APPROVED

NHS GRAMPIAN

Minutes of Senior Nurse Group

held on Monday 14th June, 2010

Seminar Room, Summerfield House

Present
Elinor Smith (Chair)
Sean Coady
Jenny Gibb
Linda Harper
Mary McAuley
Jenny McNicol
Rosemary Nixon – on behalf of Frances Dunne
Gregory Poon
Elizabeth Taylor
In Attendance
Stephanie Broadbent (Item 9)
Jane Ewen (Item 4)
Fiona Gray (Item 8)
Sheila Irvine (Item 8 ) – on behalf of Jane Ormerod
Anne MacKenzie (tried to link by V/C – Item 6)
Eleanor Murray (Item 9) – on behalf of Amanda Croft
Fiona Stewart (Item 7)
Elaine Stirton (Minuting Secretary)
Jenny Thomson (Item 5)
Item / Subject / Action
1. / Apologies
Elaine Allan, Amanda Croft, Yvonne Wright, Jane Ormerod
2. / Minutes of meeting held on 10 May 2010
Under Item 4 – Leading Better Care – A generic job description is now complete for the Senior Charge Nurse role.
Otherwise accepted as an accurate record.
3. / Matters Arising
3.1  Newly Qualified Nurses
Denise Johnson, Leadership Facilitator & Lead Contact for the Flying Start Programme has approached Elinor Smith to seek the views of this group regarding substantive posts for SNDP in October 2010. The April 2010 cohort had been informed that instead of seeking another final placement at the end of their two year programme, they would remain in their 2nd year placement thus securing them a post given that they had permanent contracts. It is proposed that the same arrangement is offered to the October cohort.
Approval has meantime been obtained from the Acute Sector Nurse Management Team but support and agreement on a NHSG wide basis is required.
The Group in principle were supportive with the proviso unless another placement becomes available.
3.2 Community Nursing Update
Gregory Poon reported that the task of reviewing community nursing in NHS Grampian was now complete and thanked all colleagues who had contributed to this major piece of work. Further direction is now awaited centrally with the Scottish CNO’s framework being paramount to future developments. However Gregory was confident NHS Grampian would be in a good position now to produce a suitable action plan.
3.3 N & M Council Referrals – Learning Resource
No further update at present.
3.4  Resuscitation – Sector Leads (area training needs)
Elaine Stirton updated group that she had only received response from the Acute Sector, which has been passed to Sandra McKandie. The Group therefore offered the following names – Linda Shaw (City); Jane Smith (Maternity); Pauline Donaldson (RACH); Eunice Chisholm (Aberdeenshire).
4. / Food, Fluid and Nutritional Care
Jane Ewen, Nutrition Champion for NHSG, shared with the Group copies of recently published reports entitled: ‘Making a Difference – The Evolution of the Nutrition Champion Role in NHS Scotland’ and ‘Food, Fluid and Nutritional Care in Hospitals’.
Jane presented a brief concise overview of her role within this 2 year government funded project. There are 16 champions overall across Scotland and each Board devised their own remit of work. Six clinical standards were set detailed below:
·  Policy and strategy (3.5)*
·  Assessment, screening and care planning (2 ↑ 3)*
·  Planning and delivery of food and fluid (3)*
·  Provision of food & fluid (3.5)*
·  Patient information and communication (2.5)*
·  Education and training (3)*
* Figures in brackets indicate local QIS results obtained.
All in all NHSG performed very well being classified as the top Board in Scotland. The challenge now is to keep the momentum going.
In summary some areas still require more work eg protected meal times/staffing issues; food waste (plated and bulk).
Jane sought continued support from the group and highlighted she would be happy to attend any staff meetings to disseminate findings more widely.
Mary McAuley expressed that it would be beneficial for this work now to develop across into children services.
Elinor Smith congratulated and thanked Jane for updating the group on this very worthwhile initiative.
5. / Face2face suggestion
Elinor Smith welcomed Jennifer Thomson to the meeting.
Following a recent face2face Jennifer had enquired about the possibility of creating a pooling system where nurses who wished to explore other opportunities could do so through secondments/buddy systems with same discipline and grade of staff. Potentially this would allow staff to develop and move forward without the stress and worry of watching for new vacancies.
The Group acknowledged this was a very positive suggestion and were very supportive of the idea. Some background work would be required into formalising ways to achieve such a workable system. Sheila Irvine agreed to discuss this further with Acute Nurse Managers. / SI
6. / Rehab Framework – Update
Anne MacKenzie attempted to V/C from Elgin but unfortunately encountered problems. Item deferred to next agenda.
7. / Workload/Workforce Planning
Fiona Stewart tabled draft copies of workforce re-configuration planners for 2010/11 which have been based upon published ISD 2009 figures and modelled using the Plymouth tool. Fiona agreed to send these electronically via Elaine Stirton to allow the Group members more time to digest the contents for their own specific area. The initial purpose of this documentation being a starting position for a question prompting exercise.
Group members agreed to feedback in due course.
Fiona also tabled proposed draft response to the Scottish Government Health Workforce Directorate request regarding the number of possible placements for newly qualified nurses. A deadline of 16th June must be met and Fiona sought advice from Group members on more realistic figures. After indepth discussion the Group agreed the total figure for nursing/midwifery was more likely to be in the region of 27.
A multi-disciplinary A & E tool meeting is scheduled for this week and an ISD visit planned for next week looking at current processes.
SANE
Elinor reported that there was not much to update other than work is still ongoing around best use of rostering/leave/different ways of working. Highland colleagues have looked at the possibility of 3 x 10 hr and 1 x 7.5 hr shifts. There are still questions around shifting to 12 hr shifts and trying to balance the difference of increased long term sick and decreased short term sickness levels.
The Group were in agreement that Senior Charge Nurses at least should be visible on the ward in core hours.
Bank and Agency Spend/Bank Nursing
Elinor reported both elements are continuing to progress very well. / FS/EStirton
ALL
8. / Leading Better Care
Fiona Gray agreed to share with the Group the generic job description for Senior Charge Nurses via Elaine Stirton.
Group members expressed generally how difficult it was to access generic job descriptions and Fiona Stewart agreed to take this comment back to HR colleagues.
Fiona Gray confirmed all in-patient Senior Charge Nurses/multi sister units are all on target. All have the CQI baseline indicators based upon food, fluid and nutrition; falls and pressure areas. Some areas are running with all three indicators and others are only undertaking one. The facilitators are carrying out monthly checks and hope to establish a monthly reporting system. Meantime Fiona is looking at developing a way of sharing information more widely perhaps via the intranet.
Starting in July, Fiona will produce a progress report to SNG on the use of CQIs across NHS Grampian. / FG/EStirton
FS
Releasing Time to Care
Sheila Irvine reported there is agreement across the acute sector to continue with the proposed development of a recognised national workshop. Meaningful evidence is currently being collected on how and what should be measured and more information should be available for the next meeting. It is envisaged that all Senior Charge Nurses must attend.
9. / HAI/HEI
Eleanor Murray updated the group on the following items:
Daily Patient Safety Briefing Roll-Out
Completed in A&E Dept/Ward, Surgical 2, Neurovascular, Cardiac, Emergency/Unscheduled Care, Wards 1/2, Infection Unit, Wards 13/14, Gynae, Anchor Unit, Medical Unit 2 and Wards 7/8.
·  Meeting with out-patients planned for 28th June
·  Radiology cancelled meeting but will introduce and ask for assistance if required.
·  Surgical 1 – Wards 31/32 very well established. To roll out to the rest of Surgical 1 not already doing daily briefs.
·  ITU already established.
·  Audit of progress to be carried out with Carol Low and Eleanor Murray – 15.7.10
Triggering System Identifying Equipment is Clean
Green tape system not working with widespread dissatisfaction. Trial in progress using plastic pockets and cards requiring to be signed and dated by nurse cleaning equipment. Wards currently involved in trial include: Wards 19/20; 50/51, Part of ITU and one ward at Dr Gray’s. An audit trial planned shortly by Jill Perchard and Eleanor Murray.
Cleaning of Ward Equipment
A work group has been established who are utilising a DoH NHS Cleaning manual and template. Work commenced on commodes for both non-infectious and infectious patients. Plans in hand to look at hoists, drip stands and pumps. Full engagement of infection control and approval of Dr Karcher meantime being established.
Clean/Dirty Areas in Wards
Wards 19/20 currently being used as model for identifying area which is dirty and clean. Flo Morrison and Katherine Prince (Project Manager Estates Dept) have been assisting with this work, involving moving things around from their traditional place in the ward eg commodes. Central Stores also involved in removing excess items from the Clean Utility Room and making space for bigger items like mattresses. This information gathering exercise hopefully will enable a decision to be made whether roll-out would be feasible. The costs of this trial are currently being met from the HEI budget approved by Gary Mortimer.
HEI Audit
A full HEI audit for all in-patient wards in the Acute Sector is planned during June/July and hopefully will be completed by the end of Eleanor Murray’s HEI secondment.
Elinor Smith thanked Eleanor Murray for this comprehensive update and highlighted that funding for 2 days a week has been made available to continue Eleanor’s secondment.
Sean Coady updated on his recent dashboard exercise for the development of a robust tool for Senior Charge Nurses based around performance. Sean, in collaboration with Helen Robbins, is meantime creating a suitable spreadsheet and agreed to circulate this to the group for feedback.
It was agreed that this should be an agenda item for the July meeting.
Mattress Audits
Stephanie Broadbent, Acute Sector Nursing Supplies Co-ordinator, reported on recent work to establish a Grampian-wide tool for the monitoring of mattresses and tabled results of a recent audit. Initial results have been rather sporadic and identified that many practical issues still need to be addressed. There is a rolling programme for replacement of bedframes, but currently mattress replacement remains the responsibility of individual wards. Discussions are underway with Stephen Evans, Linen and Sterile Services Manager, looking at possible capacity for cleaning mattresses following the reduction in uniform cleaning.
One of the actions in the HAI Action Plan covers undertaking regular mattress audits. It was agreed that the nurses who are undertaking 2 days per week on LBC in their areas should work with Stephanie Broadbent to devise a plan to implement this. Fiona Gray agreed to pass the names to Stephanie. SNG will receive feedback at next meeting. / SC
SC/EStirton
SB/FG
10. / Updates from Areas
Deferred until next agenda to accommodate additional agenda item below.
Additional Item
Efficiency & Productivity Programme Management Office (EPPMO)
Elinor welcomed Jack Stuart, Neil Buchanan and Nadia Auld to the meeting.
Jack Stuart confirmed that he has been tasked by Richard Carey, Chief Executive - NHSG, to undertake a piece of work to establish a shift system fit for practice.
This will be evidence based, for example, around quality/ safety/ handovers/rostering/communication/holidays/sickness/SSTS/affordability, and possible correlation with datix and the feedback service.
Initial work, in the form of a literature review on the 12 hour shift, has commenced and will be shared with this group in due course.
Jack Stuart sought volunteers from each area to form a subgroup. Names to be forwarded via Elaine Stirton within the next week. It was suggested such a subgroup should include staff side and lay person representation.
A progress update to be available for July Agenda. / NB/EStirton
ALL
JS/EStirton
11. / Delivering Dignity and Compassion in Care Grampian Pilot
Linda Oldroyd, Nurse Consultant in Patient Safety and Experience, tabled a brief outline and proposed pledges on the NHS Grampian Pilot. Agreement on the pledges will be forthcoming following wider consultation. Linda emphasised this work currently transcends across all specialities and also links in closely with the Mid Staffs work and NHSG Quality Strategy programme.
It was suggested that Linda may find it useful to discuss the “tree vision” with Sheila Irvine outwith this meeting.
Linda to be invited back to the August meeting for a further update.
/ LO/SI
LO/EStirton
12. / AOCB
Elinor Smith, on behalf of the Group, thanked Gregory Poon for all his hard work during his time with NHSG and wished him well on his forthcoming retirement. Dates to be circulated around Group for evening event. / EStirton
13. / Date and time of next meeting
Monday 19th July 2010; 1200 – 1600 hrs,
Seminar Room, Summerfield House
Apologies for absence to: Elaine Stirton, ext. 58680;