Presentation is loading. Please wait.

Presentation is loading. Please wait.

Working together to achieve nursing excellence in VTE Katrina Glaister Clinical Governance Facilitator (VTE Project Nurse) Salisbury NHS Foundation Trust.

Similar presentations


Presentation on theme: "Working together to achieve nursing excellence in VTE Katrina Glaister Clinical Governance Facilitator (VTE Project Nurse) Salisbury NHS Foundation Trust."— Presentation transcript:

1 Working together to achieve nursing excellence in VTE Katrina Glaister Clinical Governance Facilitator (VTE Project Nurse) Salisbury NHS Foundation Trust

2 VTE prophylaxis in Salisbury  Who are we?  Where we were  Where we are now  Top tips!

3 Salisbury NHS Foundation Trust  500 beds. 200, 000 people locally  Specialist services to 3 million people  Spinal Unit services to 11 million people.

4 Where we were …..  July 2007  Policy  VTE Working Group  Aim: to develop a simple (evidence based) tool to assess VTE risk, implement and measure progress (improvement)

5 Where we are now…..  Demonstrated sustained improvement - Exemplar site  VTE nurse (part time)  VTE policy – Trust-wide  Risk assessment + patient self-assessment  Audit +++  Education, education, education  Patient information  Thrombosis Committee

6 VTE Risk Assessment  Local practice  Aim - one tool  Orthopaedics, palliative care, plastics, haematology & urology  Orthopaedics (oral prophylaxis)

7 Risk Assessment – documentation  Wanted it simple!  Audit Who assesses in Salisbury?  Surgery – nurses  Medicine – doctors  Either way, nurses are key

8 VTE prophylaxis  Low risk = advice only  High risk = fixed dose low molecular weight heparin (LMWH) unless contraindicated (if so then GCS if OK)  If high risk + history of previous VTE - LMWH plus GCS

9

10 Can patients self-assess? Outpatients in: Fracture clinic, Day Surgery, Oncology Can patients self-assess? Outpatients in: Fracture clinic, Day Surgery, Oncology

11 Audit  Pharmacists central to our success  Trust-wide audit  Reporting: Celebrated good practice League tables Clinical Governance newsletters Published article

12 Education & raising awareness  Staff 1:1, ward-based, awareness days, symposium, Clinical Governance Sessions, screen saver, Hospital Rounds, Junior Doctors, Physiotherapists, M&M meetings, feedback from incidents, RCA for all secondary VTE events ….  Patient stories  Patients are key! Governor on Thrombosis Committee, DVD, written information, plasma screens, Patientline/Hospedia, Foundation Constituency meetings, Annual Review article, Health Fairs, AGM ……. Message is : Get out of bed ASAP Exercise if on bed-rest Take deep breaths Stay hydrated.

13 An informed public?  Terminology – the general public vaguely understand what DVT is, but not VTE  From a member of public at a Wiltshire Health Fair “VTE is the thing you get on a plane or when you have an operation and three weeks later you die”

14 An informed public? I've heard of a DVT – what is a VTE? Is VTE the new buzz word? Is VTE a breakfast cereal? - I've heard of DVT - a pain in the leg!' I still call it DVT - never heard of VTE Never heard of VTE - is it when you have thick blood? They changed it did they? I knew DVT! I've had 3 DVTs - I wouldn't know VTE - I had sticky blood as part of Lupus

15 Educating patients  Written patient information: Average reading age in UK is around 11 years Health literacy is recognised as a problem in UK and elsewhere Coming into hospital patients are given many information sheets – do they read them? “Oh yes, I did get one of those, I sent it home with the wife, she’s much more interested in that sort of thing than me”

16 Information must be accessible

17 1 = Policy approved, 2 = Policy launched, 3 = Audit data presented to wards as league tables, 4 = Intensive education & link nurse programme, 5 = Executive drivers & pharmacy mandate (no RA = no drugs)

18 Deaths with VTE at Salisbury Oct 07 - Mar 08 Apr 08 - Sep 08 Oct 08 - Mar 09 Apr 09- Sep 09 number of deaths Deaths with VTE Deaths from VTE

19 20 secondary VTE, 5 PE* Oct 09-date

20 VTE in the Southwest

21 Top tips  Patient stories are a powerful learning tool/motivator  Regular early reinforcement about VTE ‘at the coal face’ ensures that risk assessment is embedded  Build ‘change’ into normal practice  Audit – essential and time consuming – IT helps!  Semi-competitive ‘league tables’ increase compliance  Provide VTE outcome data directly to staff  Executive endorsement ensures that work progresses  Work in progress, there is more to do!

22 Bottom line – drip feed!


Download ppt "Working together to achieve nursing excellence in VTE Katrina Glaister Clinical Governance Facilitator (VTE Project Nurse) Salisbury NHS Foundation Trust."

Similar presentations


Ads by Google