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Innovation: how nurses can identify need and find solutions

Nurses have an essential role in helping organisations adopt new ways to cope with demand

Nurses have an essential role in helping organisations adopt new ways to cope with demand


Nurses are often central to the sharing of innovation across all sectors,
often as part of multidisciplinary teams. Picture: iStock

If we are to transform health and social care to meet the future needs of society we must draw on innovation.

Innovation doesn’t just mean ‘something new’. It also means adapting or adopting ways of working or products and technologies that have been tried and tested elsewhere.

Nurses in all sectors and specialties are well-placed to support the adoption of innovation, guide patients and their families to use innovative technologies, provide feedback about how these are received in the real world and help remove the barriers that stop successful adoption.

Nurses are often central to the spread of innovation across all sectors, often as part of multidisciplinary teams.

Safety huddles

For example, safety huddles – short, non-hierarchical multidisciplinary briefings that focus on improving safety – are a simple innovation that is being used to reduce pressure ulcers, improve care of deteriorating patients and reduce delayed discharges.

Safety huddles have prevented falls in 1,600 people in one Yorkshire and Humber AHSN (Academic Health Science Network) project. The intervention avoided 13 fractures and saved an estimated £1.1 million in direct care costs.

With more than 200,000 falls in hospitals in England in 2012, this is a common and serious problem estimated to cost the NHS more than £2.3 billion per year, as well as the human cost of distress, pain, injury, loss of confidence and loss of independence. It’s clear that simple interventions can have a significant impact.

Health and wealth

The Academic Health Science Networks were introduced in 2013 to bring industry, academia, health and social care together to stimulate innovation, improve health and generate wealth for the nation.

The 15 AHSNs in England each host patient safety collaboratives, which have achieved a number of improvements through the testing and scale-up of innovations. These include:

  • NEWS2, an early warning tool to detect deterioration in adults. It has been implemented in all ambulances and 77% of acute trusts, and ensures a common language and escalation process for deteriorating adults. Further spread to other areas of health and social care are planned.
  • Suspicion of sepsis insights dashboard, developed by Imperial College Health Partners. This is a tool to track improvements over time in mortality related to sepsis, for the first time allowing individual trusts and regions to understand where to focus their improvement work.
  • LPZ is an international, standardised benchmarking tool for care homes. It measures care problems such as falls and pressure ulcers, supported with quality improvement. It has demonstrated a reduction in both, with a predicted £4.5 million in savings by reducing pressure sores alone over three years, saving £3,440 per care home.
  • Simple hydration projects, including structured drink trolley rounds in care homes. They have helped reduce hospital admissions.

Hydration projects such as structured drink trolley rounds in care homes
have helped reduce hospital admissions. Picture: Alamy

Safety checklist

Future work will focus on implementing an emergency department safety checklist – which has been tested in the west of England and is now being scaled-up across England – further testing of early warning systems in different sectors and specialties, and implementing the chronic obstructive pulmonary disease (COPD) discharge care bundle as part of the NHS Improvement national patient safety collaborative programme.

However, there is a danger in making patient safety a separate responsibility within organisations. As we have learned, making lasting improvements needs to be a collaborative endeavour.

Everyone has their role to play, and nurses’ participation is essential. Across the AHSN Network the theme of patient safety is addressed by a wide range of projects and not just the role of patient safety collaboratives, as these examples demonstrate:

  • PReCePT is a national programme across England to reduce cerebral palsy in premature babies. In the UK, 1% of births are up to 30 weeks premature. Of these babies, 10% develop cerebral palsy. Antenatal magnesium sulphate given prior to birth reduces by 50% the risk of a preterm baby developing cerebral palsy. The AHSN Network aims to treat at least 1,048 additional babies, which could result in potential lifetime savings of £5.1 million.
  • Through compliance with the emergency laparotomy collaborative bundle, national spread could result in 85,000 fewer bed days and a net benefit to the NHS of £9.8 million.
  • The AHSN medicines optimisation programme has identified a number of innovative and impactful programmes of work such as transfer of care around medicines, to prevent harm at transitions of care.
  • The non-injectable arterial connector is a needle-free, one-way valve connector. This simple device prevents wrong route injections into an artery, saving money and avoiding harm to patients.
  • Wiresafe is a human factors engineered solution designed to prevent retained guidewires during operations.

A non-injectable arterial connector is a needle-free, one-way valve connector.

Identify needs, provide solutions

The AHSN Network is uniquely placed to support innovation by bringing together people to identify needs and provide solutions.

If nurses are to navigate barriers to successful adoption of innovation they need the skills to do so and time to act. They should also be connected to their local AHSN, which is there to support local communities through training, networks and connecting people and sectors together.


Cheryl Crocker is AHSN Network patient safety director and honorary associate professor at the University of Nottingham

 

 


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