The Newcastle Hospitals is delighted to have once again been recognised by the British Journal of Nursing Awards with a total of three shortlistings.

These Awards are a showcase of nursing excellence, highlighting the critical contribution that nurses make to healthcare and represent a fantastic opportunity to gain the recognition that hard work and dedication so richly deserves.

Our Finalists have been recognised for their dedication towards ensuring that every patient we care for receives harm free care wherever possible, and in particular for their innovative approaches towards supporting colleagues working under pressure in one of the largest of most complex NHS organisations in England as they strive to provide safe, high quality care.

Continence Nurse of the Year

The Newcastle Specialist Continence Service has been named as Finalists for two impressive harm free care initiatives – the RIISE Project and the Bladder and Bowel Assessment Project.

The RIISE Project (Reducing and identifying infection using surveillance and education)

The Newcastle Specialist Continence Service provides direct and indirect care across all areas of the organisation (in both acute and community settings), working alongside a number of other specialist teams.

The service supports clinical colleagues on all aspects of harm free care practice with the aim of achieving and maintaining the highest of local and national standards. However, the onset of the COVID19 pandemic in 2020 led to huge changes in the clinical management of patients, becoming reactive rather than proactive – the prevention of issues arising such as urinary tract infections (UTI) and catheter associated urinary tract infections (CAUTI) became a major issue of concern.

The Newcastle Specialist Continence Service decided to take action and devised a new initiative called the RIISE project – Reducing and identifying infection using surveillance and education.

Jackie Rees, Nurse Consultant for Continence (Adults) explains: “During the pandemic the focus here in Newcastle – as with all healthcare organisations around the world – changed dramatically as we endeavoured to proactively manage such an unprecedented situation. This resulted in reactive responses to specific, clinical areas of concern which, whilst the right thing to do, presented us with worrying challenges for the delivery of the overarching harm free care agenda.”

Jackie adds: “Working together, Newcastle’s Harm Free Care Leaders responded by introducing additional support through the secondment of staff working collaboratively to target areas of concern at the point of identification.”

A key area that was highlighted in the early stages was to reduce the incident of E. coli associated with urinary catheterisation.

The seconded Nurse Specialist for UTI/CAUTI – Amy Griffiths – worked with both the continence service and the IPC team and was given dedicated time to progress with the aims for harm free care.

A programme of activities to promote safe and effective care and empower clinical teams to take responsibility for the ongoing care and management of patients’ infection risks was devised. This included:

• Developing harm free care strategies including interventions and prevention measures
• Providing targeted education through walk arounds, “trolley dashes” and drop-in sessions
• Generating enthusiasm by creating an inclusive learning environment using Institute for Health Improvement QI strategies with measurable outcomes ie:
  • conducting catheter surveillance  reviews both in acute and primary care to provide the information needed to facilitate improvement and benchmark performance
  • evaluating the effectiveness of the educational strategies through a programme of behavioural change and audit
  • carrying out Directorate level compliance audits for care and documentation
  • reviewing GNBSI data
• Demonstrating the benefits of integrated working with other specialist teams
• Engaging with patients at ward level to ensure inclusion of their perception of bladder health care and urinary catheterisation

This collaborative and highly visible approach allowed teams to work more effectively by creating a supportive, proactive approach and sharing information and learning. The success of this can been seen in the demonstrable reduction in some Directorates ‘use of urinary catheters and alternative approaches for bladder care, helping to improve infection risk, ensuring gold standards of best practice are achieved.

Monitoring of catheter related equipment and the inappropriate use of catheters also generated a Task and Finish group to review the regional catheter product formulary with a view to ensuring patients have the correct products to meet their health needs, and that products prescribed meet the Trust’s sustainability targets along with making cost efficiencies.

Jackie adds “By using structured learning and applying practice changes that bring about improvements the team has ensured that accountability for quality has become embedded in our everyday practice.

“We’re very proud of the positive changes we’ve been able to make despite working under such challenging circumstances, and the activities from the RIISE project will continue going forward.”

The Bladder and Bowel Assessment Project

The aim of this project was to increase the number of patients with bladder and bowel dysfunction on active treatment plans and reduce heavy reliance on containment products.

To achieve their objective, the team increased the number of bespoke training sessions for staff across the Trust with a focus on full holistic assessment and treatment of bladder and bowel dysfunctions.

They supported staff during joint patient visits or appointments to complete comprehensive assessments, and also carried out bespoke team training, desk side training and regular departmental walkabouts to help identify any training needs.

All requests for containment products are triaged by the team allowing any gaps in treatment to be identified – this approach ensures that patients receive high standards of care and colleagues feel well advised and supported.

Since the project’s inception, 100% of patients now receive the nationally recommended care which means:

• patients receiving active treatment plans for their condition has risen to 29% – an increase of 24% from the start of the project;
• 75% of district nursing staff engaged with and attended bespoke face to face training;
• triage of product assessment forms now ensures 100% of patients prescribed containment as first line treatment are clinically indicated;
• prescribing of products <470mls has decreased by 37% over 12 months

The project has highlighted the importance of appropriate continence care, encouraging it to be seen as a condition that can and should be improved and not simply tolerated.

“It is extremely exciting for the team to be shortlisted again for the category of ‘continence nurse of the year’ at the British Journal of Nursing Awards,” says Sarah Killeen, Specialist Nurse for Continence. 

“It gives a great platform to advocate for quality, evidence-based bladder and bowel care.”

Cheryl Teasdale is Associate Director of Nursing for Clinical Standards and Community Services. She says “The proactive and innovative work that Sarah, Pasqua and Amy have undertaken has been fantastic. At a challenging time in terms of staffing, accessibility to training and the attainment of both knowledge and skills, delivering education and support within clinical areas has increased accessibility for staff which has led to an increase in knowledge and skills in community settings, wards and departments.

“These projects have greatly contributed to our plight to deliver harm free, high quality care to our patients. I am delighted that these three projects have been recognised and shortlisted for the awards which are well deserved – good luck to our Finalists.”

Of the shortlistings Jackie Rees, Nurse Consultant for Continence (Adults) says: “The Newcastle Specialist Continence Service is absolutely delighted to have been shortlisted for two quality improvement projects for the category of Continence Nurse of the Year and another for Infection Control Nurse of the Year at the forthcoming British Journal of Nursing 2023 awards”.

Good luck!

The British Journal of Nursing Awards Ceremony is being held on Friday 24^th March – we wish all our Finalists the very best of luck!