PATI ENT SAFE T Y
When used in conjunction with a patient identifier (GSRN) on a patient wristband, it becomes possible to trace the medicine or product used back to the patient. Leeds Teaching Hospitals NHS
Trust provides a prime example of this methodology. Prior to Scan4Safety, the average time taken to recall a product took 8.33 days. The process was reliant on cross- referencing records manually, and physically tracking down stock across the hospital. Now, the product details are recorded into the patient record at the point of care, and real-time inventory management is enabled to show where the consignment stock is held. With this process in place, Leeds have been able to reduce the time taken to recall products to less than 35 minutes.
Delivering improvements to patient safety From a patient safety perspective, this real-time data capture is essential. As Gavin Boyle, chief executive at University Hospitals Derby and Burton NHS Foundation Trust, explains: “GS1 standards support tried and tested technology and, in the healthcare environment, its strength is that you can collect and cross-reference data without human error. That’s useful in all sorts of situations, whether: ‘Have I got the right patient, right drug and the right dose?’ or ‘Have I got the right implant in the right eye for the right patient?’” In this capacity, point-of-care scanning
serves to reduce the frequency of Never Events.5
The incorrect insertion of
nasogastric tubes is an example of one such Never Event and, of the 435 that occurred between 1 April 2019 and 29 February 2020,4
The equivalent can also be applied to pharmacy, with reference to closed- loop medicines supply and closed-loop medicines administration. Before supplying or administering a medication to a patient, the wristband is scanned to ensure an accurate positive patient ID and the medicine is then scanned to verify the product details. Doing so in the pharmacy department
at Royal Cornwall Hospitals NHS Trust has allowed chief pharmacist, Iain Davidson, and his team, to reduce prevented-error rates by 76%, including elimination of all errors caused by wrong patient, wrong drug, wrong dose and wrong form.
3% of incidents of errors where tubes were misplaced into the lung instead of the stomach. However, for North Tees and Hartlepool Hospital NHS Trust, this is an area where point-of-care scanning is making a difference. Scanning the nasogastric tube prompts a patient safety alert, reminding the clinician to confirm that a pH test has been conducted. Although this does not itself prevent the error from occurring, it does provide an early indicator of whether the tube has been misplaced, potentially causing long-term harm to the patient.
Enhancing workforce utilisation Workforce resourcing has been a long- standing challenge for the NHS. As demand continues to increase in line with changing socioeconomic factors, the need to ensure staff time is used where it is needed most, is critical to the long-term sustainability of the NHS.
Through the adoption of Scan4Safety, the six demonstrator sites were able to release an incredible 140,000 hours of clinical staff time – 140,000 hours that can, today, be refocused back into direct patient care.
For clinicians to be able to effectively monitor patient outcomes and to enable efficient post- surgical observation of a product or device’s performance by regulatory bodies such as the Medicines and Healthcare Products Regulatory Agency,point-of-care scanning for data capture needs to become our ‘business as usual’.
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University Hospitals Derby and Burton
NHS Foundation Trust found this when they transitioned to electronic observations (e-obs), from traditionally manual-based processes.
Before using the e-obs machine (Connex Spot Monitor), the nurse scans the patient’s wristband and their own staff ID. This ensures the right observations are recorded in the right patient’s record with the correct clinician’s details tracked against the encounter. With this system in place, the average time taken to complete observations for each patient was reduced by 35% – from five minutes 11 seconds to three minutes 22 seconds. That equates to approximately 20 nurses’ worth of time saved every day for the Trust, and to 3,800 nurses’ worth of time saved across the NHS in England.
Driving operational efficiency savings
By capturing data at the point of care, clinical staff are afforded a level of transparency which enables them to use data insights to monitor trends and reduce unwarranted clinical variation between procedures.
This is something of great importance
to Chris Tulloch, consultant orthopaedic surgeon at North Tees and Hartlepool Hospital NHS Trust, where point of care scanning enables him to monitor pricing variation between surgical procedures. Responsible for patient-level costings at
his Trust, he found that Scan4Safety provided him with the confidence in the accuracy of those costings. “For about 80 operations we now have the absolute breakdown of what I spend to do a procedure and what my colleagues spend. With every item scanned – and linked to the patient and staff, who also have barcodes scanned – there is a complete
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