Care of the deteriorating patient: Year 1 Progress

Aim:   By March 2017 we will reduce avoidable harm caused by failure to rescue or failure to recognise the deteriorating patient by 50% from our 2015 baseline of ‘Failure to Rescue’ cardiac arrest calls

Aim: In Maternity we will ensure compliance with NICE intrapartum guidance and the sepsis pathway

We said we would measure the effectiveness of our actions by demonstrating:

The number of patients experiencing a cardiac arrest as a result of failure to rescue/recognise. At the end of Year 1 we achieved a 16.67% reduction in patients experiencing a cardiac arrest as a result of failure to rescue and a 7.14% reduction in the number of patients experiencing a cardiac arrest

Compliance with NICE CG50 guidance – This is NICE guidance that proposes how patients who are acutely ill should be treated. At the end of Year 1 we achieved 100% compliance

Compliance with NICE CG190 guidance –This is NICE guidance that proposes how we care for healthy women and their babies during childbirth. At the end of Year 1 we achieved  100% compliance

Other improvements in Year 1:

Introduction of the new National Early Warning Score  – This is a tool that look at patient observations and supports staff to detect if a patient’s condition is deteriorating. It also helps staff recognise trends and triggering pathways easier

Reviewed and updated Fluid Balance Chart – This helps staff monitor a patients’ fluid intake and fluid balance in order to prevent either dehydration or under hydration and then make clinical decisions regarding further treatment.

Introduction of newly purchased equipment to support patient monitoring and the avoidance of unnecessary admission to critical care This has allowed staff to detect earlier deterioration and has supported expedited admission to critical care by demonstrating ongoing failure to respond to treatment in a ward area but where patient has the potential to respond to advanced interventions offered in critical care

Introduction of newly purchased foetal monitoring equipment and the introduction of a peri-natal training programme in maternity care – This equipment has supported midwives and doctors to safely mange high risk women in labour as it will enhance the quality of foetal heart rate monitoring, especially for women with large BMI’s. The equipment has been complimented by the training programme which has supported, teaching and competency assessment of midwives and doctors in CTG interpretation and management of obstetric emergencies.