MACILWAIN WARD Lindsay Phillips Intentional Rounding MACILWAIN WARD Lindsay Phillips

THE PROJECT The Improvement Foundation (IF) has been commissioned by the Health Foundation to run an improvement programme for PCTs and community service providers in South Central SHA. Macilwain Ward is participating in this programme. Each area has an improvement team who will attend 3 training workshops. Between the workshops, much of the actual work will take place, enabling the improvement teams to apply the learning to their own real life situations through the rapid testing of ideas for change. . The IF approach to improvement programmes is underpinned by the Model for Improvement which is based on 3 fundamental questions: What are we trying to accomplish? How will we know that a change has led to improvement? What changes can we make that will result in an improvement? Our progress will be measured through gathering baseline data to demonstrate where teams are starting from and to reflect the impact of their efforts, as well as to highlight issues and achievements, gain support and agree actions

THE CHANGE IDEAS WITHIN THIS PRINCIPLE ARE: CHANGE PRINCIPLE 4 THE CHANGE IDEAS WITHIN THIS PRINCIPLE ARE: MINIMISE FALLS REDUCE INCIDENTS OF PRESSURE ULCERS HYDRATION

WARD PARTICIPATION, DISCUSSIONS AND PLANNING

PROJECT PLAN PATIENT SAFETY FIRST PROJECT USING INTENTIONAL ROUNDING. MACILWAIN WARD. PROJECT LEADERS. Lindsay Phillips and Zenny Pennycate. PROJECT AIMS: To reduce the incidence of falls by 50% in 6 months. Within a 60 day period the incidence of community hospital acquired pressure ulcers (grade 1-4) will be zero. All patients to have access to a drink and assistance to drink if required. METHODOGOLY: Base line information from datix on falls and pressure ulcers. Collect information using monthly audits. WHO AREA HOW Lindsay Falls. Datix / Safety cross. Ongoing collection. Zenny Pressure ulcers. Datix / safety Cross. Ongoing collection. Wendy Nutrition and hydration. Intentional Rounding Tool. Monthly collection. Graphs to be displayed monthly. IMPLEMNTATION PLAN. Week one. Share information with staff and formulate documentation for intentional rounding. End of week one. Commence with 2-3 at risk patients. End of week two. One Bay. End of week three. Whole ward.

WHAT IS INTNETIONAL ROUNDING? IT IS A SYSTEMIZED, PROACTIVE APPROACH TO PATIENT CARE. Rounding occurs on all patients. The goal is to provide better than expected care. A checklist approach is used with the intention of checking high risk patients each hour.

THE CHANGE IDEAS WITHIN THIS PRINCIPLE ARE: CHANGE PRINCIPLE 4 THE CHANGE IDEAS WITHIN THIS PRINCIPLE ARE: MINIMISE FALLS REDUCE INCIDENTS OF PRESSURE ULCERS HYDRATION

THE AIMS OF INTENTIONAL ROUNDING To reduce the incidents of falls by 50% in 6 months. Within a 60 day period the incidence of Community Hospital acquired pressure ulcer (grade 1 -4) will be zero. All patients will have access to a drink over 24 hours period.

SOURCES OF DATA COLLECTION MUST ASSESSMENT TOOL. FALLS ASSESSMENT. MEDLEY PRESSURE ULCER ASSESSMENT TOOL. ROUNDING DOCUMENTATION. GREEN CROSS. DATIX.

INTENTIONAL ROUNDING CHECK LIST Please enter either ‘A’ = achieved or ‘V’ = variance in columns DATE: 12am 2am 4am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 1. SKIN 2. CONTINENCE 3. PAIN 4. ORIENTATION 5. POSITION / COMFORT 6. DRINK / MOUTHCARE 7. REACH CALL BELL 8. BED RAILS DOWN 9. BED TO LOWEST LEVEL 10. ANYTHING ELSE SIGNATURE COMMENTS:

Audit results

RECOMMENDATIONS Understand the risk assessment process. Provide training to ensure all healthcare staff understand correct completion of documentation. Implement the purchase of equipment to identify patients most at risk. Audit results.