Career advice

Spearheading a technological revolution in district nursing

Award-winning district nurse Paul Crank reflects on how he ensured connectivity across care records

Award-winning district nurse Paul Crank reflects on how he ensured connectivity across care records

Paul Crank, senior nurse in district nursing at Cwm Taf University Health Board, has spearheaded a technological revolution in his 250-strong community workforce. He has overseen each member of the team gaining a small laptop that gives them immediate access to secondary and GP records while they see patients. This project, which means the nurses are better informed when they visit patients at home, helped Mr Crank win the community nurse award at the 2017 RCN in Wales Nurse of the Year awards.

Mr Crank became a nurse

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Award-winning district nurse Paul Crank reflects on how he ensured connectivity across care records


Paul Crank, senior nurse in district nursing at Cwm Taf University Health Board

Paul Crank, senior nurse in district nursing at Cwm Taf University Health Board, has spearheaded a technological revolution in his 250-strong community workforce. He has overseen each member of the team gaining a small laptop that gives them immediate access to secondary and GP records while they see patients. This project, which means the nurses are better informed when they visit patients at home, helped Mr Crank win the community nurse award at the 2017 RCN in Wales Nurse of the Year awards.

Mr Crank became a nurse after he decided to switch careers following six years working in personnel for the NHS. He started training in 1992 in Glamorgan in south Wales. ‘I enjoyed all my placements, but I particularly loved community nursing experience,’ he says.

‘By my third year I decided that I wanted to be a district nurse. We provide one to one care in a patient’s home and for that moment in time you are solely focused on that patient and what they need health wise.

‘While some patients are short admissions, some will be there for life and we get the chance to a build a huge relationship with them and their families.’

Rarity

Going straight into the community was rare for newly qualified staff at the time, but the health board decided to try out taking four new nurses that year. Mr Crank got one of those posts and became a community nurse in a district nursing team in Merthyr Tydfil, and gained his district nursing qualification in 2000.

He became a charge nurse for a team five years later, and then, in 2010, became senior nurse in charge of the 250 district nurses, community nurses and healthcare assistants in Rhondda and Taff Ely. He is responsible for their management and leadership, and the clinical standards in the service.

‘The ultimate aim in this is a better service, we are more informed and that has got to lead to better outcomes’

Service development is also part of his brief, and this is where Mr Crank began the innovative IT project. He successfully applied for a grant from the Welsh government, which funded the 250 small laptops connected to local primary, community and secondary care records. Arranging such connectivity meant talking to and gaining approval from each local GP practice, as well as the hospitals, and a great deal of governance to ensure that the records would all be secure.

‘It allows nurses in real time to have all the information we need to care for a patient,’ he says. ‘It was a big project, we had to reassure a lot of people from a governance point of view.’

Real-time patient records

The community staff can update records in real time while they are with the patient. This replaces writing information on bits of paper that were handed over to GP receptionists, which could be misinterpreted or lost. GPs and practice nurses can see immediately what has been requested or carried out by a community nurse.

While there were some challenges in convincing and supporting all staff to move onto the computer-based system, it is now well embedded, he says.

One unexpected beneficial side affect has been for mandatory training. The training packages can be accessed through the laptops and compliance has improved from 41% last year to 72% this year, and continues to increase.

'Transformational work'

The RCN in Wales award judges praised Mr Crank’s ‘exceptional leadership’.

‘His use of IT solutions to deliver care at home has been transformational and the work has been recognised as an exemplar for others,’ the judges said.

Mr Crank says that the use of technology is helping the team bring the best care to their patients. ‘The ultimate aim in this is a better service,’ he says.

‘We are more informed and that has got to lead to better outcomes.’

Click here for more on the RCNi nurse awards 

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