A team of nurses who created a set of tools that help the independent care sector in Shropshire prevent infections and reduce hospital admissions have been shortlisted in the Nursing Standard Nurse Awards 2015.

Tanya Kidson Tanya Kidson (pictured right) and colleagues. Picture credit: Neil O’Connor

Check to Protect, which enhances the skills and knowledge of staff in care homes, has been taken up by almost half the 300 adult social care providers in the county. It has earned the nurses who led their implementation a place Nurse Awards finals in the infection prevention and control category – sponsored by Nursing Standard.

‘Being a finalist in the Nursing Standard Nurse Awards is a huge achievement and the whole team is blown away by it and delighted that their work has been recognised,’ says Tanya Kidson, infection prevention and control lead nurse for Shropshire, Telford and Wrekin clinical commissioning groups.

She explains why the support and guidance was needed: ‘There are lots of supportive initiatives and tools around for NHS organisations to monitor practices and maintain consistency, but not so much for the independent care sector – which still has to meet Care Quality Commission (CQC) requirements.’

Tanya and her colleague Jill Hassall began to look at how the infection prevention and control team could work with the independent sector to ensure that residents and clients enjoyed the best care and that providers met commissioning and CQC requirements.

‘The tools provide the sector with a means to evidence that every resident/client is receiving the right care, at the right time in a safe environment,’ says Tanya. They include hand hygiene, oral hygiene, waste disposal, enteral feeding and equipment cleaning.

Developing the tools

It was important to develop something that the sector was happy taking forward, she explains, so they invited infection prevention and control link nurses from across Shropshire and Telford to come together and participate in working groups to develop something ‘useful and used’.

The information gathered, coupled with the nurses' specialist knowledge, enabled the team to produce a set of assessment tools built around the main areas that the independent sector felt were its priorities.

As each tool was developed, volunteers from the working group piloted the tools for six to eight weeks within their work area. Feedback was also obtained from service managers, staff and residents/clients, with the results taken on board and the tools refined.

Assessor prompts are provided for each of the tools to ensure assessments are consistent, so Tanya’s team delivered training sessions for staff designated to the role. ‘We spend time in the home to help skill those who will carry it forward,’ says Tanya.

Raising awareness

They promoted the tools further through the infection prevention and control nurse link group and visits to care homes. ‘Using the infection prevention and control link nurses has been a tremendous success,’ says Tanya. ‘We can’t get to over 300 providers so we rely on them to act as a resource and role model in the area. We have a very active link nurse group which meets regularly in various locations across the county.’

The team also worked closely with Shropshire Partners in Care, a not-for-profit member organisation for the independent care sector to promote and raise awareness of the initiative.

The input of the sector has been vital to the initiative’s success. ‘It has been invaluable in creating a sense of ownership which in turn has encouraged take up by providers – almost half of care homes have implemented it,’ says Tanya.

The Check to Protect tools have been used for the past three years at Alexander House in Ludlow, a 22-bed residential care home for people aged over 80. It cares for people with dementia, physical disabilities and sensory and visual impairment.

Manager Sue Grehan says: ‘All the Check to Protect tools are user-friendly and easy for employees to understand,’ says Sue. ‘Implementing them has certainly improved the standard of infection control within the home and staff are also more vigilant in spotting any infection issues so that they can be addressed.’

Norovirus outbreaks reduced

County-wide, the tools have also been credited with helping to reduce the attack rate and length of diarrhoea and vomiting outbreaks as a result of norovirus. A review of all diarrhoea and vomiting outbreaks reported to date in 2014/15 has found the majority of outbreaks have been contained within a period of eight days compared to 15 in previous years.

It has also been attributed to helping cut hospital admissions when norovirus has been circulating in the community. To date in 2014/15 no residents from care homes have been admitted to hospital due to diarrhoea and vomiting, dehydration or associated urinary tract infections.

Chief nurse of Shropshire Clinical Commissioning Group Linda Izquierdo says: ‘Care homes in the independent sector are responsible for some of the most vulnerable people in society. It is vitally important staff practice infection prevention and control procedures to the highest standard. Any shortfall can lead to hospital admission and subsequently affect NHS services.

‘Check to Protect has taken a partnership approach to clinical and care processes to improve cleanliness and safety for patients in the independent sector. Early signs are highly promising, and are a great credit to Tanya and the team’s hard work and enthusiasm.’

Judges impressed by achievement

The Nurse Awards judges were also impressed. They praised the widespread impact Check to Protect had achieved and Tanya’s leadership.

RCN nurse adviser for infection prevention and control Rose Gallagher says that the work was of real value and was pleased to see such a comprehensive initiative for the independent sector. ‘Tanya’s work is very important and I think it will go places,’ she added.

North Hampshire Clinical Commissioning Group chief nurse Jan Baptiste-Grant said: ‘Tanya and her team had a great collection of ideas and have overcome real challenges to put it into practice.’

The building blocks laid by Check to Protect bodes well for the future – the initiative has strengthened the relationship between Tanya’s team and the independent care sector.

‘Creating an environment in which independent sector nurses could have their voices heard has built trust and confidence,’ says Tanya. ‘That trust has created something special in Shropshire and the sector’s enthusiasm for this has been truly inspirational.’

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