Nursing Times Awards highlights: Patient Safety Improvement

Category criteria: Patient Safety Improvement

In healthcare, patient safety is non-negotiable, a lesson starkly illustrated by high-profile care failings, including those at the former Mid Staffordshire NHS Foundation Trust.

These incidents underscore the repercussions of neglecting patient safety, a concern heightened during winter pressures and severe nursing shortages.

Nurses, as the frontline professionals with the most extensive patient contact, bear a profound responsibility for ensuring safety across every stage of patient care.

This category welcomes individuals or teams from the NHS or independent sector who have embarked on initiatives addressing factors placing patients at risk, championing safety as an indispensable element of healthcare.

Entrants must substantiate their efforts with clear outcomes that demonstrate tangible improvements in patient safety.

What the judges are looking for?

Examples of commendable initiatives include:

• Reducing the incidence of falls
• Enhancing safety in the prescription and administration of medicines
• Mitigating risks and minimizing delays in treatment

How the entries are judged ?

Each entry undergoes rigorous evaluation against the following criteria, emphasizing the pivotal role of healthcare professionals, especially nurses, in driving patient safety improvements:

• Innovative: The originality and uniqueness of the proposed idea.
• Value: The tangible impact of the initiative on patient care or service effectiveness.
• Measurable: Clear presentation of data or measures demonstrating how the initiative drives clinical or service improvements.
• Leadership: Substantiated evidence of nurse-led initiatives, recognizing their pivotal role.
• Transferable: Evaluation of the potential for ideas to be shared or adopted by others, fostering a culture of safety.
• Evidence: Submission of concrete evidence backing up measures of success or efficacy, ensuring credibility.

Find out more about our 2023 Patient Safety Improvement winner

WINNER – The Newcastle upon Tyne Hospitals NHS Foundation Trust

A collaborative model of meningococcal vaccination response monitoring for patients receiving complement inhibition

Some patients at the National Renal Complement Therapeutic Centre (NRCTC) receive eculizumab, a C5 inhibitor that increases the risk of meningococcal sepsis more than 600-fold.

This is mitigated via vaccination and antibiotic prophylaxis but, as patients were geographically disparate, NRCTC specialist nurses noted a defi ciency in local monitoring.

Working with stakeholders, new service level agreements across all trusts were negotiated and implemented, resulting in an innovative system to increase monitoring of meningococcal titres and revaccination. The scheme’s success has resulted in a wider roll-out.

What the judges said about the winner

Judges said the Newcastle atypical haemolytic uraemic syndrome (aHUS) service clearly described how current approaches to effective monitoring did not work for this rare disease in a complex health landscape.

The team recognised a gap in local management and put in place a new national collaborative pathway involving patients, multiagency partners including health, home care providers, independent sector, and pharma to reduce risk which has significantly improved patient safety.

What the winners said themselves about the experience

Find out about the 2023 finalists for Patient Safety Improvement

Blackpool Teaching Hospitals NHS Foundation Trust – Operation Provide
NHS-employed independent domestic violence advisers attended incidents of domestic abuse with the police to deliver risk assessments, safety planning, and emotional and practical help. Having supported more than 3,000 people, the initiative has been launched as a national homicide prevention framework.

Bolton NHS Foundation Trust – Enhanced Care and Support Team
Innovative therapies were o¬ffered to patients at risk of harm due to cognitive decline, falls and challenging behaviours. Therapies o¬ffered included personal care assistance, haircuts, arts and crafts, and music therapy. Huge financial savings were made and violent or aggressive incidents fell by more than 65%.

Dartford and Gravesham NHS Trust – Clinical nurse tutors
To combat a rise in medication errors and delayed care, clinical nurse tutors were introduced to educate and support more junior nurses. Inspiring them to upskill in their clinical environment proved successful in improving patient safety.

Kettering General Hospital NHS Foundation Trust – Call 4 Concern: implementation and one-year review
Call 4 Concern was rolled out trust wide to give patients and relatives direct access to critical care outreach services to prevent clinical deterioration and improve their experience. Feedback from service users was overwhelmingly positive and deterioration was reduced.

Kingston Hospital NHS Foundation Trust – Nasogastric feeding tube safety
An adult nasogastric feeding tube audit and competency assessment pathway was devised, comprising scenario-based training, ongoing education, routine reviews and spot-checks. There are now more competency-assessed nurses, better compliance audit data and improved reporting of near misses.

Lancashire and South Cumbria NHS Foundation Trust – The Bus Stop
To reduce self-harm and aggression/violence on an acute mental health ward, the ‘bus stop’ – chairs strategically placed between communal areas and bedrooms – became an area where brief therapeutic interventions, such as relaxation activities, were delivered to aid mental wellbeing. Concerning incidents reduced and service users reported feeling supported.

Medway NHS Foundation Trust – Acute and emergency medicine collaboration to maximise community safety
This project to substantially reduce ambulance handovers and patient harm meant building inter-service trust where relationships had been fragile, or even hostile. Roles and procedures were amended, and same-day emergency care access improved, leading to fewer delays.

Nottingham University Hospitals NHS Trust – Advanced practice governance maturity matrix
A nursing advanced practice (AP) lead role was established to understand and implement AP governance to underpin patient safety across the trust. A maturity matrix was developed to ensure a positive, asset-based approach to building a patient safety culture around AP roles. It has been adopted by multiple employers.

The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust – Let’s Get Moving
This quality improvement initiative to prevent deconditioning in older patients on Feltwell Ward set out to get them out of bed and dressed, and enhance their wellbeing. Innovative methods resulted in significant improvements in their functional independence, optimised patient flow and happier staff.

Shropshire Community Health NHS Trust – Named nurse in community nursing
A new model of care was rolled out in the community nursing service so each patient had a named nurse responsible for their assessments, care plans and treatment reviews. Serious incidents and complaints reduced, patient feedback was positive and staff¬ job satisfaction rose, improving retention.

Spire Healthcare – Reducing the incidence of post-operative hyponatraemia and improving care
Patient safety incident reports showed that hyponatraemia cases were higher than expected after major joint replacement surgery. A new team that was set up to address this developed a nurse training package, and created guidance and prompts for staff. Hyponatraemia cases dropped by 70%.