in PICC use

• Reduces line complications associated with

malpositioned PICC’s

• Reduces manipulations of dressing to re-position

PICC

• Significant cost savings.

The change to a Power PICC and an ECG tip

verification system provides safer patient care,

improves the patient experience and is a cost saving

of at least £40,000 per year.

• Do you like teaching?

• Are you interested in clinical education?

• Are you already in a Practice Development or

Clinical Educator role?

Practice Development needs YOU!

Hello, my name is Beccy Maslin. I am the Matron for Practice Development. I’m new to SASH and want to get to know you. I probably need to tell you a bit about me: I started my career in health at Worthing Hospital as a Nursing Assistant. After completing my nurse training in Cambridge I have worked in a few different roles including Cardiothoracic intensive Care, Cardiothoracic surgery (ward), Clinical Education and service transformation. With me in the new Practice Development Team are Sue Pirie (Lead Nurse for Practice Development) and Luisa Espiritu (Clinical Skills Trainer). We work closely with the wards and departments as well as with Education and Training, the PGEC and nursing leads. I am really excited to join you at SASH, and hope we can continue to improve on what is already a fantastic level of quality patient care.

I want to set up a network of like minded people to

help support each other, share ideas and ultimately

improve the quality of care we deliver at SASH.

Register your interest: Rebecca.maslin@sash.nhs.uk or phone x2678

Could you spare an hour a month?

Perceptions of the Critical Care Outreach service: a staff survey Critical Care Outreach Team. May 2015

Surrey And Sussex Healthcare NHS Trust

Methods: A convenience sample of 200 doctors and nurses in 10 clinical

areas were asked to complete a simple questionnaire.

Information about the survey was provided, participation was

voluntary and anonymity assured.

Excellent 86%

Good 14%

Satisfaction with CCO Service Introduction: Evaluations of Rapid Response Systems (RRSs) have tended to base their effectiveness on physiological outcomes such as the rate of cardiac arrests, the number of unexpected admissions to intensive care and patient mortality1; there has been less interest in other benefits such as staff support and education2 3. A survey was conducted to identify how clinical staff perceived and utilised the CCO service in the East Surrey Hospital.

Clinical areas : • Medicine - AMU, Charlwood, Tilgate, Tilgate Annex. • Surgery - Buckland, Copthorne, SAU, Woodland. • Orthopaedics - Leigh. • Emergency Dept.

Main themes derived from data: 1. Patient safety

• CCO related improved patient care & outcomes. • Providing support & advice.

2. Team attributes • Always accessible. • Reassurance for ward staff. • Teamwork with peers & colleagues. • Augmenting doctors care.

3. Team skills • Expertise. • Knowledge & skill.

4. Accessibility • Prompt response. • 24 hour service & access to ICU.

31% 24% 24% 20%

1%

ClinicalConcern

EWS Trigger NIV AssistanceWith Patient

Other

Reason for referral to CCO Results:

• Eighty three questionnaires were returned (41.5%). • All respondents had used the CCO service. • Sixty nurses and twenty three doctors responded. • Overwhelmingly there was a perception that CCO

involvement had assisted in managing their patient. • There was significant support for the CCO service and

four main themes were derived from the qualitative data.

Discussion: The Critical Care Outreach service makes a significant contribution to the detection, prevention & management of patient deterioration. It provides invaluable support, skill & expertise to the hospitals' clinical teams. The survey indicates the additional benefits that CCO teams can bring to the clinical teams, organisational processes & the patients’ experience. The survey suggests the value of the CCO service, a platform from which we can develop & shape team attributes & skills to meet future service needs, such as developing the new respiratory ward & the move towards Foundation Trust status.

References 1. McGaughey et al (2007) Outreach and EWS for the prevention of intensive care admission and death of critically ill adult patients on general hospital wards. Cochrane Systematic Review.18:CD00552. 2. Richardson et al (2004) Ward nurses’ evaluation of critical care outreach. Nursing in Critical Care:9(1);28-33 3. Salamonson et al (2006) Voices from the floor: Nurses’ perceptions of the medical emergency team. Intensive and Critical Care Nursing.22:138-143

++++++++++ How can we improve the support for families and friends of people with a diagnosis of cancer?

Clinical Nurse Specialist (CNS)

A key role of a CNS is to provide support and information both verbal and written to people and their families who have been diagnosed with breast cancer. Traditionally, the information supporting the person with a diagnosis of cancer carers is aimed at the person’s partner.

Macmillan Cancer Support

Across the UK, over one million people look after someone with cancer, yet half of them don’t receive any support. Many people who look after someone with cancer don’t see themselves as a carer, so don’t know that there is help available. Yet caring for someone with cancer can affect people’s own health, mental wellbeing, working life and relationships. Lack of support to carers can lead to an increased need for health and social care services, for the carer and the person they’re caring for. (Macmillan 2015)

Teamwork

As a team we regularly review and reflect on the information given both verbal and written. Many people we see in clinic are supported by various people including family members, friends and work colleagues. In this situation we felt that the information on support did not take into account that not everyone has a partner.

Carer’s Event

In June 2014 we held our first Carers Event held

in the Atrium in the PGEC.

Feedback The feedback form both the organisations who

took part and the people attending was that

many people who have someone close to them

effected by cancer do not see themselves as

carers and are not aware that there is support in

many forms from many sources from practical

to emotional support.

Reflection

Reflecting on the event the

CNS team considered ways

as to how we could increase

the awareness of the

partners, friends or relatives

of the support that is

available for them both

locally and nationally.

Action We have installed three Macmillan information racks in the outpatient’s department ensuring that there is a supply of appropriate publications. We know that the publications are being taken as we have to regularly restock We also wanted a more targeted approach to providing this important information as highlighted by Macmillan and our own personal experience is that the people that the publications are aimed at may not see themselves as a carer and therefore do not take them. After reviewing a number of publications the CNS team decided that a selection of three key publications along with a letter from the CNS

explaining the aim of the ‘partners and friend pack’ would be put together and placed in a bag to create a ’pack’

The ‘packs’ are now available for the CNS to give out when and where they feel it is most appropriate.

We have been using the ‘packs’ for the past few months and

have received positive verbal feedback.

We have shared the concept of the ‘pack’ with other CNS’s

within the Trust, at a regional breast CNS meeting and at a

national meeting to which a positive interest in the packs

was shown.

We plan to do an audit to find out if people have found the

packs useful and what other information people would like

included.

We will be holding our second carer’s event on Tuesday 16th

June 2015 from 10.30-2.30 in the atrium of the PGMC.

Macmillan Clinical Nurse Specialists (breast)

Liz Darragh, Jan Horner, Sue Gattinesi & Chris Turner

It has long been felt there is a need to offer a remembrance service for all the

families of patients who die at East Surrey Hospital and not just those

known to the palliative care team. Over the last year there has been a working

group looking into this involving members of the Chaplaincy

department, Palliative Care Team and the bereavement office.

National Institute of Clinical Excellence recommendation in the Supportive and Palliative Care

Guidance (NICE 2004) that individuals should be offered bereavement support as part of good practice

Families are given an ‘invite’ when they come to

collect the death certificate………

The first service of remembrance, ‘A Time to Remember’, will be held at SASH on May 9th

at 11.30am.

This is planned to be a twice yearly event and will consist of a short

non-denominational service with readings and music followed by

refreshments and the opportunity to talk with various team

members. We are delighted that the Brigitte Trust will be able to support the service by providing

representatives.

We will audit the service in preparation for the next service which will be held on 21st

November 2015

There are approximately 1200-1300 adult deaths in East Surrey hospital annually

tg ©

What Does AMU Nursing Mean to Our Patients?

What Does AMU Nursing Mean to Our Team?

Multi-disciplinary teaching from

the medical team

Specialised respiratory nurses

Ward based nurses

Discharge liaison nurses, matrons and

pharmaceutical reps

RESPIRATORY

FAILURE

OBSERVATION

CHARTS - EWS DISCHARGE

PLANNING

CHEST DRAINS

MANAGEMENT TRACHEA

MANAGEMENT

CHRONIC LUNG

DISEASE

Team building Interactive quiz

Feel valued

Improve care

Informative

Gain knowledge

Empowered

Practical session

Specific to your role Investing in you