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Proudof our nurses and midwivesNursing & Midwifery Report 2013/14

Introduction 02

01 Our improvement in 2013/14 04

02 Our 2014/15 priorities 24

03 Celebrating our successes 26

CONTENTS

Introduction

01

02

03Celebrating our successes

Our improvement in 2013/14

Our 2014/15 priorities

Page 02

Page 26

Page 04

Page 24

01NUH | Nursing & Midwifery Report 2013/14

01

It is a pleasure to work with nurses and midwives who are so passionate about what they

do and who always strive to do their best for patients.

Jenny Leggott, Director of Nursing & Midwifery

INTRODUCTION

02 NUH | Nursing & Midwifery Report 2013/14

We have developed this report to update you on our progress against the priorities we set last year. Throughout this document we celebrate our many successes and achievements.

Our Care Quality Commission inspection report which was published in early 2014 said NUH was a ‘good trust’: safe, caring, effective, responsive and well-led. It also commended our hard working, compassionate and dedicated staff, and observed many examples of excellent practice. I know how much hard work each of you do every day. The result speaks for itself and validates the good care we deliver to patients at NUH. Thank you.

I am immensely proud of what you have achieved over the last year. We can confidently say that patients continue to be safe in our care and that most have a good experience.

Some of the headlines:

• Our infection rates are lower than ever

• We had 14.6% fewer falls and 11.5% fewer falls resulting in harm

• We had 35% fewer avoidable stage three pressure ulcers and it is over 12 months since we reported a stage four pressure ulcer

• We have consistently been in the top 25% of trusts for response rates and scores for the ‘friends and family’ test – most of our patients would recommend our hospitals. This ward-level, near real-time patient feedback is helping us to improve quickly when there are problems

Thank you for the dedication and commitment you demonstrate throughout the year. We are continuously improving patient care and safety as a result of your ongoing hard work. It is a pleasure to work with nurses and midwives who are so passionate about what they do and who always strive to do their best for patients.

We have made progress in many other areas, including the roll-out of Accountability around the Clock (our nurse handover project). Through nurse handovers and Caring around the Clock we are working to improve consistency of practice and to build trust and confidence through regular contact and conversations with patients and relatives.

We have invested much time and energy over the last year raising the profile of nursing and midwifery at NUH to promote a positive image of our profession. We have made strong progress. In May 2013 we worked with the Nottingham Post to launch our first ever people’s adult, children’s nurse and midwife of the year awards. We celebrated nursing excellence with our local community and recognised those colleagues who regularly go above and beyond their duties to provide exceptional patient care. We celebrated International Day of the Midwife and International Nurses’ Day with a city-wide campaign to publicly say ‘thank you’ to our nurses and midwives for their dedication. We also distributed ‘thank you’ cakes to every ward to mark the occasion, something we will aim to repeat every year in the month of May.

Following the success of our Unit Practice Council on Ward B3 at QMC, we have rolled-out shared governance on Hogarth and Gervis Pearson Wards at the City Hospital. This new way of working is empowering frontline staff to become more involved in decision-making and feeling in control of their practice.

I hope you enjoy reading this report and reflecting on our many success stories. It also describes our priorities for the coming year. Our three-year nursing and midwifery strategy is now available and is designed to be read with this report. It sets out our priorities for the coming years and vision for the future of nursing and midwifery at NUH and your part in this.

Thank you once again for all you do. I am proud of all we have achieved. I will be leaving NUH later in 2014 to take up retirement and explore new opportunities after 15 memorable years in Nottingham and 39 in the NHS, where I have had the privilege of working with some extraordinary people. I very much look forward to working with you over the coming months to deliver further improvements for the benefit of patients, their loved ones and carers. I have every confidence you will support my successor as you have me to continue to strengthen the nursing and midwifery journey at NUH.



REDUCING PRESSURE ULCERSOur target was to reduce avoidable stage two pressure ulcers by 40% in 2013/14. Following the launch of the new SSKIN bundle (and increased awareness and reporting) we have seen an increase in the number of reported stage one and two pressure ulcers.

We launched our ‘React to Red’ campaign, which is encouraging staff to identify early skin damage and to ensure the right plan of care is in place. We have rolled-out new patient bedside chairs and pressure relieving boots to protect patients from pressure damage.

This campaign and the new SSKIN bundle helped us achieve a 35% reduction in avoidable stage three pressure ulcers. It is now over 12 months since we reported a hospital-acquired stage four pressure ulcer.

In this section we share with you a number of case studies which demonstrate our progress against the objectives we set ourselves last year.

01OUR IMPROVEMENT IN 2013/14

PRIORITY 1: PATIENT SAFETY & ESSENTIALS OF NURSING

I’m so proud of my team for their proactive approach

and hard work in achieving a 50% reduction in avoidable pressure ulcers. We’ve made this a priority and having simple monitoring systems and inspections in place means we are able to focus on prevention.”

Ward Sister, E16 Ward

CASE STUDY

E16 PATIENT SAFETY SUCCESS

Most patients on Ward E16 are vascular surgery patients who can have a limited blood supply which makes the risk of developing pressure ulcers high.

Our ward which sees more patients than any other has reduced avoidable stage three pressure ulcers by 50% this year.

There were eight cases recorded on Ward E16 in 2012/13 compared to four in 2013/14.

This fall in pressure ulcers is attributed to the hard work of the nursing team who have made tackling these wounds a priority for the patients on the ward.

We have rolled-out new patient bedside chairs and pressure relieving boots to protect patients from pressure damage.


Staff at Hayward House are celebrating after seeing the number of avoidable pressure ulcers in patients fall from five in 2012/13 to none in 2013/14.

Ward Sister Rebecca Bentley joined the ward six months ago and one of her priorities was to tackle pressure ulcers. The team achieved this by:

• Raising staff awareness – displaying a pressure ulcer prevention banner in the clinical area; increasing the amount of time Band five nurses were able to have as tissue viability link nurses so they are able to increase awareness and compliance through study sessions

• Introducing Accountability around the Clock – staff check their paperwork at the handover to the next shift which ensures patient charts are updated and patients repositioned frequently

• Visibility and supervision – spot checks are carried out on paperwork and by being visible on the ward Rebecca is able to support nurses

Small proactive changes to our checks and paperwork as well as raising awareness

have had a dramatic effect in preventing avoidable pressure ulcers. It’s been a fantastic team effort and I’m so proud to see the results of our work. (From 5 to none!)”

Reducing the pressure at Hayward House

Ward Sister, Hayward House

CASE STUDY


01

REDUCING FALLSWe set ourselves a target of 5% fewer falls than in 2012/13. We achieved a 14.6 % reduction. We had 11.5% fewer harmful falls (vs target 10% reduction). We had 9.3% fewer repeat fallers (target 15%).

Key actions to reduce falls (notably harmful falls) included:

• Our Falls Prevention Team, who provide extra support to our acute medical wards. Since the team has been in place we have seen significantly fewer falls

• Cohort nursing high-falls-risk patients to facilitate their continuous observation

• Learning from previous falls and root cause analysis, notably focusing our attention on supervising patients during toileting (while respecting privacy and dignity)

• Bought extra low beds for patients at high risk of falls

Measures such as night lamps, minimising clutter

and dementia training to easily see who’s at risk have made all the difference.”

Falls champion, C53

CASE STUDY

HOW WARD C53 AT QMC REDUCED ITS FALLS

In the last 12 months Ward C53 has reduced the number of falls by 40%.

The acute medical ward saw the number of falls drop from 139 in 2012/13 to 84 in 2013/14 – a feat that has been achieved due to a renewed emphasis on falls prevention and training.

Falls reduced by 40%


IMPROVING DEMENTIA CAREWe have developed a three-year dementia strategy which sets out how we will further improve dementia care for patients and their carers. The strategy focuses on FIVE key areas:

1 Individual assessment and care plans

2 Education and training of the workforce

3 Dementia friendly-environments

4 Active research

5 Involving and supporting carers of patients with dementia

In 2013/14 we:

• Developed a dementia training strategy. Over the last year we have trained over 650 registered and non-registered staff in advanced dementia care. A significant success has been the inclusion of non-clinical frontline staff in dementia training, including porters, ward waitresses, cleaners, ward receptionists and phlebotomists

• A further 600 healthcare assistants attended a theatre production and participated in workshops to explore the complexities of caring for patients with dementia

Sara Deakin, Practice Development Matron for Dementia Care, said: “Implementation of this training has been a particular success story as it values all staff groups’ contribution to patient experience. People who have dementia are no longer only being cared for in healthcare of older people wards but receive care and treatment in all wards and departments throughout the trust. Recognising the impact non-clinical frontline staff have on patient experience has been extremely important and empowering them with the knowledge and skill to contribute to improving patient experience is a great achievement.”

• Were one of just nine trusts who gained a place on the Royal College of Nursing transforming dementia care programme. This year-long programme (which concluded in March 2014) explored how we can better support and develop staff and service to improve dementia care at our hospitals

• Were shortlisted in the ‘dementia friendly’ hospital category in the national dementia care awards

• Worked with Nottingham Hospitals Charity and Nottingham Contemporary to engage dementia patients through art on Ward B47 as a pilot scheme

• Created dementia-friendly environment – we have invested in coloured crockery to support nutrition and large clocks and toilet signs to support orientation

03OUR WORKFORCE

Recognising the impact non-clinical frontline staff have on patient experience has been extremely important and empowering them with the knowledge and skill to contribute to improving patient experience is a great achievement.

Sara Deakin, Practice Development Matron for Dementia Care

CASE STUDYSPOTLIGHT ON DEMENTIA CARE

More than 700 staff attended a theatre play and workshop to better understand the experience of patients with dementia.

This unique and insightful play looked at the experience of dementia care in the hospital setting and has been produced using the research notes from rigorous observation of patients with dementia in hospital wards over three years.

Sara Deakin, Practice Development Matron for Dementia Care at NUH, said: “This is a unique opportunity to put the spotlight on the way we care for our patients with dementia. We’re always looking for new and different ways to enhance our understanding of what it means to have dementia and how this group of patients should be cared for within our hospitals.”



CARING AROUND THE CLOCK (‘NURSE ROUNDING’)We evaluated the effectiveness of ‘nurse rounding’ (‘Caring around the Clock’) on patient experience following its introduction on our inpatient wards in 2013/14. Thank you to the 1,000 clinical staff who contributed their views on its impact on ward-level safety and patient experience. We are working to improve consistency of practice and to build trust and confidence in our patients through regular contact and conversations with patients and relatives.

CASE STUDYVISIBILITY IS KEY ON WARD C4

Creating an environment which allows nurses to be more visible to patients and increasing the amount of time senior nurses spend on the ward has made a big difference to Ward C4 at QMC.

Ward Sister Catherine Price-Hazlehurst helped to implement the changes.

She said: “Visibility is key and although nurses are having to spend increasing amounts of time at their computers/writing, we wanted to make sure patients knew they were still there to help. We moved desks and computers so that they are at the end of bays so patients could still see the nurse delivering their care and ask for assistance if required. Getting the physical environment right is so important.”

Catherine said: “My deputies and I tried to get out on to the ward as often as possible to meet patients and relatives and find out which staff have gone the extra mile. It’s about being visible and having a real understanding of what’s gone on.

“Staff were not that keen on the idea of the feedback board at first but now they really like it. The number of complaints we receive as a ward has gone down and staff feel more valued.”

Thank you to the 1,000 clinical staff who contributed their views on its impact on ward-level safety and patient experience.


ACCOUNTABILITY AROUND THE CLOCK – ONE YEAR ON

Our handover project is now in use in all inpatient wards across QMC and City Hospital, including Children’s, Midwifery and Critical Care.

The project aims to enforce the importance of consistent handovers between nursing staff at the start and end of their shift, making sure patients are fully involved.

Staff stand at the patient’s bedside, rather than the end of the bay, and include them in their discussions. It is a chance for patients to raise any issues they may have and discuss their care.

Nurses are also required to complete and sign a checklist at the point of handover. This ensures all checks and documentation have been completed. Drug charts are also checked to make sure patients have received the required medication. Feedback from patients and staff show it is already having a positive impact on patient care, with most people describing it has improved communication and safety on our wards.

A survey of ward managers found that 75% believed it has improved communication generally, while 74% felt it had improved patient safety. 85% felt it had improved communication between nurses and 87% said they like the scheme. An audit of 100 patients also gleaned a positive response with patients saying that, where the handover took place at the bedside, they felt more involved in their care.

What our patients think:

Kevin Starkey, of Birmingham, was on Ward C25 at QMC following a sinus removal operation. He said: “The nurses always come round and introduce themselves and ask how you are. I’ve stayed in four or five different hospitals in the last four years and I’ve never had that. You always feel like they’ve got time for you.”

Jenny Martin, of Nuthall, spent time on Ward E15 at QMC. She said: “It makes such a difference as it helps you feel they care about you as a person. They know I don’t like the name Jennifer, so they all call me Jenny. It might seem like a small thing but it shows they care.”

I chat to patients and relatives and ask them about their nursing care. When nurses are praised, I make

a point of trying to speak to those nurses to thank them and post these comments on our recognition board.”

Thumbs up for leadership rounding

CASE STUDY

Matron in Acute Medicine

The nurses always come round and introduce themselves and ask how you are. I’ve stayed in four or five different hospitals in the last four years and I’ve never had that. You always feel like they’ve got time for you.

Patient



The nursing team on Ward F22 make patients feel part of a family by doing their daily walk-round hand-

overs. The team explains what’s happening during the day, times and details of activities and treatments to make their stay as comfortable and supported as possible.”

CASE STUDY

WARD F22 FOCUS ON DAILY WALK-ROUND HAND-OVERS

The team takes, on average, half an hour every morning to walk round the ward and introduce themselves individually to each patient. They explain what will be happening during the day, giving times and details of any activities, treatments or tests that are planned. They also discuss what the nursing team will do and what the doctors will do and explain that a nurse will visit every hour to check the patient’s needs are met and that they feel safe, comfortable and supported during their stay on the ward.

One patient said: “I may not always remember the nurse’s name after the meeting but I can recognise their face so I know who’s looking after me that day.”

The initiative has attracted attention from other hospital trusts. Laura Griffiths, Clinical Lead for the project, visited Ireland in December 2013 to talk to hospitals in Sligo about Accountability Around the Clock, and a poster about the project has been accepted for the National Patient Safety Conference.

Laura said: “I am delighted ward staff have found the project helpful. We now have a gold standard to work towards. We know when we handover at the bedside and involve our patients that this has a positive impact, and we will strive to make sure that this happens consistently across all of our wards.”

Patients feel part of a family

Ward Manager, Ward F22

Our success in maintaining high performance in nursing excellence comes from looking after and supporting

our staff as well as our patients. Achieving the most gold scores under Essence of Care and high marks in the nursing dashboard is fantastic. It means patients feel they are being looked after well and is tribute to a dedicated team who work very hard to provide exceptional care.”

CASE STUDY

CELEBRATING NURSING EXCELLENCE ON BARCLAY THORACIC WARD

Barclay Thoracic is one of our highest performing wards when it comes to our quality measures which reflects nursing excellence and gives us a good indication of the experience of our patients.

The ward has achieved the most gold scores under the Essence of Care benchmarks which are a national tool to support quality improvement at a local level.

Essence of Care features 12 national benchmarks identified as aspects of fundamental care that are of most importance to patients and carers including falls, respect and dignity and patient observations.

In addition to gold scores in Essence of Care, Barclay Thoracic has also scored highly in our nursing dashboard which gathers metrics to enable staff to get a better understanding of patient experience in their areas of responsibility.

Top scores for Barclay Thoracic

NURSING DASHBOARDThe introduction of our nursing and midwifery dashboard in 2011 has been the catalyst for both changing and measuring the impact of new documentation. It provides easy access for ward-based staff to review and then action improvements in both care delivery and the documented evidence of care.

Overall the Trust’s score has improved and in the last six months of 2013/14 has risen to over 90%.

Ward Manager, Barclay Thoracic ward


SHARED GOVERNANCEFollowing staff nurse Laura Hailes’ experiences on the Roosevelt Travel Scholarship across America, NUH has chosen to adopt a shared governance model of management for its nurses and midwives.

Shared governance is a very different style of leadership which enables frontline staff to be more involved in the decision-making process and managers acting as facilitators to support this.

Due to the success of the Unit Practice Council (UPC) pilot on Ward B3 at QMC, in 2013/14 we started pilots on Hogarth and Gervis Pearson Wards at City Hospital.

Project Lead Laura Hailes is a Board member of the International Forum for Shared Governance. To help build up a UK-based support network, in December 2013, NUH set up and hosted the first UK Forum of Shared Governance meeting. This provided an opportunity to share our work with three other UK organisations that are also embarking on the shared governance journey. This event hosted guest speakers (via web link) from the Brigham and Women’s Faulkner Hospital in Boston, USA, who told us the learning they had gained from implementing shared governance. This event was well evaluated by all involved and is something which the forum hopes to replicate twice a year.

Over the next year we will be rolling-out a “whole hospital model” of shared governance across Maternity. From this we’ll learn from what went well and design a way to implement shared governance on every ward across NUH.

Thanks to support from the Nottingham Hospitals Charity, we are providing coaching sessions to council members and managers so that we can ensure everyone involved in shared governance has a smooth transition to this new way of working.

Deputy Sister, B3

CASE STUDY

IMPROVING SAFETY AND CARE ON WARD B3

The UPC on Ward B3 has now been in action for almost two years and is made up of representatives of the ward team. The group was previously chaired by Staff Nurse Kerry Taylor and is supported by Alison Dinning, Critical Skills Educator, and Dr Joanne Cooper, Head of Nursing & Midwifery Research.

Catherine Harrison, Staff Nurse on Ward B3, took up the role of Chair in December. She said: “Since the creation of the UPC, there have been some significant changes on the ward which have improved patient safety and care, as well as boosting staff morale.

“Taking up the role of Chair has reinvigorated me, as I feel I am able to drive forward change within the ward and I am taking on new challenges.”

The team has identified and implemented practical solutions to patient safety issues. These include:

• Improved access to clinical supplies such as IVs and observation machines on the wards, enabling quicker responses to patient need

• Influencing the development of streamlined patient documentation for less than 24 hour admission, allowing nurses to concentrate on patient care more and promoted visiting times for patients, families/carers through creating additional ward posters

The UPC has also focused on engaging the ward team, providing increased staff support and improved communication, which is essential for staff retention and well-being in such a high pressure clinical area. This has included auditing staff development and morale. The findings have influenced the planning of team development days.

Empowering our nurses on the frontline to work together and

make decisions that affect them every day as well as improving patient care has led to real change for the better. A number of improvements are already making a real difference to the quality of care, patient experience and staff morale.”

Making a difference to patient care

Since the creation of the UPC, there have been some significant changes on the ward which have improved patient safety and care, as well as boosting staff morale.

Catherine Harrison, Staff Nurse on Ward B3



IMPROVING NUTRITION & HYDRATIONMealtime volunteers are now working across a third of our wards at QMC and City Hospital. Our volunteers help us to support ward teams with mealtime care.

Other achievements include:

• To mark Nutrition and Hydration Week, in March 2014 we served cream teas to patients across all wards, worked with local catering colleges who baked and served cakes to patients and arranged tea parties for wards

CASE STUDYEATING WELL TO GET WELL

Good nutrition is a vital part of our patients’ recovery and staff work hard to ensure individual needs are met.

In March 2014, we supported Nutrition and Hydration Week with many wards and departments organising activities to raise awareness of the importance of nutrition and hydration.

On the Special Receiving Unit (SRU) ward-based teaching took place on the importance of nutrition and hydration with particular focus on acute kidney injury and pressure damage that can result from poor nutrition and hydration. Other activities included an afternoon cream tea for all inpatients and a bake off which saw staff raise £140 for charity.

Ward Manager Gavin Hitchman said: “It’s no secret that during illness and recovery, nutritional requirements increase.

“Our patients are working at an increased metabolic rate – using up energy stores more quickly. Taking a moment to encourage the patient to focus on nourishment has huge benefits for them and their recovery.

“I try to focus the patients to engage in their nutritional needs as a way of taking some control over their care, ideally being able to feed them with their preferred choice of food/supplement but equally stress the importance of eating to survive not just for pleasure and appetite satisfaction.”

Poor nutrition leads to weight loss, a reduced immune response to infection and delays wound healing which increases the risk of pressure sores.

On a day-to-day basis patients on SRU are assessed for their nutritional needs and red trays are used to identify those requiring additional support. Mealtimes are protected to reduce interruptions while patients get their nutritional needs.

• Organised four development days for nutrition link professional networks, which are supported by the Directorate Nutrition Champions

• Improved partnership working between nursing, catering and dietetic teams

• 95% of our wards scored gold or green in early 2014 when the food and drink ‘Essence of Care’ benchmarks were re-scored

• The nutrition metric on the nursing dashboard exceeded 90% between December 2013 and March 2014

Taking a moment to encourage the patient to focus on nourishment

has huge benefits for them and their recovery.

Gavin Hitchman, Ward Manager


of your nurses and midwivesBe proud

Lights being turned off early and staff being mindful of volume levels is reducing noise at night on our wards.We have put up posters on doors to let patients know ear

plugs and eye masks are available and signs to remind staff to turn the ringer volume on phones down at night and not slam doors.These small changes ensure our patients get a better night’s sleep and in turn a better recovery.”

Reducing noise at night – our ‘Shhh’ campaign

C25, QMC

REDUCING NOISE AT NIGHT Getting a restful night’s sleep is a key part of helping patients feel better, but the 24/7 nature of a hospital means that it can be a challenge to keep noise down. We know from the feedback we get from our patients that we have more work to do to reduce noise at night from both staff and other patients. We have done a lot of work over the last year to reduce noise at night with our ‘Shhh’ campaign. Ward C25 was one of the three trial wards to implement this project.

Patients were asked to complete a survey about noise at night which identified several themes – lights being turned off any time between 10.30pm and midnight, staff talking and general workload noise.

Staff were told about the campaign to reduce noise at night and signage was put on the ward to help raise awareness. This included posters on bay doors to let patients know ear plugs and eye masks are available, and signs to remind staff to turn the ringer volume on phones down at night and not slam doors.

Visiting staff, such as porters and transfer staff, were also made aware that patients were sleeping through a large sign at the ward entrance.

In addition to this a noise at night notice board was put together with patient comments regarding main areas of noise, reasons why this noise may be unavoidable and actions taken to minimise it.

These measures are in place to try and ensure a better night’s sleep for our patients and seem to be having a positive impact.

Feedback from patients has included: “I have been in hospital a lot, of all the wards I’ve been on this has been the nicest and peaceful at night.”

“The nurses are aware it’s night time and do their utmost to reduce noise.”

Developments in Maternity

SHARED GOVERNANCEIn October 2013, Alison Atkinson Head of Midwifery, and Julia Gudgeon Intrapartum Matron, attended the MAGNET conference in Orlando, Florida. Their trip also included a visit to Sarasota General Hospital to look at the maternity unit and to see shared governance in action in a MAGNET accredited hospital.

The trip enabled them to gain insight into the benefits of having a shared governance model within maternity. The valuable learning from the conference, particularly relating to leadership, and the sharing of ideas with other delegates will help create the foundation for our future model.

Our next steps are to encourage our midwives to become involved and tell us how they would like shared governance to look in maternity. We already have a number of midwives keen to lead and develop the change.

MEDICINES FOR MEMBERS’ EVENTIn February 2014, our maternity service was the focus of a medicine for members’ event. We showcased to our public and staff members some of our services, including aromatherapy, breastfeeding, parent education classes, our bereavement service and normal birth.

MIDWIFERY & MATERNITY SUPPORT WORKER FORUMSFor a number of years we have held very successful training forums for community midwives. In the last year we have developed this concept in the acute setting. These forums provide an opportunity to provide a service update for all our staff, engage with the senior midwifery leadership team and update everyone on current practice changes.


01

BEREAVEMENT SERVICENUH has had a full-time bereavement midwife in post since August 2013. Families suffering the loss of a wanted pregnancy, and who will be cared for on our labour wards are supported physically and emotionally. They are supported to make choices in the care that they need at this sensitive time.

The bereavement midwife’s link role supports families at a time when the mother may be physically unwell herself and the family need individualised and sensitive care to help them in the process of caring for their lost baby and to start to grieve for their loss. Co-ordinating the care of the families through the maternity areas, including the community and within other hospital departments promotes a seamless care pathway. Providing holistic care at this time enables parents to take the time they need to consider the many decisions that they have to make in relation to the care of the mother and the baby. Ongoing educational and emotional support of staff is provided to empower them to feel confident in this area of care. The recently-updated pregnancy loss guideline to support care in this area reflects NICE and SANDS guidance.

MATERNITY ‘FRIENDS AND FAMILY’ TESTIn October 2013, we launched the ‘friends and family’ test in maternity. There are four touch points in a woman’s journey of care where we now seek feedback from them about their experience.

CASE STUDYELECTRONIC DISCHARGE IN MATERNITY

A significant number of women and babies were receiving delayed community midwifery care because the communication regarding their discharge home from hospital was not received appropriately within the community teams.

Staff developed a new communication process to ensure women receive the care they need when they are transferred home from hospital.

Staff caring for women are now able to automatically send electronic transfer of care information directly to the appropriate community midwifery team.

This improves communication and care for women and babies.

• Antenatally at 36 weeks

• At delivery

• At transfer from the postnatal ward to the community

• Discharge from the community midwife

This has enabled us to get valuable real-time feedback and to respond to any areas for improvement. As a result of this feedback we are working with our dietician to improve food options and are reviewing our menus. We are also improving bathroom facilities on the postnatal wards.

BREASTFEEDINGOur maternity service is currently working towards achieving Baby Friendly Accreditation. This is a UNICEF award that rewards excellence in breastfeeding in maternity units. There are three stages to the award.

We received stage one in 2012 and in October 2013 we were accredited stage two. This means that over 500 staff including maternity staff as well as neonatal staff, doctors and neonatologists have received training in breastfeeding. This knowledge was assessed by external UNICEF assessors in July and October 2013. Our plans now are to continue towards stage three full Baby Friendly accreditation in the next year.


Nottingham Children’s Hospital developments

15TH ANNIVERSARY FOR YOUTH SERVICE Our youth service was shortlisted as a finalist for the Children and Young People Now Awards 2013 for its outstanding work over the past 15 years in hospital youth work.

The NUH Youth Service supports young people (11-24 years old) living with a wide range of long-term medical conditions and disabilities in both children’s and adult services.

Other achievements for the Nottingham Children’s Hospital include:

• Successful recruitment of nursing staff (no newly-qualified nurses left the service in 2013 thanks to the new and improved welcome and model of preceptorship)

• Daniel Walsh, staff/research nurse from our children’s intensive care unit was awarded the Roosevelt scholarship. Thank you to the QMC League of Friends for funding these scholarships. Dan received funding from the League of Friends to examine the development, implementation and evaluation of paediatric rapid response teams (PRRT). During his four month period in the USA, he visited 13 hospitals spread across 12 States to learn from other hospitals. The rapid response system used in the Nottingham Children’s Hospital has led to the integration of an excellent system for ‘recognising’ our sickest/deteriorating children. In America, Dan spent time with those who work on or oversee PRRT. He is currently working with people from NUH to build a business case for establishing a PRRT within the Nottingham Children’s Hospital. The team will help to ensure that the Children’s Hospital ‘rescues’ every deteriorating child/young person and that we use our resources in the most appropriate way

OTHER DEVELOPMENTS:

• We have launched an effective NIPE clinic which allows all babies to be examined by a neonatologist with 72 hours and prior to discharge from hospital into the community. The clinic is supported by a maternity support worker. This enables women to be discharged in a timely way and avoids patients visiting their GP for the newborn examination

• In 2012/13, we were successful in securing a Department of Health grant to improve the birth environment for women and their partners. We received £170,000 and over the last year we have invested in new reclining chairs for partners to use and had vinyl over lays applied to the windows on each labour suite. As the sun shines through it creates a rainbow effect within the room which is calming and relaxing. We also purchased two birthing pools at QMC and one for the City labour suite to support women wishing to use water during labour

• Maternity achieved level two in its Clinical Negligence Scheme for Trusts assessment after scoring 47 out of 50 – one of the highest pass rates in the East Midlands. The service was praised for:

- A strong multidisciplinary team approach

- Strong transparency and learning

- Strong governance processes

- Use of the Accountability around the Clock (handover)


01

PRIORITY 2: ADVANCED CLINICAL PRACTICEHCOP trainees

Catherine Russell was awarded the Atkinson Morley and Amandus Club Neuroscience Travel Scholarship via the Florence Nightingale Foundation to visit NICHE hospitals in America. She visited geriatric nurse practitioners at hospitals across a number of US States, learning from best practice along the way.

She came back with the idea of training nurses to be Advanced Nurse Practitioners (ANPs) working in our frail older people wards at QMC, expanding the role of ANPs, who are already working in our Emergency Department.

The Geriatric Nurse Practitioners role is integral in NICHE hospitals in the US to ensure a high quality of clinical care and to offer wider education to the nursing workforce.

In 2013/14, Catherine’s idea was translated into reality with the appointment of four ANPs in Healthcare of Older People HCOP).

We received £400,000 following a generous private donation via the Nottingham Hospitals Charity to pilot the role of ANPs for frail older people at NUH. In September 2013, we began training four experienced nurses as ANPs.

Such has been their success that a further three trainee ANPs for frail older people are due to start at NUH in September 2014.

Benefits of this new role include better communication with patients, their relatives and carers. Closer working between the multi-disciplinary team (particularly nursing and medicine) and the trainee ANPs is leading to a greater understanding of the long-term goals of these patients and their families. ANPs also provide a clinical career pathway which is considered beneficial to the recruitment and retention of nurses to HCOP.

Nottingham is a national leader with the development of this new role. We presented the work we are doing, including Catherine’s learning from America, at the Royal College of Nursing Older Person Conference in March 2014.


PRIORITY 3: EDUCATION & WORKFORCE

Our Healthcare Assistants Skills Academy

In 2012/13, we developed the NUH HCA skills academy to ensure HCAs who provide direct patient care receive a consistent and high quality practical clinical skills induction programme before they start work at NUH.

Over the last year, the HCA skills academy has become more firmly embedded into our nursing and midwifery training programme.

580 HCAs (non-registered and support staff) accessed the training in 2013/14.

The Cavendish Review recommends that the Care Quality Commission should require HCAs in health and support workers in social care to have completed this certificate before they can work unsupervised. This has been a requirement at NUH since the Academy was introduced in 2012.

The NUH modular programme incorporates Essence of Care benchmarks and other Trust priorities to improve the quality and safety, including Caring around the Clock, Productive Ward and values and behaviours. We are currently awaiting final national guidelines relating to the ‘Certificate of Fundamental Care’ following the Cavendish Review, to ensure the NUH course content meets the recommended national training standards.

Presenters have shown great compassion and dedication. My faith in the NHS has been restored. If all our nurses had the same compassion and dedication, we would not have a problem in the NHS.

I am finding the course really interesting and learning a lot, I am one of the ones who has worked at NUH for a long time and didn’t think I needed to know anything else – very surprised!

I welcomed this course, just wish I had this when I first came to NUH.

Feedback from the training includes:



Today I faced my first cardiac arrest as a qualified nurse, whilst in retrospect it was terrifying, for the first ten minutes I was leading on an arrest confidently awaiting the crash team. This is largely down to the Acute Care Skills course. So many, many thanks.

Feedback from a newly qualified nurse (adult course)

Developing and enhancing the practice education environment

STUDENT NURSE TASK GROUPWe have established the NUH student Nurse Task Group to actively engage and work with students to improve student experience and the quality of patient care. The group enables students to influence and develop clinical practice placements and to have a wider involvement in Trust events and nursing developments.

We support and encourage our students (and all nursing and midwifery staff) to raise concerns and ‘Speak Out safely’. In 2013 we signed up to the Nursing Times’ ‘speak out safely’ campaign to demonstrate our commitment to a culture of openness - which includes colleagues feeling comfortable to raise concerns about patient safety and quality of care. This means vigilance across all aspects of safety and colleagues having confidence to speak up where we feel colleagues don’t meet these standards or when things don’t feel right.

We have had an article published in Nursing Times celebrating achievements of the task group over the past year and the group was shortlisted as a finalist for the Student Nursing Times Partnership Award.

ACUTE CARE SKILLS PRECEPTORSHIP PROGRAMME FOR NEWLY-QUALIFIED NURSES A new and innovative seven day acute care skills foundation programme was developed and piloted in 2013/14 for new starters in all clinical areas. The course started in October 2013, and to date 181 registered nurses have attended. This focussed training programme supports development of key acute care knowledge and skills such as adult hospital life support, IV drug administration skills, medical device competencies, caring for septic patients and using the early warning scoring systems and the sepsis screening tool. It includes a summative clinical skills assessment using real simulated ‘patient actors’.

Improving the knowledge and skills of newly-qualified nurses and nurses from community settings, has been shown to develop their confidence when recognising patient deterioration and ensuring appropriate timely care, with increased self assurance to escalate to senior colleagues.


I feel like opinions matter and what I do as a nurse matters, which makes me feel appreciated.

Feedback from band five Staff Nurse

CLINICAL LEADERSHIP DEVELOPMENTFor the first time, in 2013/14 NUH worked in partnership with Sherwood Forest Hospitals NHS Foundation Trust’s Ward Sisters as part of the Royal College of Nursing (RCN) clinical leadership programme. The course was attended by 18 band seven nurses from both Trusts. This joint working has enabled sharing and networking with ideas for improvements to patient care. Participants have undertaken patient stories and observations of care and identified areas for improvements leading practice-based projects.

INVOLVING AND ENGAGING STAFF IN THE DEVELOPMENT OF OUR FUTURE STRATEGY The registered nurse timeout days that we held throughout 2013/14 provided an opportunity to work with our nursing workforce on Trust and professional issues. We asked staff at these sessions for their views and feedback on our draft three-year nursing and midwifery strategy for 2014-17. This strategy has been updated following consultation with staff and will be launched in May 2014.

Thanks to the generosity of the Nottingham Hospitals Charity, a timeout programme has been delivered between July 2013 and April 2014 involving our Staff Nurses, Deputy Sister-Charge Nurses, Nurse Specialists, and Ward Sister-Charge Nurses in development days tailored to their specific needs. This is to ensure maximum benefit can be obtained through staff networking and sharing improving care for patients and their families at NUH. Between July 2013 and April 2014 2,821 registered nurses from band five to seven will have attended a time out development.

BAND FIVE STAFF NURSE TIMEOUT DAYS 1,747 band five staff nurses attended these timeout sessions in 2013/14. Overall, the sessions were well-received by staff. Comments included: “I feel like opinions matter and what I do as a nurse matters, which makes me feel appreciated.”

The workshops included shared governance, professional practice models, compassion in care and talent development.


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PRIORITY 4: RESEARCH & INNOVATIONNurses and midwives play an essential role in research, education and practice innovation within the NHS.

NUH is achieving yearly success in developing its infrastructure for research and evidence-based practice. In 2014, we have three nurses with doctorates, nine undertaking doctoral studies and a growing number of staff with masters level research training and internships. We are fully committed to supporting all to be evidence based practitioners in order to ensure the best possible outcomes for patients and staff.

We are developing the Nottingham Centre for Nursing and Midwifery Research and Education (to be launched 2014), which includes four research units:

1 Children, Young People and Families (including midwifery)

2 Rehabilitation, Dementia and Care of Older People

3 Research allied to Research Centres (e.g. NDDC-Biomedical Research Unit)

4 Workforce development (leadership and management)

We are delighted to showcase in this report a sample of our activity relating to Clinical Academic Career mentorship, Children and Young People and Care of Older People.

NOTTINGHAMSHIRE NON-MEDICAL CLINICAL ACADEMIC CLINICAL MENTORSHIP PROGRAMMEThe Department of Health published its strategy on the development of Non-Medical Clinical Careers, in March 2012. In support of this, the East Midlands Strategic Health Authority (EMSHA) commissioned a mentorship infrastructure funding programme. On behalf of NUH, Dr Joanne Cooper led a successful joint application for a structured mentorship programme aimed at securing NIHR Masters in Clinical Research and PhD fellowships.

Eighteen staff were accepted onto the mentorship programme in 2013/14, 11 of which applied to complete their Masters in Research at the University of Nottingham upon completion of the programme. Eight secured places and started their courses in September 2013. Of the three that were unsuccessful, one commenced the Masters in Advanced Nursing Practice and one an internship at the University of Lincoln.

Mentees described the benefits of multi-professional learning and networking, support with the application and time to examine their clinical and academic development needs. Greater focus is required in future years to support successful doctorate level applications. We are delighted to receive pump-priming funding from NUH Research & Innovation for bridging awards post Masters training for 2013/14 – The NUHRISE Non-medical Clinical Academic Doctoral Infrastructure Award.


UNDERSTANDING PARENTAL EXPERIENCES OF CARING FOR INFANTS WITH PIERRE ROBIN SEQUENCE MANAGED WITH NASOPHARYNGEAL AIRWAYS: A PHENOMENOLOGICAL STUDYKarine Latter. Lead Nurse Cleft Lip and Palate, NUH. Academic Supervisors: Dr Linda East, Prof Fiona Bath-Hextall

Pierre Robin sequence (PRS) occurs in approx. 1:15,500 births in the UK. It is a condition which includes a cleft palate, micrognathia (a small jaw) and glossoptosis (a retroverted, retroplaced tongue), resulting in total or partial airway obstruction and feeding difficulties. A significant number of infants with PRS are managed by the insertion of a nasopharyngeal airway (NPA).The available literature reviews the clinical outcomes of interventions and protocols for the clinician management of PRS within the hospital setting. To date none have addressed parental experiences on which to base nursing service improvement, evaluate and compare outcomes and highlight issues.

This study was conducted as partial completion of Karine’s Doctorate in Health Sciences Thesis, final submission date expected 2015. The study was undertaken utilizing a hermeneutic phenomenological approach. Participants were recruited from five UK cleft centres. Twenty-five open ended interviews with parents were conducted within the home setting by Karine (14 with both parents and 11 with

the mother only). Participants’ infants ranged in age from 6–27 months.

In the absence of literature surrounding parental experiences of the management of infants with PRS the focus of the study was to explore experiences, views and feelings of the care and support that parents had received. This was to contribute to identifying gaps in care provision and inform nursing practice based on expressed needs and perspectives.

The findings of the study revealed three key themes: impact, coping and communication. The parent accounts highlighted that the quality and equity of care within and between the five centres differed and this impacted on parental experiences. The key messages were for better communication, support, management pathways and information provision. Parents experienced high levels of stress and anxiety especially in relation to managing the condition and it appeared to be worse in those families who received the least input from the cleft service. The findings of the study bridge the gap in the knowledge of how PRS impacts on families and provides valuable insights for cleft teams in meeting the needs of this group.

National nursing standards for PRS are currently being ratified. Findings from this study are playing a crucial part in informing their development.


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END OF LIFE CARE FOR OLDER PEOPLE WITH DEMENTIAChricy Kainga, Deputy Sister, HCOP, NUH Project supervisor: Dr Sarah Goldberg

NICE clinical guideline CG42 states that “Older people with dementia must receive similar end of life care as to those without dementia” (NICE, 2006). As a deputy sister on a Healthcare of Older People ward, Chricy Kainga identified the problem that people with dementia were not getting the same level of service that other patients received from the palliative care team. She wanted to investigate this further and successfully applied for an East Midlands HIEC internship in order to conduct a project on this area. She also secured one day a week salary backfill through NUH Research & Innovation Research Capability Funding to further develop her project.

Communication is a major cause of dissatisfaction with care for families of people with dementia. Poor or inconsistent communication is likely to result in distress for the family and may lead to complaints.

Chricy initially completed a service evaluation of end of life care for people with dementia on her ward. This involved two in-depth case studies including interviews of doctors, nurses, healthcare assistants and families of patients at the end of life. She also reviewed case notes and made observations of care given. Chricy identified that whilst care quality was good and end of life procedures were followed for patients with dementia, the nursing staff had very little confidence in talking to family about end of life. This resulted in them referring to a doctor rather than taking ownership of end of life care.

This first project led Chricy to want to find ways of improving care on her ward. She started to think about what the nursing team on her ward could do to improve end of life care for their patients, rather than what the palliative care team could or should do for them. Chricy’s second service evaluation involved interviews of nurses working at Hayward House and nurses working in HCOP to compare and contrast their attitudes to end of life communication with families. She found a striking difference between the two groups. The Hayward House nurses considered it their responsibility to talk to family about end of life and they felt empowered to do this through the training they’d received. In contrast, the HCOP nurses felt that it was the doctor’s responsibility to talk to family about end of life.

Since completing the internship, Chricy has enrolled on the MSc in Advanced Nursing and is using her work to improve end of life communication as the basis for her service development project.

Chricy has:

• Presented her findings to the multi-disciplinary team attending the HCOP Quality Risk Safety meeting

• Presented and made a poster presentation at the East Midlands Academic showcase 2013

• Poster presentation at the annual ‘Engage, Enthuse, Empower’ conference at NUH

• Poster presentation at the ENTER (Enabling Nurses to Engage in Research for Palliative and End of Life) conference at the DE Montfort University in Leicester

• Concurrent presentation at the RCN Older Person’s conference

Chricy is now working with the ward sister and the palliative care link nurse to improve nursing confidence around end of life care on her ward. She has developed a proposal of:

• Sending a group of nurses on the ‘dying to communicate’ course run by Hayward House

• Working with the medical team to ensure a nurse is always present when doctors have the first end of life conversation with family. The nurse will then handover what was discussed with the nursing team

• Ensuring peer support is available on the ward so that the nurses can embed into practice what they have learnt on the ‘dying to communicate’ course

Communication is a major cause of dissatisfaction with care for families of people with dementia.


2013 NUH RESEARCH AND EDUCATION FESTIVALJune 10–14 saw another successful Research and Education Festival. This event celebrated the work of nurses, midwives and AHPs which continues to go from strength to strength each year. The five-day itinerary included:

1 International visit from Dr Sasha Cuttler, from San Francisco General Hospital

2 Research and education stands at QMC and City Hospital

3 RCN Research Society Meeting considering opportunities for entrepreneurship and innovation

4 Showcase event of pre-registration Masters in Nursing Science Student dissertations

5 Full day Engage, Enthuse, Empower Conference, with keynote speaker Dr Lisa Bayliss Pratt (Director for Nursing, Health Education England). Over 110 staff attended this event

6 Celebrating Mentorship Day in collaboration with the University of Nottingham

Please see the Nursing and Midwifery Research and Innovation annual report 2013/14 for full information.


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02OUR 2014/15 PRIORITIES

During 2013/14, we will continue our established programme of work to further improve patient experience and safety.

We will be launching our final three-year nursing and midwifery strategy and new professional practice model with staff at our timeout days. We will invest time and energy describing the next steps in our nursing and midwifery journey at NUH so that we are each clear of where we are trying to get to and the individual and collective contributions required to get there.

There is much to look forward to over the coming year. We will roll-out shared governance to maternity services and across more inpatient wards, we will embed Caring around the Clock and Accountability around the Clock. Through doing so, we will encourage our staff to embrace our values, every day, across every ward.

In response to feedback from our patients, visitors and carers we will consider what more we can do on each ward to reduce noise at night, which we know impacts on our patients’ experience. This will involve delivering on individual ward pledges so that we can make a Trust-wide improvement in this area.

We will continue to build on the excellent work we have been doing to celebrate our successes and achievements, and raise the profile of Nursing and Midwifery in Nottingham both nationally and internationally.

The chart right describes our main priorities for 2014/15.

Nursing & Midwifery@NUH 2014/15Aim: To achieve excellence by 2016, with safety, compassion and professionalism at the heart of care

Nursing & Midwifery Strategy 2011-2016

Nursing & Midwifery Vision

Supporting patients, families & carers

• Attitude: always being aware of the impression we give & recruiting colleagues who share our values

• Behaviour: communicating promptly and clearly to keep patients safe and well informed

• ‘Friends and family’ test

Areas of special focus:

Noise at night

• Learning from concerns and complaints

Consolidate:

• Caring around the Clock

• Accountability around the Clock

• Falls• Pressure ulcers• Infection• Nutrition and hydration

Area of special focus:

• Medicines safety

OBJECTIVES 2013/14 OBJECTIVES 2013/14

Patient Safety & Essentials of Nursing


Nursing & Midwifery@NUH 2014/15Aim: To achieve excellence by 2016, with safety, compassion and professionalism at the heart of care

Nursing & Midwifery Strategy 2011-2016

Nursing & Midwifery Vision

Principles of Nursing/Values & Behaviours

Being the best

Consolidate:

• Shared governance on B3, Gervis Pearson and Hogarth Wards

• Support scholarships

Areas of special focus:

• Developing shared governance in Maternity, Children’s, MSKN & DDT

• Embed the Professional Practice Model

Research & Innovation

Consolidate:

• Support Systems for Clinical Academic Careers

• Evidenced Based Practice programme

• Research festival


• Development of NUH Nursing & Midwifery Research Centre

Education & Workforce

Consolidate:

• Review of establishments and the Safer Nursing Tool

• Health Care Assistant Skills Academy

• Appraisals and Personal Development Plans

• Expand Advanced Nurse Practitioner roles


• Develop talent management process

OBJECTIVES 2013/14 OBJECTIVES 2013/14 OBJECTIVES 2013/14


02OUR 2013/14 PRIORITIES

In 2013 we teamed up with the Nottingham Post to celebrate our nurses and midwives.

More than 600 votes from the public decided the winners of the awards in three categories: adult, children’s and midwife. A special ceremony was held at the Council House in Nottingham in July 2013 to announce the winners:

ADULTS’ NURSE OF THE YEAR – JENNY WRIGHTJenny is a Specialist Parkinson’s Nurse at QMC. She was nominated by a patient who said that, “with her friendship and wonderful support I could face up to what life had thrown at me.”

CHILDREN’S NURSE OF THE YEAR – AMANDA WARDAmanda is a Children’s Cystic Fibrosis Nurse at QMC. She has worked as a nurse for more than 30 years and was nominated by a patient who said: “Amanda is a very compassionate and caring nurse and goes way above her work plan to ensure that the Cystic Fibrosis children in Nottingham get the highest quality compassionate care.”

MIDWIFE OF THE YEAR – JENNIFER ROSSJennifer is a Lead Midwife at City Hospital. After her dedication over the last eight years, colleagues described her as “an absolutely fantastic midwife that really does her best to give women a positive birth experience”. They added: “She supports women through a huge life event and gives them the best care possible.”

Jenny Leggott, Director of Nursing & Midwifery, said: “These awards have boosted morale and injected positivity across NUH. I hope these awards will become an annual event which allow us to work together to say ‘thank you’ to our wonderful team of nurses and midwives for all they do.”

Celebrating the image of nursing and midwifery with first ever people’s Nurse and Midwife of the Year Awards

03CELEBRATING OUR SUCCESSES

Amanda is a very compassionate and caring nurse and goes way above her work plan to ensure that the Cystic Fibrosis children in Nottingham get the highest quality care.

Patient


These awards have boosted morale and injected positivity across NUH. I hope these

awards will become an annual event which allow us to work together to say ‘thank you’ to our wonderful team of nurses and midwives for all they do.”


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NUH | Nursing & Midwifery Report 2013/14

We celebrated during the month in May in 2013 all that is good about nursing and midwifery at NUH. This included a city-wide campaign to say ‘thank you’ to our team of nurses and midwives for the dedication and commitment they show throughout the year.

Members of the Trust Board joined NUH’s Director of Nursing & Midwifery and Medical Director to give out cakes on every inpatient ward on International Nurses’ Day, to say ‘thank you.’

We have worked closely with members of the Nottingham Nurses’ League to boost membership in 2013/14. This included a tea party in May 2013 to celebrate nursing and midwifery past and present, where NUH nurses updated members of the League on developments in nursing at NUH and priorities and improvements we continue to make.

MARKING INTERNATIONAL NURSES’ DAY AND INTERNATIONAL DAY OF THE MIDWIFE

NATIONAL RECOGNITION IN 2013/14Dermatology nurse Sandra Lawton won first prize at the Johnson & Johnson Skincare Journalism Awards in the category Best Healthcare Professional Trade Journalist, for an article she wrote about dermatitis.

The judges at the 10th Annual Johnson & Johnson Skincare Journalism Awards held in London on Tuesday 28 January, 2014, praised Sandra’s article for taking a weighty subject and making it “digestible but still informative.”

Sandra has been working in dermatology for over 27 years has written over 140 published articles related to her work. She said it was an important part of her role to share her knowledge and raise awareness about skin conditions.

She added: “I had a lovely evening at the awards night and it was a great honour to win when the other nominations were of a very high standard. I was up against my very good friend and colleague Julie Van Onselen from Oxford, she was last year’s winner of the Best Healthcare Professional Trade Journalist category at the awards and runner up this year.”

We have worked closely with members of the Nottingham Nurses’ League to boost membership in 2013/14.


Three NUH nurses reached the finals of the Nursing Times Awards in 2013.

Sara Deakin, Sue Mazengarb and Kerry Taylor were praised for their contribution they make to nursing care at NUH and the way in which they embody the 6Cs identified as the values underpinning excellent nursing: care, compassion, competence, communication, courage and commitment.

SARA DEAKIN – NURSE LEADER OF THE YEAR FINALISTSara is a Practice Development Matron in dementia care. She is passionate about improving care for patients with dementia, their families and carers. Sara provides leadership and expertise in the development and delivery of the NUH dementia education strategy which includes all staff and volunteers, providing a framework for prioritising training needs while influencing and responding to regional and national developments. Through partnership working with the Alzheimer’s Society, Sara has developed a bespoke practical skills training programme for staff, as well as training for our nursing ‘Dementia Champions.’

SUE MAZENGARB – NURSE LEADER OF THE YEAR FINALIST Sue is an inspiring Ward Sister at QMC who leads by example; she is compassionate, motivated and aspires to excellence in everything she does. She leads the Head & Neck Unit at NUH. In 2011 following service redesign, Sue was promoted to ward sister for this unit comprising of two wards and a team of 65 staff with 34 beds caring for patients undergoing surgery, trauma and emergency admissions. It also functions as an eye casualty out of hours. Sue is a fantastic ward sister, a role model for nurses who inspires others to take the step-up in their careers.

KERRY TAYLOR – RISING STAR FINALISTKerry is a junior Staff Nurse on Ward B3 at QMC – the acute admissions and assessment ward. Kerry has worked at NUH since qualifying as a nurse. She is a caring and compassionate nurse who has developed confidence in a fast-paced acute care clinical environment. She’s a passionate advocate for patients and exhibits effective clinical leadership skills on a daily basis.


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