Community Nursing Patient Held Records and Digital Pen Technology
NHS Western Isles
Community Nursing Patient Held records and Digital Pen Technology
2020 Workforce Vision / Examples of Service Change in ActionContact name, number and Board: / Kathleen C McCulloch.
Community Lead Nurse
Health Centre,
Stornoway,
HS1 2PS
Tel: 01851 763307 ex 3307
Mob: 07824 343195
E- mail
The service being delivered / Background -
Nov 2009 – Leading Better Care programme invited Senior Charge Nurses to lead on improvement initiatives.
Jan 2010 – Documentation Group established to develop, standardise and improve on current documentation practice and to manage the patient held record at point of care.
March 2010 – Invitation to stake holders to join group initiated a synergy and joint working with I.T. department that would impact on the design and implementation of core objectives.
Problems –
Patient held documentation evidenced only a narrative of care given by nurse; it did not evidence patient involvement, nursing assessment or plan of care. Additionally, inefficient use of Community nursing time spent duplicating patient documentation in patients home and then electronically back at base. This raised the question of the quality of data being recorded electronically several hours after interaction as opposed to recording at point of contact.
A scoping exercise evidenced that 41% of community nurses time was spent on administration tasks at base, 28% of time was spent on direct patient contact.
Aims- To achieve improvements in efficiency and productivity and patient safety.
The changes that have taken place in the service in the last 7 years / Action Taken –
· An inclusive approach was used involving key stakeholders.
· The group worked jointly with IT department to explore solutions to improve efficiency a scoping exercise was commissioned to identify issues and propose solutions.
· Digital pen technology commissioned.
· Patient held documentation piloted across Western Isles and improved and finalised using PDSA cycles of change.
· Digital pen technology pilot launched alongside revised patient held documentation in July 2012 in one community nursing team in Western Isles.
· A local Workload Tool was utilised to evidence outcomes.
· Patient and staff satisfaction surveys were conducted and will be repeated one year on from implementation
The project has delivered on developing a universal Patient Held Record which has improved on the quality of data recorded. Documentation is instant at the point of patient contact and records can be shared with other professionals electronically evidencing safer practice. The initial phase of the project has met with significant technological challenges which are being overcome; these problems have compromised the expected goals for this stage of the project and significant results are not evident at this time. The pilot Community Nursing team has been absolutely integral to the implementation of the digital pen project, initially through simply trialling the technology but, more latterly, by playing a proactive role in its development and effective application in practice. The finalised product is now being rolled out to other teams within the Western Isles with significant support being provided during each teams initiation phase. Feedback from staff is extremely positive and we would expect to have evidence of improvement in efficiency and productivity over the next three months
The impact on patients / · The universal patient held record is patient centred involving patients and carers in developing and agreeing their plan of care involving aspects of self care where appropriate there by enhancing the quality of patient care, experience and safety.
· Increase patient facing and patient enhancing activity time.
· Support people to manage their own health and wellbeing, and to become more active participants in the care and services they receive
· The technology gives the opportunity to share patient information electronically instantly from point of care with other authorised health care professionals.
The impact on staff / · Reduces the amount of time community nurses spend on administration and data entry and increase patient facing and patient enhancing activity time
· Reducing the lapsed time and duplication of data entry.
· Having the opportunity to share information electronically from point of care with other authorised health care professionals
· Releasing time to care for patients.
· Staff have been integral and directed the change process and have been at the centre of this process of service development.
The impact on the wider public sector / · Integrated working with the potential to share electronic records with social care colleges.
· Releasing nurses time to focus on complex, long-term and intermediate care work to address the “Shifting the Balance of Care” agenda.
· Maximise efficient working practices, minimise wasteful variation, bring about savings and ensure value for money
· Improve the availability of appropriate information for healthcare workers and the tools to use and communicate that information effectively to improve quality