This article describes a nurse-led telephone service that was introduced to improve the quality of patient discharge from the emergency assessment area (EAA) of a large NHS acute teaching trust. The service originated from concerns regarding the increasing volume of telephone enquiries received from patients after discharge. In addition, an audit of patients' discharge plans revealed a minimalist/cursory approach to documentation. To improve discharge practice, a nurse-led telephone follow-up was introduced for all patients within 24 hours of discharge from the EAA. Evaluation over the first 12 months demonstrated improvement in the quality of discharge documentation and more explicit discharge plans. The service has successfully addressed issues regarding follow-up arrangements, documentation, new prescribed medications and GP letters. For its second year of operation, the service has been refocused using criteria linked to a new 'patient-focused' discharge checklist before discharge, to determine who is most likely to need telephone follow-up.
This article discusses the findings of an audit to assess the improved outcomes of a systematic approach to training nurses working in an emergency assessment area (EAA) to conduct dysphagia screening for patients who have had a stroke. The investment in training has reduced the time patients wait for dysphagia screening from 35 hours to less than one hour. As a result of this audit dysphagia screening competencies have been established.
This article describes the secondment of a critical care practitioner to an acute medicine unit. The aim was to develop the acute assessment skills of the unit's nurses and to implement a new assessment framework. The secondment took place over four months from December 2007 to March 2008 at the Heart of England NHS Foundation Trust, Birmingham. There were several stages to the project, commencing with exploration of existing practice and culminating with evaluation of the project's effect on practice. A review of the multi-professional patient records was conducted six months after the conclusion of the secondment. This revealed that the assessment framework continued to be used in practice. The secondment demonstrated that supporting nurses to embrace new skills resulted in a change in practice. However, a permanent change cannot be assured unless practice is revisited and supported on a continual basis.
This article discusses the findings of an audit to assess the improved outcomes of a systematic approach to training nurses working in an emergency assessment area (EAA) to conduct dysphagia screening for patients who have had a stroke. The investment in training has reduced the time patients wait for dysphagia screening from 35 hours to less than one hour. As a result of this audit dysphagia screening competencies have been established.
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