Back Care Advisor & Manual Handling Instructor David Pont BSc (hons) Back Care Advisor & Manual Handling Instructor Who I am and what I do.

St Mary’s Hospital Isle of Wight Unlike other NHS Trusts the IOW has all branches of healthcare under the same banner. We have a population which is static, however in the summer months it is a holiday destination for many and the population can rise to around 400,000. During the festivals is is not uncommon to have an extra 70,000 people on the island.

An Inclusive Trust – Acute Care Mental Health Community Ambulance Serves an Island Population of circa 150000 Can increase to 400000 During summer months Unlike other NHS Trusts the IOW has all branches of healthcare under the same banner. We have a population which is static, however in the summer months it is a holiday destination for many and the population can rise to around 400,000. During the festivals is is not uncommon to have an extra 70,000 people on the island.

What We Have & Why We Need mhaps

St Mary’s & mhaps First heard of mhaps at a DLF conference in 2014 It appealed to the IOW NHS Trust because:- Ageing population Multiple care teams Time constraints Patient Safety We first heard of the mhaps system in 2014 while at a conference. It was of interest to us as we have an ageing population. Over 75% of the island draws a pension. Many people are on their own due to employment on the island being limited. Nursing, physio, OT are all involved with patient care and therefore all need to see the same information. As with any Trust time (or lack of it) is always an issue. We were drawn to the patient safety aspect, anything that could add to the patient experience and keep them safe is always worth exploring.

At present we have a risk assessment booklet which should start to be completed as soon as the patient is admitted to the hospital. The RA has many different forms which would have previously been separate sheets of paper of instruction written in a patients notes. The scope for lost paperwork is huge and many staff don’t have the time, or ability, to read medical notes.

This is a copy of the Falls RA This is a copy of the Falls RA. This is one of the areas where the mhaps system enhances patient safety. By knowing your patient and giving everyone else that information you can reduce the amount of falls that occur within a Trust. One thing to note here is in the next version up from this an additional question has been added, it asks if the patient is over 65 years old. As previously mentioned, on the island we have an ageing population and it would not be uncommon to have up to 90% of the patients over that age at any given time.

This is our patient MH profile This is our patient MH profile. I will talk you through this and explain some of the issues we incur.

The Risk Assessment is updated every week, or If the patient moves wards, or If the patients condition changes, or The patients plan of rehabilitation changes We created a simple spread sheet that would randomly chose a ward every week for us to audit. The audit information is inputted in to the spread sheet and this creates a graph of who has been audited, their compliance with the completion of the RA and the use of the mhaps system. The information gained from these audits is passed back to the wards and also used at board level to show compliance with patient safety legislation. The graphs also give a clear pictorial view of how, we as a Trust are performing in regards to patient safety.

The Risk Assessment is audited. Every ward is audited A ward is chosen at random from a computer programme A report is sent back to the ward sister/charge nurse with the audit results The information is made available to all departments who work with patient safety and patient experience

Permission & Ethics Permissions were sought to run the trial from the hospital directorate It was presented at the Matrons and the Ward sisters meetings It was presented to the patient council At all meetings and presentations the system was well received and permission was given to commence a trial. All matrons and ward sisters were very keen on the system and could see how it would work. Once they overcame the initial issue of it’s simplicity it was clear that it would be worth running a trial. The patient council are a lay group who are charged with being the patients voice. The presentation to them was done in order to gain their permission and to give them an understanding of why we wanted to trial the system. They had concerns that many patients would not understand the symbols, however once it was explained how the system worked they could see the benefits to patient safety and the overall patient experience. I presented again to the patient council after the trial had commenced and had been running for some time to give them an update and to inform them of how the wards were finding it s suitability.

Trial General Rehabilitation Ward 28 patients Stay 5 days to 18 months Staff turn around Multidisciplinary Patient changes & Priorities This is where we trialled the mhaps.

Feedback Easy to use Easy to update Clear Time saving Removes Barriers PLANABILITY New Symbols This is what the staff thought and also what the patient council thought about it. After the initial feedback some changes were made to some of the symbols. We also decided to include PEEP information on the mhaps posters. However everyone who used the system agreed that the benefits were great.

What is gained from using mhaps Everyone knows the patient moving and handling requirements Patients families can see the plan and the progress that is being made They can assist their relative in moving and handling which frees up nurses time It saves time by removing the need to find patient notes If everyone is aware of the patients requirements time is saved and patients are not delayed in their needs. Patient families want to feel part of their relatives care, this system gives them the opportunity to help their relative and to also follow the plan and to see what progress is being made. It gives them information on their relative and allows them to plan ahead. It saves time looking for notes as these can often be taken away by doctors or other members of the multidisciplinary team and can even be taken from wards for MDT meetings.

! Development of Personal Emergency Evacuation Plan (PEEP) information Patient Emergency Evacuation Plan ! Patient requires evacuation by BED By CHAIR (with or without assistance) See MHAPS Plan Patient is MOBILE

Mottistone Ward 10 single rooms Mix of private and NHS patients Medical & Surgical needs A vast array of manual handling needs which change from patient to patient and day to day

Some Staff Quotes ‘Easy to use and update’ - Staff nurse ‘Saves time when the nurses and doctors have the patient notes’ - HCA ‘It allows me to check at a glance that all the patient handling assessments are up to date’ - Ward Sister

Ongoing The mhaps system stays with the patient when they leave the hospital Aids in continuing care Reduces the amount of readmissions Helps to maintain the ongoing rehabilitation of the patient by giving care providers, community nursing teams and families a clear plan of the needs and abilities of the patient