Dignity in Healthcare: Restoring Trust and Respect

1. Dignity – everybody’s business? Linda Pascall, RN,RM,MBA, PgCert Deputy Chief Nurse Sandwell and West Birmingham Hospitals NHS Trust

2. About my Trust…. City Hospital Sandwell Hospital Rowley Regis Hospital The Future: The Midland Metropolitan Hospital

3. National Context

4. We don’t always get it right… Damning Report on Hospital Care A damning report into standards of care at Sandwell General Hospital has found critical failings in the way patients have been treated on one of its wards. “Officials found a mixed ward with patients left with their gowns open, fully exposed.” “Hospitals lambasted for ‘alarming’ treatment of older people At Sandwell General Hospital in West Bromwich inspectors witnessed a patient who had been incontinent not being washed for 90 minutes, despite requesting help.”

5. “ We found that Sandwell General Hospital was not meeting either of the essential standards we reviewed. Improvements are needed.” “People do not always receive the information they require and do not have sufficient attention to ensure their privacy and dignity” “Recording of patient’s food and fluid intake is patchy to the extent that these records could not be used as a tool to determine if patients had eaten enough or if they had drunk enough to prevent dehydration”

6. How would you feel if you were.. • Working for this Trust? • A relative with a loved one as a patient in this Trust? • A patient in the care of this Trust?

7. Putting it right • We spoke to each other – discussed not debated • We listened to our patients and their carers and heard what they said • We learned from good examples and ‘pinched’ with pride • We did what we said we would

8. “The scenarios made you stop and think and not take patient care for granted” What dignity means to me.. “ Made me realise how important our job is and our responsibility to patients and relatives” “It really makes you think about your approach. I learned from everyone around me”. “QUEST suited my learning style” “E-learning is a good way of learning for me; it meant I could work at my own pace” “The scenarios helped me identify weaknesses and training sessions I may need to update my knowledge.” “Much more enjoyable than PowerPoint all day”

9. Start by doing what's necessary: then do what's possible;and suddenly you are doing the impossible. Francis of Assisi

10. Putting it right Ward Team Building through Team Challenge Service User Engagement through Patient Forums Staff engagement through LiA Breakfast club ‘Good night, sleep tight’ ‘Mi Way’ Volunteers Open Visiting Trust wide competency reviews QUEST – an online competency check Clinical MOT

11. The Clinical MOT • Designed for registered and non-registered nursing staff • A fortnightly session that staff ‘check in’ to • Taught tutorial-style sessions and a range of interactive clinical scenarios with following topics: • End of life care • Sepsis • Escalating the deteriorating patient • Promoting nutrition and hydration • Challenging practice and escalating concerns • Caring for the patient with dementia

12. QUEST Quality, Understanding, Experience, Safety, Training • An online education tool hosted on a MOODLE platform which consists of an annual competency check and links to online learning resources • Quick and easy to access • Competency check quiz with • certificate of completion • Complements practical training of MOT

14. QUEST – the modules Nutrition Cannulation Sepsis Nutrition Cannulation Infection Control Sepsis Infection Control Nutrition Cannulation Sepsis Infection Control Dementia Dementia Moving and Handling Diabetes Moving and Handling Diabetes Dementia Moving and Handling Diabetes Pain Pain Safeguarding Tissue Viability Pain

15. Volunteers • Support the work of the Trust • Embrace the wider community Three streams: • Mi Way • Mi Day • Mi Plate

16. Open patient visiting • Reduce the feeling of isolation and fear • Helps effective communication • Promotes healing • Reduces stress

17. Good Night,sleep tight.(The Quiet Protocol) • Why it was needed: • Patients were not sleeping well on the wards and so did not get enough rest • Sleep is a potent aid to healing. • Sleep-deprived patients are less likely to be fully active participants in their care. • They aren’t able to fully process instructions given to them by hospital staff. • Some of the simple things we did during sleep time: • Dimmed lights as a visual reminder to be quiet and create a sleep environment • Reduced all controllable noises (soft close bins, squeaky trolley wheels, reschedule goods deliveries, etc.) • Put pagers/bleeps on vibrate or on lowest ring setting • Patient monitors and alarms set on lowest safe levels • Request patients to use TV headsets • Asked staff to converse softly • Door signage on every patient care areas to remind staff and carers that quiet hospitals help healing.

18. Breakfast Club

19. Dignity – the other side of the fence

20. People will forget what you said, people will forget what you did but people will never forget how you made them feel. Maya Angelou