RAPID RESPONSE SERVICE Catriona Briers Lead Nurse Rapid Response Service Making Life Better Mossley Mill, Newtownabbey 4 th March 2016

CURRENT MANAGEMENT STRUCTURE Director of Nursing Nicki Patterson Assistant Director of Primary Care & Older People Sarah Browne Operational Manager /Nurse Lead Primary Care Janice Colligan Lead Nurse Rapid Response Service Catriona Briers Co-ordinators x6 - 3 Day and 3 Evening Three Day Co-ordinators undertake the bulk of the Managerial work Down Locality: Tracey Steenson (9-5pm) Lisburn Locality: Amanda Malone (9-5pm) North Down & Ards Service: Cheryl Fitzpatrick (available 9-5pm)

THE TEAMS 4 Localities Down, Lisburn, North Down & Ards 3 Team Bases Down- (Located near ED) Downe Hospital Lisburn- (Behind ED), Lagan Valley Hospital North Down & Ards- Ards Community Hospital

TO CONTACT US DLT Localities Primary Care Connect NDA Localities (In the near future ONE new central number)

CRITERIA FOR ADMISSION Without DNIS; The patient’s condition would require, - Attendance at ED, Outpatients, OOH’s Doctor - or Admission to Hospital There Must Be Agreement From; - General Practitioner - Consultant - DNIS Co-ordinator - Patient

WHO IS SUITABLE? Any patient who meets the above criteria and is; MEDICALLY STABLE

SERVICE KEY PURPOSES Delivering TYC Advancing Health Care in the Community (Service Available 24/7) Prevention of Admission to Hospital Facilitation of Early Discharge from Hospital Improved Patient Choice (such as timing & location of treatment provision)

SERVICE PROVISION In House Training for staff (Nursing & Medical- e.g. BLS, midline insertion) Insertion of Intravenous Cannulas Insertion of Midline Venous Access Devices Transfusion of Red Cells/Transfusion of Platelets (Anaemia/low HB various cancers/palliative) Venesection of Blood (Haemochromatosis/polycythaemia) IGG infusions Intravenous & Subcutaneous Fluid Therapy (Dehydration/assist with IVAB’s to flush out infection)

SERVICE PROVISION Intravenous Antibiotic Therapy -bolus & infusions (1 to 4 per day/cellulites/UTI/Chest Infections/COPD/Bronchiectasis/osteomyelitis) Administration of other Intravenous Drugs (Iron therapy -Venofer/Ferinject/Methylprednisolone-MS) Intravenous Chemotherapy Related Drugs (Zometa/promidronate) Blood Sampling (Chemo/Transfusion/venesection/ other Cases) Insertion of Catheters male/female Re-insertion of P.E.G. & N.G.-Tubes/Supra pubic Catheters

SERVICE PROVISION Syringe Driver & Symptom Management (Palliative Care) Support REDS/PITSTOP Team at Weekends/Public Hols (Respiratory) Care of Venous Access Devices (Porta-catheters/ Picc lines/Hickman lines /Midlines/Cannulae ) Oro-Pharyngeal Suction & Nebuliser Therapy Verification of Life Extinct Work across Private/Voluntary & Statutory Sectors Residential/Nursing Homes Support Families & Carers

PROBLEMS ENCOUNTERED We can’t take everyone- sometimes departments want to off load. Patients requiring multiple investigations Patients requiring more acute care than we can safely provide Challenging staff prescribing requests that are not current or suitable (IVAB’s) Potential duplication of some services such as :  Rapid Access Clinics  Enhanced Care at Home Teams  Medical Assessment Units

KEY OUTCOMES Patients Timely Access to Treatment Convenient location for Treatment Home or Community Clinic Reduced Complications within patients environment Efficient & Effective Use of Hospital/Community Resources Reduced Admissions, Attendances at ED & other Depts. Improved Communication between Primary /Secondary Care Working well with GP’s & OOH/ED/Hospital Consultants Improved Patient Satisfaction- (98-100% in recent surveys) Providing a Service that is Adaptable to Patient Current NeedsProviding a Service that is Adaptable to Patient Current Needs

Structural Change of the Service Staffing levels in the Service (under review). Expand the Capacity of the Service (only if increase in resources ). Working with Enhanced Care At Home/Rapid Access Clinics etc. Further Development of Clinics  Clinic in Ards – Clinic in Down – Developing Clinic in Lisburn Extend the Range of Conditions Managed. Heart Failure treatments started in NDA rolling out to Lisburn then Down  Currently looking at Cancer therapies Herceptin/ Rituximab CRMS (IT System for referring to the service) 24 hr support One Contact Number for the Service 24 hr number FUTURE DEVELOPMENTS

RAPID RESPONSE SERVICE QUESTIONS? Lead Nurse Catriona Briers Mobile: