SAFER CARE PROJECT
time to care, ensuring rapid intervention and reducing variation.
Having previously been part of the Trust’s electronic patient record implementation team, Gerry Bolger successfully bid to secure £1m investment from the Nurse Technology Fund to support the implementation of electronic bedside monitoring devices that were capable of connecting to the electronic patient record. As part of the solution, the Trust invested in
70 Welch Allyn Connex Vital Signs Monitors (CVSM) to provide continuous monitoring and spot checking of vital signs – including measurement of pulse oximetry, blood pressure and temperature. These devices also have the capability to provide clinicians with early warnings scores and alarms. In developing the technology, Welch Allyn collaborated with Cerner to deliver a connected solution, so the Connex Vital Signs Monitors can be seamlessly integrated into the electronic patient record, using CareAware VitalsLink. The Trust has also commenced integrating Phillips patient monitoring into a number of high dependency and acute areas to provide a blended integrated solution. These will also bring monitoring data into the Cerner electronic record. The Welch Allyn vital signs monitors have now been rolled out to all the areas and 10% of the Philips devices have been integrated to date. This means that 25% of beds have access to a bedside monitoring device. Before the introduction of bedside devices for the electronic monitoring of vital signs, nurses would often document the observations on a piece of paper. This created the risk of transcription errors and delays in recording results into the electronic record. Evidence shows that this approach to recording vital signs can incur transcription errors of up to 17%.1
Improving the process and reducing waste
At this time, Gerry Bolger also won a scholarship from the Florence Nightingale Foundation, and visited Virginia Mason, one of the leanest hospital groups in the US, which gave him an insight into how processes could be improved. By applying the learning from the visit, Gerry Bolger sought to address two key areas of the seven wastes, outlined by Virginia Mason: l Processing (entering the same information in several systems).
l Time (waiting for people to arrive or services to be delivered.)
“We set a baseline of what we wanted to do, observed practice, implemented the approach, then re-set the baseline and observed practice again. At the first baseline, we measured actual bedside observations and found that nurses were spending between 2.5 and 3.5 minutes documenting the observations. By implementing the vital signs monitors and integrating this information into the patient’s
OCTOBER 2016
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