Improving Patients Experience: Nurse Led Interventions. 14/02/2014 Speakers: Col Te Aho Matron and Verity Berry Staff Nurse Colne Ward (PICU)

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1 Improving Patients Experience: Nurse Led Interventions. 14/02/2014 Speakers: Col Te Aho Matron and Verity Berry Staff Nurse Colne Ward (PICU) Riverside Centre, CNWL.

2 CNWL Vision and values Our vision and values underpin everything we do. Our vision Wellbeing for life: We work in partnership with all who use our services to improve health and wellbeing. Together we look at ways of improving an individual s quality of life, through high quality healthcare and personal support. Our values Compassion: Respect:. Empowerment: Partnership:

3 Our strategic objectives underpin our vision & values We will provide integrated, high-quality, timely services based on the needs of the individual. We will involve, inform, empower and be guided by the people we serve. We will ensure our healthcare facilities are well maintained and fit for purpose. We will recruit, retain and develop skilled and compassionate people who embody our values of care. We will use our resources wisely, to support the delivery of patient care. We will invest in technology to deliver better patient care. We will develop new relationships, business and partnership opportunities, consistent with our vision and value

4 Why Improving Patient Experience & Nurse Led Interventions Nurses to work in Partnership with patient to ensure Activities & Groups meet their needs to create a Respectful and inclusive environment. Physical Health Care - Empowering patients to Improve their Physical Care specifically weight management Nurses will be led by Compassion and embody the values of care mental health interventions are designed to be empowering, enabling the person themselves to take responsibility for decisions about there lives (Frese et al 2003 Evidence Based Practices in Mental Heath Care )

5 Colne Ward. (PICU) Colne Ward is based at the Riverside Centre Hillingdon. We provide care for patients compulsorily detained in a secure environment, who are in an acutely disturbed phase of a serious mental disorder. with a corresponding increase in risk, which does not enable their safe, therapeutic management and treatment in a general open acute ward. Cone Ward is the smallest of the 3 males, with a maximum capacity for 8 patients (2 of which are designated for detention centre patients). We admit patients on Sec 47/49 or Sec 48/49). We do not have a De-escalation or Seclusion Room All O.T facilities, such as ADL kitchen are located off the ward. Colne Ward layout

6 CNWL PICUs CNWL has 3 male PICU s and 1 female PICU. Caspian Ward (Male), Park Royal Mental Health Centre, Nile Ward (Male), St Charles Hospital Shannon Ward (Female), St Charles Hospital

7 Why Improving Patient Experience & Nurse Led Interventions 1. Colne Ward has had an increase number of referrals and admissions from prison s and courts. 28% of admissions to Colne Ward during 2013 where admitted on sections with restrictions.(sec 47/49 or 48/49) 2. Service User Feedback following review of activity programme in the patient community meeting 3. Ongoing Physical Health Clinical Study Safe Wards Trial Safewards intervention the organisational intervention THE RESULTS Both conflict and containment went down significantly more on the experimental wards compared to the control wards. The rate of conflict went down by 15%, and the rate of containment went down by 24%. The Safewards intervention really worked! such as Calm Down Methods(Talk Down Tips) 4. Productive Mental Health Ward Incidents of Violence and Aggression Excel slide) 5. Review following a Ward Away day September 2013 increased nurse led activities, 6. Improving Overall environment

8 Activities: Garden Smoothie Exercise session. (Stretch & Flex) Recovery Men s Health Movie night. Ping Pong. Quiz/puzzle night.

9 Planned Events/ Activities: Colne Ward Pedometer Competition (1 Week Challenge) - 3/03/2014 Shrove Tuesday 4/03/2014 Easter Sunday 20/04/2014 Mens Health Week 9/06/ /06/2014 Commonwealth Games 23/07/14 3/08/2014 Football World Cup /06/ /07/2014

10 Welcome Packs Colne Ward Information Leaflet Colne Ward Activities Information

11 Physical Health:

12 Physical Health Care - Working with Patients to Improve their Physical Care : CNWL Value Empowerment: We will involve, inform and empower our patients, service users, carers and their families to take an active role in the management of their illness and adopt recovery principles. We will ensure our staff receive appropriate direction and support, to enable them to develop and grow. Empowering patients to improve their physical health care. How to continue monitoring physical health when transferred/discharge Nurse Led Clinical Study Peer to Peer (Staff) Training

13 Colne Ward Clinical studies: Weight gain in a PICU environment. Small nurse led clinical study established the need for weight management programmes and interventions within the Colne Ward. Outcome - Nursing team implemented a variety of interventions to address both overall physical health of the patients and to promote weight management support involving patients with support from MDT staff.

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15 Empowering patients to understand their weight: BMI Step Guide for patient to calculating their BMI Tool to assist staff in having The Conversation Taking steps to healthy lifestyle and nutrition

16 TPR and MEWS (Modified Early Warning Signs) Scoring: The TPR charts are designed to make the chart clear, visible and easy to understand. The Introduction of the MEWS score was designed to act as an early warning score. All staff have been further trained ward based to ensure staff are competent in using the MEW s score. The MEW s score assist staff in clinical decision making to ensure the patient get the correct follow up to physical health issues, this include calling out Duty Dr or if needed access to the general hospital for further investigation and treatment.

17 Measuring Patients Experience: Colne Ward Activity Programme =Questionnaire Service User Survey 09/13 Survey Community Meeting Coffee Morning. Carers Meeting.

18 Branches of Thanks: treated with respect big thank you to all the staff! Was a great experience 10/10 performance all the way Thank you for looking after and making him better

19 Pictures and information boards:

20 References Barker, J. (2001) The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing. Journal of Psychiatric and Mental Health Nursing, 8(3), p Department of Health (2006) Best practice competencies and capabilities for preregistration mental health nurses. In: The Chief Nursing Officer s Review of mental health nursing. HMSO: London Department of Health (DH) (2006) Best Practice Competencies and Capabilities for Pre- Registration Mental Health Nurses in England. DOH [Online]. Available at digitalasset/dh_ pdf [Accessed 12 December 2013] Pearson, D. (2003) Weight management. Primary health centre, 13 (10), p Repper, J. and Perkins, R. (2003) Social inclusion and recovery: a model for mental health practice. Bailliere Tindall: London Roberts, G. and Wolfson, P. (2004) The rediscovery of recovery: Open to all. Advances in Psychiatric Treatment, 10, p Department of Health (DH) (2006) From Values to Action: The Chief Nursing Officer s Review of Mental Health Nursing DH, London Available at: