1. Main title slide page By Caroline Attard In-patient Nurse Consultant
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By Caroline Attard
In-patient Nurse Consultant
Berkshire health foundation trust
Using Innovate Technology to monitor physical observations following Rapid tranquilization

2. What is Rapid tranquilisation ?
“Rapid tranquillisation is when medicines are given to a person who is very agitated or displaying aggressive behaviour to help quickly calm them. This is to reduce any risk to themselves or others, and allow them to receive the medical care that they need.” (NICE, 2015)

3. RT

4. Welcome Main title for slide set Optional sub title or name
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Rapid tranquillisation (RT) is a high risk clinical intervention in terms of potential physical health complications.
PHYSICAL MONITORING
 Blood Pressure (BP)
 Pulse
 Respiratory rate
 Temperature using tympanic device
 Oxygen saturation levels via pulse oximeter
 Resuscitation equipment
 Blood glucose level
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5. Welcome
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6. Human Factors Theory Inappropriate Response Inappropriate Activities
Overload
Environmental factors (equipment)
Internal factors (emotional stress)
Situational factors (unclear instructions & risk level)
Inappropriate Response
Detecting a hazard but not correcting it
Removing safeguards from equipment
Ignoring safety
Inappropriate Activities
Performing tasks without training
Misjudging degree of risk involved with a given task

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AIM PRIMARY DRIVERS SECONDARY DRIVERS
Welcome
Test new equipment
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New technology or equipment to make process easier
Train in using new equipment
Increasing the amount of RT monitoring on one ward in 12months by 80%
Increase awareness re need, why and rational, risks etc
Education around RT and risks involved
Taking one nurse one patient approach to cascade learning
Safe and reliable use of equipment
Reliable and safe RT physical monitoring
Safe, reliable and timely able to identify problems arising

10. How I engaged the team
Caroline

11. Predictions: Lose equipment, ipad disappearing Difficult to test as numbers of RT are small Nurses wont use it Although easy to use will technophobes use it?? ….Or even try it Wifi connection letting us down

12. Welcome PDSA Testing Ramps Main title for slide set
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DATA FEEDBACK TO FRONTLINE STAFF
PDSA Testing Ramps
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1E: Collate information review PDSA
Cycle 1D:using info in MDT, handovers etc to triangulate info
Cycle 1C:
RT monitoring book
Cycle 1B: in house training re RT
Cycle 1A: Intro new equipment Ipad, cuff and oximeter etc

13. Welcome Measurement Number of incidents against numbers of RT monitor
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Measurement
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Number of incidents against numbers of RT monitor
First of all do we have reporting right so did a safety cross
Wanted already collected data to help reduce time
RT monitor book

14. using info in MDT, handovers to triangulate info
RT monitoring book introduced
RT monitoring training
New equipment

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Update
Welcome
Started in March 2016 from 0% RT monitoring to 100% FROM June till October 2016.
We are still testing (we keep finding obstacles) that we did not predict at first
Engagement of the team (new staff )
Culture change (student example)
Patient engagement
Risks reduced
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16. Welcome Benefits to patient and staff Main title for slide set
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Benefits to patient and staff
Staff
Easy to use
Takes away the hassle of going with a trolley
Tells you if something is wrong
Don’t disturb the patient
Safe
“ I don’t have to be intrusive to the patient following a difficult restraint” sometimes patient is still angry at staff
Less patients are refusing to cooperate
Less awkward
Its brilliant
Didn’t know that when a patient is sleeping it’s the most risky time at least now we use our equipment
Patient
“Its cool”
“I don’t know why other wards don’t use it”
“ I know they are doing it for my own good but having them in my room after they jumped on me is not nice like this they can leave me alone”
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17. Welcome Key improvement message learnt Main title for slide set
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18. Future Spread to other wards
Look at other aspects of RT ( prescribing part etc)
Look at patient refusal why and how to improve
Better technology