Brain Injury Nurse Project: Reflection

Transcription

1 Brain Injury Nurse Project: Reflection Davina Richardson Clinical Service Lead Therapist for Neurosciences Imperial College Healthcare NHS Trust. Charlie Howard Brain Injury Nurse specialist Imperial College Healthcare NHS Trust.

2 Objectives Share an experience Iden.fy what went well Iden.fy poten.al barriers Next steps

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5 How do we measure success?

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7 What did we measure? Face to face.me with pa.ents and rela.ves 30% Non face to face.me with pa.ents and rela.ves 15% Data collec.on and management 10% MDT mee.ngs 10% Resource management 10% Role development and training 20% Teaching and suppor.ng team 5%

8 What went well? Pa.ent informa.on leaflet and resource folder for staff on shared drive. Recorded pa.ents detail seen by TBI nurse from November 2013 to May people and families. Iden.fied 2 validated outcome measure for post TBI. Data on 20 pa.ents/rela.ve for the 2 outcome measures. Supported the TBI clinic MDT ( x 10) iden.fied changes to rehab support required, feed back to the ward, quality process to improve staff awareness of issues post discharge. Reflec.on on the role iden.fying barriers/challenges/opportuni.es. Iden.fied the need for a TBI support role in the MTU. Iden.fied the need for a feedback Ques.onnaire/method of capturing pa.ent experience.

9 What challenges did we come across? Recruitment to part-.me band 6 posi.on Reten.on Insufficient a\en.on to detail at the ini.al concep.on. Difficul.es liaising with families due to ward visi.ng.mes Time involved in suppor.ng such a role was not adequately iden.fied at ini.al phase.

10 Initial summary of Reflections Develop links with Headway and voluntary sector. Tracking of pa.ents pathway from the point of discharge. Follow up pa.ents in OPD clinic TBI Develop role for a Major trauma CNS. Liaison with drug and alcohol services. Links with ICU and Major trauma. Work mobile to provide telephone support to pa.ents and families. Advice line to support clinic appointments, informa.on and guidance for crisis management. 24/7 Research/evalua.on of the role Ques.onnaire.

11 Actions on Reflections Headway Project NWL Neuro Rehab project board Pilot of a web based referral tool to neuro rehab Co- design work shop Pilot of 2 full.me Navigator roles KPI s for a Clinical psychology scoping project KPI s for a Rehabilita.on consultant scoping project

12 Summary of reflections Sustainability requires buy into a whole systems approach Evalua.on of impact of a small change to a large system is challenging Coun.ng doesn t equate to connectedness

13 It was fantas.c, someone on board who knew the eventual outcome and what to do to help, very caring and wouldn t hesitate to use services. Only met him twice, he was to the point and very knowledgeable, put our minds at ease

14 Patient Review 1 Planned follow up with pa.ent who was ini.ally seen in TBI clinic Pt displayed severe emo.onal problems and told not to return to work by employers Benefits stopped in community Contacted pt by telephone for follow up, ques.onnaire performed and given further Headway informa.on Also given informa.on on how to access benefits through

15 Patient Review 2 Pt contacted by telephone for TBI follow up Ajer ques.onnaire pt informed about issues since returning home from hospital. Given intermediate care bed which was turned down as pt too well Pt struggled at home but was able to sort many services through GP On discussion with pt she felt an intermediate bed would have benefi\ed her recovery

16 Patient Review 3 On telephone follow up pt complained of many symptoms due to HI. Struggling to work more than 11 hrs/week due to fa.gue. Also complaining of memory, concentra.on, anxiety, emo.onal, apathy & taste issues Pt also discussed at TBI clinic and again issues were highlighted Pt commenced on an.- depression medica.on and referred to the Wolfson Neuro Rehab Centre for return to work program

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