The launch of a Patient At Risk service is an important step towards minimising risk and improving outcomes for seriously ill patients at Waikato Hospital, says Waikato DHB chief operating officer Jan Adams.
Patient safety is a top priority at Waikato Hospital with many initiatives successfully in place and others underway. One launched recently is a project to improve out-of-hours (weekends and evening/night shift) support on the wards for nurses and doctors.
A team of six clinically expert nurses has provided this support at Waikato Hospital for many years, but the development of a more formalised Patient At Risk team gives their role a more structured focus.
Known as clinical resource nurses, they are available to assist with any patients identified by hospital staff as being unstable or deteriorating and to support staff with patient who have acute or complex care issues.
The formalisation of their role has now increased to include a caseload of patients transferred from critical care to the general hospital wards.
The Critical Care Outreach service provides assurance and support to the receiving ward when a patient transfers out of Critical Care but still require close monitoring to support nursing care.
“It is important for patients and their families to know that we have good systems in place to monitor patients and keep them safe, especially at out-of-hours times when the hospital can appear to be quiet.” Mrs Adams said. “All our staff are trained to identify deteriorating or concerning conditions in patients, but the Patient At Risk team will give them experienced and skilled support on hand.”
The introduction of the Adult Deterioration and Detection System (ADDS) at Waikato DHB hospitals complements the Patient at Risk service.
This internationally recognised scoring system gives staff a way of identifying deteriorating patient condition. The use of the early warning score is in conjunction with the out-of-hours PAR team skills to provide early detection and medical intervention.
Other patient safety initiatives for after hours and weekend hospital care include a more structured approach to the way a doctor going off shift hands over patients to the doctor coming on shift.
A staff survey and audit identified improvements and as a result, specialties use more standardised processes and documentation to ensure staff coming on shift know about overnight priorities and patients who may need close attention during the shift.
Another initiative is the introduction of a task list that overnight ward staff use to identify non-urgent medication and other tasks requiring house officers and registrars action.
This helps these doctors prioritise their work and that they do not overlook non-urgent but important tasks.
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