Neonatal Network Annual Report CHANTS Ambulance neonatal dashboard

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1 We are delighted to announce that Claire Richards will be joining the Network as Lead Nurse. This post will be alongside her current CHANTS Service Manager role. Claire is looking forward to the challenges ahead and working closely with nursing and therapies colleagues across the Network. In June, the Network Board approved the 2017/2018 Neonatal Network Annual Report which presents the highlights, achievements and challenges experienced across the Network. It also provides analysis of activity. In 2017 there were 3395 admissions and readmissions to units across Wales and 6474 intensive care, high dependency care and special and normal care days were provided to these babies. The report has been published on the Network website CHANTS Ambulance Over recent months Alan, Network Business Support Officer, has been working hard to develop an interactive neonatal dashboard which will enable neonatal colleagues across the network to view data on activity, NNAP, Transport, Quality Improvement and Workforce. The team has been around to all units across Wales to demonstrate the dashboard. From 1st October a 3 month trial of the activity and NNAP elements of the dashboard will take place and colleagues are encouraged to make maximum use of it via Sharepoint (further information will be shared with units) and feedback to Alan any issues they experience or suggestions for improvement. On 27 th April the new transport ambulance was put into service. It has been designed to accommodate an extra person, improve communication between the team and driver, and better utilise the working space within the rear cab. Colleagues from the Swansea team were the first to travel in the ambulance, transferring babies from University Hospital of Wales to Singleton.

2 Annual Audit & Quality Improvement Day Act Training, Ocean Park House, East Tyndall Street, Cardiff, CF24 5ET 17 th October 2018, 09:00 17:00 This years theme is Neonatal Infection and short presentations on any audit / Quality Improvement topic is invited from trainee doctors / Nurses / ANNPs / Therapists. If you would like to present please contact Dr S Sen, Consultant Neonatologist, Royal Gwent or Jacqui or Alan, Neonatal Network on /5936 To register please go to wnnad2018.eventbrite.co.uk LEARNING EVENTS The network plan to host / support a number of additional collaborative learning events in 2018/19 The following events are planned: EMRTS / CHANTS review of air transfers - 12 October Family Integrated Care The Network team and units across Wales are continuing to work together to implement Family Integrated Care. You too can get involved by Raising awareness of FiCare throughout your unit Putting yourself forward as a FiCare Champion Attending Network training and cascade the knowledge and skills learnt to your peers Recruiting Veteran parents to support your unit and the Network in implementing FiCare Sepsis - 10th November Consenting to post mortem - 11th December New neonatal nurse education day - 24th January Neonatal Safeguarding Conference - 25th January Parent Conference 20th February The Network is pleased to announce joint working with the Charity 2 Wish Upon A Star to support bereaved parents. We have a meeting with North Wales colleagues on the 6th September and a further meeting in South Wales in November. Information on these and future events will shortly be displayed on the Sharepoint calendar phwsharepoint.cymru.nhs.uk/whc/nn/ _layouts/15/start.aspx#/lists/events%20calander

3 Clinical Peer Review is on its way What is it and what does it mean for neonatal units? Early in 2019 the Wales Neonatal Network will begin a programme of peer review across Wales.. Following publication of the NHS Wales Peer Review Framework by the Welsh Government in July 2017 it is a requirement for all clinical networks to undertake peer review under an all Wales programme managed by the NHS Wales Health Collaborative. What are the expected outcomes? What is Peer Review? Peer review is a process to drive continuous quality improvement involving selfassessment, enquiry and learning between teams of equivalent specialisation and knowledge. Peer review is not an inspection; it is also not just about trying to fix problems. It is really about using critical friends to peer in on internal assurance systems for identifying and sharing good practice and suggesting areas for improvement. an improvement in the safety, quality and effectiveness of services a better experience for patients the consistent sharing of good practice and demonstrable commitment to prudent healthcare. Who are the Reviewers? The review team will consist of a Neonatologist / paediatrician, an Advanced Neonatal Nurse or Senior Nurse, a parent or lay representative, Network Manager / deputy, commissioner representative and administrative support. A reviewer cannot review a unit in their own Health Board, and must declare any conflict of interest. Undertaking Peer Review In practical terms the review process has four main stages: Stage 1 Unit self-assessments. Each unit will be requested to complete the documentation requested by the review team. Stage 2 Validation of self-assessments. The review panel will undertake a desktop review of the self-assessments provided, within the 2 weeks prior to the review day Stage 3 Peer Review Visits. The structure of the review will be as standardised as possible. Giving units the opportunity to present their information. Stage 4 - Writing the report. The review team will provide a written report to the Health Board within 2 weeks of the review. Over the coming months the Network will advertise across units in Wales for clinicians and a parent / lay representative interested in taking part in the peer review process as well as publishing a timetable for Neonatal Review. Do not hesitate to contact us if you have any questions.

4 Ysbyty Glan Clwyd Congratulations to the team in Ysbyty Glan Clwyd gaining the Bronze ANTT accreditation the first unit/hospital in Wales. Simulation Training Day Great day, well organized, fun and relaxed environment in The Neonatal Simulation Faculty at Glan Clwyd Hospital held a very successful Simulation Training Day March. The day was very well received with really good feedback from the candidates. Confidence building! The Simulation Programme is currently in development with regular local sessions including transport scenarios. Our next Deanery Simulation Day is planned for the autumn. We have recently obtained some new simulation resources including a Premature Anne manikin and we are excitedly anticipating the arrival of our newly purchased tetherless SimNewB. Best take away message Teamwork and situational awareness Thank you for building my skills Really useful learning experience

5 Neonatal Bereavement support provided by the Neonatal Outreach team In August 2014 Neonatal services for the 3 counties serviced by Hywel Dda University Health Board changed. Two Special Care Baby Units amalgamated into one larger unit. This opportunity allowed for the development of a neonatal outreach service. As team leader for this service, and with 15 years neonatal nursing experience, I was passionate that appropriate bereavement support would be offered to families whom had suffered the trauma of a neonatal death. Prior to the development of the neonatal outreach service there was little organised support available for these families. Bereavement support in this setting is enhanced by having neonatal knowledge and an awareness of the journey the baby and their family experience within a neonatal unit. Therefore I started to develop bereavement support as a specific duty for the Neonatal Outreach Team. I wanted to initiate formal bereavement support, recognised within the role of the Neonatal Outreach Team. The main aim of the bereavement support service is to offer practical and emotional support. Aims of the Neonatal Outreach bereavement support service: Quality - improve family experience - making the process smoother. Guiding - providing an information source and professional link for the family. Signposting - providing a resource for members of the MDT. Education for the wider Neonatal team - therefore improving the experience for families. Prevention - potential reduction or prevention of subsequent long-term emotional or mental health problems. Having spoken to families I realised that initially it was often the practical issues that they need help with. They are not aware of the options that are available to them, like the length of time they can have their baby with them, that they can wash, dress and cuddle their baby. They want guidance with funeral arrangements, who to contact and when, what they should expect from the funeral. Families need a go to person who can provide them with practical advice, and communicate with and arrange follow up appointments with the medical team. The families appreciate somebody to listen to them and address their emotional needs; they want to talk about their baby, show photos of their baby. Having neonatal nursing experience means I can answer some of their questions and help them understand what their baby went through. Families are informed that this is not a bereavement counselling service, but that this can be arranged; direct referral from the outreach team can be made. I have received positive feedback; including a number of patient stories; for example: We didn t know how or where to start when it came to arranging the funeral. We should have been buying a pram and a cot but instead we had to arrange a funeral. No parent should have to bury their babies but thanks to Kelly s support we got through it'.

6 'One huge thing we have gained from the bereavement support is that it s ok to be sad, angry, fearful, scared. The pain of losing a baby will never go away but we have learnt to cope with the pain, and this is down to the support we have received and the bond we had with the neonatal outreach team' 'Little did we know that the nurse on the end of the phone was going to become our lifeline. Kelly listened to us when we couldn't see the light, arranged appointments with doctors to assist us with obtaining answers, signposting us to specialist services'. 'With Kelly s specialist skills, experience, and personal qualities; the horrific journey which my husband and I faced was made a little easier, elements of pressure were taken off us to enable us to work with our emotions'. Future plans to develop this service include increasing and improving the knowledge within the wider neonatal team of managing neonatal death and the wider implications, recognising the direct impact for families. Delivering teaching sessions to medical and nursing staff. This would include sharing the patient stories to raise awareness of the impact the service and their actions have on families. Improving links with other neonatal units and neonatal outreach services to raise awareness of the service we provide. Make closer links with local and national charities and support groups and look at setting up a local support group. Everyone grieves differently. I have been offering this service for three years now and each family has reacted to their loss in their own unique way meaning the service provision needs to be individual, flexible and responsive. Family-centred care is at the forefront. Kelly Brown Neonatal Outreach Manager Hywel Dda University Health Board What Kelly hasn't mentioned in her story is that that the bereavement support work she is doing has been shortlisted for a Nursing Times Award! Good luck Kelly If you would like your stories published in Your News please them to Jacqueline.Davies1@wales.nhs.uk. There is such a lot of amazing things happening in neonatal units across Wales and we want to let everyone know

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