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Lister Big share.

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Presentation on theme: "Lister Big share."— Presentation transcript:

1 Lister Big share

2 Geographical challenge
Lister Stevenage Hertfordshire Harlow Essex Luton and Dunstable Bedfordshire St Albans Bedford

3 Big thanks to our current champions
Lister Sandra Charlotte Amanda christine John Harlow Tina Luton and Dunstable Maggie Sharon St Albans Tibbi Randy and Arnold Bedford Deborah Rijo

4 Great Inroads met All units participating
Everyone knows about it word has spread Part of our culture Patients /staff satisfaction

5 What were we trying to accomplish
Promote patient independence by enabling them to be competent in haemodialysis tasks knowledgeable about their health as well as their disease

6 What is Shared Care? Shared care is not self care
Patients in shared care can learn as they go along and at their own pace, doing as little or as much as they want to

7 What is a shared care programme?
Gives patients control of their treatment while still working alongside healthcare professionals Evidence gathered from dialysis patients who have participated in their own care, show that they: Understand their treatment and condition. Gain confidence. Feel better in themselves.

8 Is shared care for every patient?
May not be for everyone This is about patient choice! This is a patient, not nurse led programme Patients will influence each other Situations or attitudes may change over time

9 Barriers to implementation
Staff shortages High sickness rates Skill mix Staff \ patient attitudes beliefs Resources Space in older units

10 The patients view

11 How do you feel you made the difference
Slowly and persistently Listening but remaining steadfast Evidence and choosing champions Posters Flip charts Staff attitudes gradually changing and accepting concept taking ownership

12 The old ways The process inhibiting nurses' power
Adib Hagbaghery et al. Human Resources for Health :9  

13 Fight for change, but pick your battles wisely
Rules for radicals You can’t make a difference without doing things differently Sometimes you break glass, sometimes you leave it the way it is and look through it Fight for change, but pick your battles wisely

14

15 Resource folders Ken has devised some resource flip charts

16 Encouragement

17 Simplifying posters

18 Peer support wasn’t working
Good idea Very few volunteers although many do this role unconsciously

19 How did you expect to demonstrate improvements
Introducing DOM’s Role

20 What I wasn’t keen on The 14 task idea it was a good starting structure and necessary for the Cquinn but Left other allied professions out Themes for the month such as tips dieticians phosphate control Fluid balance potassium Counsellors Taking control back strategies Motivational talks

21 Exercise Bike was too cumbersome and heavy
Trying out simple alternative

22 Feedback from team Consistency required for patients
Busy periods difficult Patients loose confidence if taking longer to learn Gradually you build on your achievements

23 What did you lean From Sheffield Days
That we were doing well at a trust but we couldn’t get complacent That the Care support workers wanted to be involved just as much as the nurses and when they really got behind the message great things happened That just because you change something it might not make it better

24 What changes did you actually make
Pdsa cycles 1 train one patient in a non shared care bay 2 to train 3 3 introduce more staff to shared care team 4 that these staff needed formal training 5 from listening to other units ideas coffee morning / booklet revision

25 Measurements of change
Costing and health economics Nurses are sometimes intimidated by statistics and shy away from it get defensive as a knee jerk reaction Given the appropriate support and encouragement we can take it on board

26 Obstacles to shared care
Communication between shared care staff and all staff members Perceptions and staff views on selected shared care pts for e.g. pts seem to elderly for shared care, and often staff tend to put these pts without notifying a trained shared care staff

27 What would you do differently
More staff at the beginning Teaching sessions Staff allocated to one patient at a time Include research reg or stats person

28 What we want to do Shared care in pre dialysis
Simple steps temp BP and weight Question? Will pre dialysis input make a difference when the patient starts dialysis Is it the earlier the better or too soon!

29 Nurses role Nurses must be a strong voice and through planning and careful monitoring can make improvements to the services provided to the patient Nurses must be accountable for clinical outcomes

30 Long term problems Keeping momentum when staff leave or
Go on rotation or get promoted Reliance on few to “ do shared care”

31 Thank you


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