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Implementation of the Nursing Strategy Sheena Vernon

Implementation of the Nursing Strategy Sheena Vernon. The Standards. Section A: The network approach Section B: Staffing and skills Section C: Facilities Section D: Interdependencies Section E: Training and education Section F: Organisation, governance and audit

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Implementation of the Nursing Strategy Sheena Vernon

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  1. Implementation of the Nursing StrategySheena Vernon

  2. The Standards • Section A: The network approach • Section B: Staffing and skills • Section C: Facilities • Section D: Interdependencies • Section E: Training and education • Section F: Organisation, governance and audit • Section G: Research • Section H: Communication with patients • Section I: Transition • Section J: Pregnancy and contraception • Section K: Fetal diagnosis • Section L: Palliative care and bereavement • Section M: Dental

  3. Nursing strategy- approved Network Board 27th November CHD nurse/link nurse job description- approved Network Board 27th November Established joint nursing meetings- Level 1 and 2CHD CNS, biannual to6 to offer support, share clinical practice and for education, Network Link nurse meeting BRHC link nurse meetings, monthly Link Nurse activity survey Next steps Update

  4. Nursing Strategy – approved! Where to access? CHD Network website!

  5. Link nurse / CHD nurse job description- approved!

  6. Survey monkey- 90 people Purpose: To understand what is happening with the Link Nurse role across the network 15 responses (16%) Results useful but incomplete Link Nurse activity across the network- survey results

  7. 2. Please state your place of work (Hospital and Clinical area) • Virgin Care BaNES • Gloucester Royal Hospital • Community nurse • Childrens Community Nursing Team, Torbay Hospital • BRHC - Cardiac Team • Children's Community Plymouth • Royal Gwent Hospital • Gloucestershire Royal Hospital - paediatric assessment • Musgrove Park Hospital, Cardiology • Cardiology out-patients UHW • NDDH Community Children's Nursing • University Hospitals Plymouth Trust CHDU • Cardiff • Great Western Hospital, Swindon. Generic Community Children's Nurse • Comments: • Childrens • In a very adhoc way as there is no dedicated time to support this role • Outpatients and home visits • Weekly • Both –Daily • Daily • Adults • Bi-monthly joint clinics, inpatients as and when they are admitted, advice line set up • Weekly for clinic, couple of times/week for toe procedure

  8. Comments: • Childrens • We seek advice and obtain as needed for cardiac nurses specialists in Bristol • British Heart Foundation info • The information is usually supplied by the lead centre and we are a DGH • Always provide the most up to date information. Use various web sites to get this information and the cardiac nurses in Southampton and Bristol for information. • Adults • Teaching boards • Comments: • Childrens • Unsure. I will check

  9. Comments: • Childrens • However it be useful to have a named clinical nurse specialist. If you have 2 different consultants visiting, who work with different specialist nurses, it can be difficult. Is there a generic email address?? • As with previous comment it is supplied by the lead centre • Adults • But know where to access from CNS team in Cardiff • Comments: • Childrens • Yes and no Its obvious if they need a procedure, but we are not specialists • I am part of the CNS team • Have a good link to both Southampton and Bristol Nurses.

  10. Comments: • Childrens • Having now added this meeting I will sign post here in the future • But I can. Please can you send some colour posters about this? • I haven't yet as I was not aware of this until the previous network meeting I attended but I will in the future

  11. Comments: • Childrens • But perhaps unrealistic expectations in a non paid role • The lead centres offer support but we mainly access the nurses • We can liase with local paediatricians if the patient has direct discussion with the local children's ward. • We work as an MDT • We have two consultants in Plymouth who have an interest in Cardiac children. They are very supportive and helpful. • Comments: • Childrens • But its a link role, so the expectations and the demand don't always match • Not really applicable to us as we are community nurses not dedicated cardiac nurse, our manager is supportive • Adults • But know where to access from CNS team in Cardiff

  12. Comments: • Childrens • Time resource • Not really applicable to us as we are not dedicated cardiac nurses but general community nurses who support a variety of families in the home • The time allocated to the cardiac service is very limited at 0.2 and this was to be taken out of existing establishment. We no longer have a local cardiologist at Torbay to support patients, due to this workload has increased, although both visiting consultants are very helpful and approachable as are the cardiac nurse team. • It can be difficult sometimes when you are visiting a child at home. However there is always an option of open access to Derriford Hospital. Support from the nurses in Bristol and Southampton is also helpful. • Time to focus on the cardiac link role is very limited as I have taken it on extra to my own band 5 role and don't get separate link nurse shifts or admin time to complete anything. The manager who also acts as a link nurse sees the role as one to help educate staff. I would like more time to help parents/families/children. • Adults • I feel well supported by the network and my manager. The only challenges have been the normal ones in setting up a new role from scratch. Current challenges include change of local consultant and succession planning. • Often rostered to not work on CHD specific days

  13. Comments: • Childrens • Although more knowledge is always helpful! • And we can easily access courses based in Bristol which are very informative and Southampton • Hi I have attended study days in the past but feel that it would be very helpful to keep skills knowledge up to date to be able to access /participate in on going sessions ie once every 2 years as we always have complex cardiac patients on our caseload. • As a community nurse we are expected to retain knowledge and skills on a wide range of conditions and diseases . • 13. Where did you receive your cardiac education and what was it? (Courses, study days, in-house training, cardiac courses in Bristol) • Childrens • Advanced Cardiac Nursing Bristol • In house 20 years nursing • Bristol • study day at the BCH education centre. • Cardiac nursing course, Bristol • Liverpool and attending up dates, courses and training in Bristol. • Cardiac study days in bristol since qualifying, university teaching during degree, and cardiac ward placement during degree. • Adults • Study Days (Bristol) On the job training from Steph, Sheena and Bristol nurses • 28 years experience in Cardiology ,in-house courses , 10 month secondment ACHD CNS,study days in Bristol.

  14. 14. Is there any specific education which you would like the Congenital Heart Disease network to provide for you?  • Childrens • Shadowing specialist nurses • Basic overviews of common conditions is always really useful • yes general day on more common conditions and care in the community/monitoring / complications ect. • Regular up dates. • How to best support families/children. • Comments: • Childrens • I work as part of the CNS service • Have found it very helpful. • Adults • I think it's excellent and have encouraged local staff to access it.

  15. Comments: • Childrens • But its planned for the future • Not yet • This is not a regular teaching session however I teach as necessary to support other nurses who are looking after cardiac children. • Adults • 15 minute teachings on lesions, provide teaching boards, teach student nurse during TOE sessions aswell as members of own nursing team • Comments: • Childrens • It is easy for us to go to Bristol and it is good for networking • If this could be opened up to ward staff in the local DGH children's ward this would be shared knowledge and skills . • I believe that it is imperative that there is education provision in the peripheries for nursing staff who are caring for a large cohort of CHD patients • That would be something that I feel would benefit the team in the future.

  16. Adults- nurse with allocated time developing service, participating in clinics, seeing occasional in-patients and telephone support Children's-increasing involvement from clinic staff Transition discussions taking place between children's and adult services. Taunton- CHD nurse up-date

  17. Time for nurse to support clinics or in-patients Education for nurse Support for nurse Management support Challenges

  18. Six monthly meetings with Level 1 and 2 CNS- invite Level 3 link nurses Visit centres Exeter We need manager support- how can you help us with this?? Plan moving forward

  19. Thank you& Questions

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