Wales Critical Care & Trauma Network Service Improvement Group (SIG) Wednesday 21 st February :30 to 12:30 hours

Transcription

1 Wales Critical Care & Trauma Network Service Improvement Group (SIG) Wednesday 21 st February :30 to 12:30 hours Room 1, Media resource Centre, Oxford Road, Llandrindod Wells, Powys, LD1 6AH MINUTES Present: Tamas Szakmany, Wales Critical Care & Trauma Network Lead Clinician (South East) & Consultant Intensivist, RGH (Chair) Ed Farley-Hills, Critical Care & Trauma Network Lead Clinician (North) and Consultant Intensivist, YG Zoe Goodacre, Wales Critical Care & Trauma Network Manager Sue O Keeffe, Wales Critical Care & Trauma Network Manager (North) Ifor Evans, Wales Critical Care & Trauma Network Manager (Mid&West) Khaled Elfituri, Clinical Lead & Consultant Intensivist, ICU, WM Paul Temblett, Clinical Lead & Consultant Intensivist, ICU, Morriston Karen James, Team lead Critical Care Physiotherapist, Morriston Richard Pugh, Clinical Lead & Consultant Intensivist, ICU, YGC Carole Jones, Superintendent Physiotherapist, C&V Sandra Robinson-Clarke, Surgical Matron, YG Nicola Vaughan-Jones, Practice Development Nurse, ICU, YG Janice Cadywould, Ward Manager, ICU, YG Michael Martin, Consultant Intensivist, ICU, PPH Richard Self, Consultant Intensivist, ICU, PoW Amanda Jackson, Matron, ICU, PoW Sally Heal, Senior Nurse, ICU, Aneurin Bevan HB In Attendance: Rachael Thistleton, Critical Care & Trauma Network Administrator (North) Minute Taker 1. Welcome and Apologies TS welcomed all to the meeting and acknowledged apologies from the following: Maria Hobrok, Gemma Ellis, Greg Ead, Carly Buckingham, Joanne White, Mark Williams-Jones, Helen Williams, Diane Murphy, Orla Morgan, Mike Hague, Andrew Hermon, Danny Jones, Sam Sandow, Dave Hope 2. Service Improvement Projects SRF audit SOK presented the SRF audit data for North Wales which was collated 14 th November 2016 to the 27 th November The following points were discussed: o The possibility of extending the audit to an All Wales basis. o TS mentioned the Pandora study which is due to finish in March It was commented that the data is collected electronically which could ease the data collection burden. It was noted that the Pandora dataset has been difficult to collect in comparison to the physiological variables of the SRF data. o There is to be a NW SRF meeting to update the bundle on the 18 th April It was agreed that the revised bundle is unlikely to alter the audit criteria, therefore a deadline of the end of March was agreed to finalise the audit form. The finalised version is to be forwarded to TS for creating an electronic version. 1

2 Action 2.1: SOK to forward the SRF audit form to the group for comments Action 2.2: SOK to forward the final version of the audit form to TS to create electronic version Action 2.3: TS to transpose finalised audit form to electronic version Extended recovery project Not discussed as KE did not have the report to present. It was agreed however that KE would present report on extended recovery project at next All Wales SIG meeting. Action 2.4: KE to present extended recovery project at next All Wales SIG meeting Flu testing update Wrexham Maelor, from WG slippage, are trialling bedside viral testing. The group agreed on the requirement for a flu testing update report. KE confirmed his agreement to lead. Action 2.5: KE to compile a report on flu testing to present at the next All Wales SIG meeting 3. Decubitus ulcer survey do we support it? IE summarised the Worldwide study on pressure sores in intensive care units, initiated by the European Society of Intensive Care Medicine. It was confirmed that most Health boards are planning to participate. The group agreed for the decubitus survey be discussed at the Senior Nurse Forum in order for the Critical Care staff to learn from the survey results. Action 3.1: Decubitus survey to be an agenda item at the SNF 4. Surveillance and reporting of ICU infections should we expand it? RP informed the group of a critical care surveillance meeting which is to be held next week. He advised that with regards to reporting VAP on an all Wales basis, currently the WHAIP data for shows different infections occurring in different areas. RP noted the importance of improving identification of VAP with triggers/prompts. Currently data from PHW is submitted to ICNARC from Wardwatcher and it was queried whether to use that data for VAP. TS queried the use of triggers/prompts to improve identification of VAP in other units. MM advised of current difficulties with data collection at PPH. KJ advised that previously physios at Morriston collected the VAP data however following high numbers recorded this was amended. She further noted that physios keep all records for VAP, and are already testing sputum on daily basis. TS advised having notification to staff that an increase in VAP data recorded is not to be seen as adverse. CJ advised further discussion is required at the physio group meetings. EFH commented that the ventilator care bundle is in use already which should prevent VAP. KE advised that WM have an action plan in place with comments as currently showing increased results. Action 4.1: RP to review evidence for VCBs with a view to adopting All Wales Action 4.2: Group to relay to staff that increase in VAP data is not adverse Action 4.3: CJ to add the item for discussion at physio group 5. Update and evaluation of the peer review programme methods IE advised the group that peer review has been in place for two years and several health boards have been reviewed across Wales, with the latest to be BCUHB this week. IE commented that to bring about improvements to the peer review process he has directed questionnaires for units who have undergone peer review to complete. He has also given opportunities for staff to contact him directly. IE further stated that a questionnaire aimed at members of panels for feedback on how to streamline the process has been created also; i.e. it has been previously noted that there may be too much reading. CJ advised that the possibility of a panel meeting the day before peer review would be beneficial. SOK commented that peer review preparation workshops were ran for BCU on what to expect and for discussions of the validation tool, and the NW group agreed that these were beneficial. Action 5.1: IE to feedback on peer review evaluations at next All Wales SIG meeting 6. Update on Workshops Rehabilitation March 16 th 2018 ZG commented on the upcoming rehab workshop organised by Paul Twose, to be held in Cardiff. She advised that there had been an attempt at a North/South link however the cost (at 15,000) was too high. ZG noted that the event is however fully booked with 90 staff in attendance. 2

3 ?All Wales workshops The group discussed considering two dates for future workshops; one date for North Wales and one date for South Wales to ensure all staff could have access to learning. ZG requested suggestions for additional study day topics to incorporate shared learning; the group put forward the extended recovery project; in AB there has been press interest in the volunteer programme and CJ commented on presenting funded projects. PT commented that frailty and the long term outcomes also have several studies ongoing and would be an interesting topic. The group agreed to hold a workshop regarding the projects/innovations that the WG slippage monies have funded. 7. WG Priorities and Network work programme views please IE advised the group of the Wales Critical Care and Trauma Network annual work programme for There are five WG priorities which must have a detailed project plan and are required to be fed back to the CIIG. IE advised that the work programme is not the final document and there can be additions. SOK requested a template for the projects to ensure WG are updated. Action 7.1: IE to consider a template for the WG priorities project plans 8. GPICS for smaller Hospitals Chris Thorpe was not in attendance and therefore the item was not discussed in detail. TS however updated the group with regards to the ongoing GPICs review. GPICs 2 (smaller hospitals) has been drafted and will be published soon. TS has had input to the CIS chapter which also included standards with updated references. The group agreed that further discussion is required when GPICs 2 is finalised. Action 8.1: SOK to contact CT to ask him to present GPICs 2 at the next All Wales SIG meeting 9. ICCQIP audit should we do? TS discussed re-auditing bacteraemia rate for comparison with other hospitals. It was commented that the data is already collated from microbiological data from PHW but that there are difficulties with identification. The group discussed whether the European wide survey would require increased data collection. TS commented that there is enthusiasm to look at bacteraemia and that from his clinical perspective there are new bacteraemia cases on ICU which staff are unsure whether are healthcare associated. It was noted that ICNARC data may not aid PHW as staff are not collecting daily dysfunction scores data. 10. Standing item: Clinical Governance (time permitting) Common and serious clinical incidents arising in each Health Board lessons for sharing 11. Standing item: Current and future work programme (time permitting) 12. For Information 13. Any Other Urgent Business SOK updated the group following a recent meeting with RP regarding the collection of data from WardWatcher on devastating brain injuries. It has been advised that extra data fields are required which need to be discussed for the next update of WardWatcher. Action 13.1: RP to discuss additions to WardWatcher with Brian Millar SOK questioned whether critical care data/compliance (eg dashboard or similar) requires consideration for the next meeting SOK noted the updated Scorecards received from WG to enable an annual update. There has been discussion on ALOS and recording the median LOS instead of mean LOS. SOK advised that this primarily affects one LTV unit and queried whether to amend the CCMDS to change the mean to median. The group agreed that median should be used in the future however SOK noted that there could be difficulties changing this with NWIS. Action 13.2: SOK to liaise with Sadie Beard regarding changing to median LOS MM requested the Wales Critical Care & Trauma Network to challenge the issues of transferring West Wales patients to tertiary centres. EFH commented that there is a draft paper in circulation. 3

4 14. Date of the next meeting The group agreed that a further meeting is to be held in six months. SOK requested alternating Newtown with Llandrindod Wells. Action 14.1: RT to arrange further date in six months at Newtown 4

5 Action Card SIG Meeting 21 st February 2018 No. Actions from the minutes of the 21 st February 2018 By Whom 2.1 SOK to forward the SRF audit form to the group for comments SOK 2.2 SOK to forward the final version of the audit form to TS to create electronic version SOK 2.3 TS to transpose finalised audit form to electronic version TS 2.4 KE to present extended recovery project at next All Wales SIG meeting KE 2.5 KE to compile a report on flu testing to present at the next All Wales SIG meeting KE 3.1 Decubitus survey to be an agenda item at the SNF IE 4.1 RP to review evidence for VCBs with a view to adopting All Wales RP 4.2 Group to relay to staff that increase in VAP data is not adverse All 4.3 CJ to add the item for discussion at physio group CJ 5.1 IE to feedback on peer review evaluations at next All Wales SIG meeting IE 7.1 IE to consider a template for the WG priorities project plans IE 8.1 SOK to contact CT to ask him to present GPICs 2 at the next All Wales SIG meeting SOK 13.1 RP to discuss additions to WardWatcher with Brian Millar RP 13.2 SOK to liaise with Sadie Beard regarding changing to median LOS SOK 14.1 RT to arrange further date in six months at Newtown RT 5