This article outlines work undertaken to relaunch Essence of Care benchmarking at Nottingham University Hospitals NHS Trust (NUH), a 1,665-bed teaching hospital based on two sites. The eight high impact actions for nurses and midwives (NHS Institute 2009) have been aligned with Essence of Care to develop comprehensive tools for quality improvement at local level. This has resulted in increased patient feedback and enhanced staff ownership and involvement in quality-improvement processes and raising standards of care. As a national pilot site for the Productive Ward programme (NHS Institute 2007), NUH has developed links between the two initiatives, reviewing ward processes, increasing direct patient feedback and providing a wealth of data relating to quality of care and patient-safety issues.
Background A Nottingham Legacy Nurse Programme was developed in response to the reducing supply of new nursing registrants and an ageing workforce. The programme comprised components of focussed mentorship, knowledge transition, support and development of new learners in practice. Aims The work-based development programme aimed to improve the retention and experience of late career registered nurses. Methods The programme was informed by the evidence base and co-produced with late career registered nurses (aged 55 years or over, approaching retirement). A small pilot programme ( n = 6) was evaluated through a mixed-methods approach. Refinements and recommendations were proposed in response to findings of a scoping search of the literature, feedback from participants and stakeholder groups across the NHS Midlands and East regions ( n = 238). Results A Legacy Nurse programme has potential to address nurses’ individual career development needs, valuing and retaining them in the workforce, enabling them to share professional knowledge and skills within clinical teams and offers a cost-effective solution to improving retention of late career nurses. Conclusions Addressing the needs of late career registered nurses is required to improve retention, job satisfaction, quality-of-care provision and facilitate knowledge transfer. The programme requires evaluation in other care settings and should be considered as part of an integrated approach to nurse retention, inclusive talent management and workforce planning, alongside financial and careers advice.
Context Recent studies identify that sick patients continue to receive sub-optimal care following admission to acute hospitals. "Failure to rescue" is recognised to be one of the largest causes of harm to patients in the acute hospital setting.1,2 These reports acknowledge significant challenges to ensure patient safety in ward areas, and the critical importance of employing and developing professionals with the right knowledge and skills to care for acutely ill ward patients at the point of qualification.3 Methodology An innovative seven day programme at Nottingham University Hospitals NHS Trust delivers a new approach to acute care skills education for Newly Qualified Nurses working on wards. The course incorporates simulation training and utilises simulated patient actors (SPs) to assess essential clinical skills and compassion in care delivery using OSCEs. Patient involvement in training and assessing the nurse’s ability to deliver effective care when under additional clinical pressure in a simulation setting is seen as integral to the programme.4 Understanding human factors in acute care scenarios ensures staff are fit for purpose and confident in escalating concerns to senior colleagues. Focussed individual support is provided should the candidates fail to achieve the required standard. Results In February 2013, an Early Warning Scoring Tool (EWS) audit identified that mandated nursing escalation happened in 16% of patients in admission wards. Following introduction of the programme and focussed EWS education, this has improved to 57% in March 2014. Implementation of the sepsis six care bundle for patients admitted to critical care areas has improved to 81%. Potential impact Investing in education and simulation training for NQNs with tailored support to meet the individual needs of participants, has resulted in positive feedback from participants and clinical managers, reporting attendees greater confidence to address patient safety concerns and escalate care decisions. References Berwick D, (2013). A promise to learn - a commitment to act. Improving the Safety of Patients in England. National Advisory Group on the Safety of Patients in England. NCEPOD, (2012). Time to intervene A review of patients who underwent cardiopulmonary resuscitation as a result of an in-hospital cardio-respiratory arrest. NCEPOD, London Willis Report, (2012). Quality with Compassion: the future of nursing education. Report of the Willis Commission on Nursing Education, 2012. Royal College of Nursing Department of Health, (2012). Compassion In Practice Nursing, Midwifery and Care Staff Our Vision and Strategy. December 2012 HMSO, London
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.