Spinal care bundle set to roll out

An interventionto help nurses and doctors care for and diagnose spinally injured patients looks set to be rolled out across England.

The Spinal Injuries Care Bundle is designed to help fulfil one of the 10 high-impact interventions recommended by chief nursing officer for England, Chris Beasley, in 2004.

Nicki Bellinger, consultant nurse at Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Shropshire, helped develop the care bundle – a group of evidence-based practice interventions – as part of the multidisciplinary West Midlands Critical Care Network.

Ms Bellinger has worked on the intervention over the past two years with Alison Lamb, also a consultant nurse at the trust, after becoming concerned  doctors were failing to notice spinal injuries during clearance.

The three main focus areas of the bundle are management of the spinally injured patient, spinal clearance, and referral to specialist care in ICU and high dependency units.

'Patients were being seen by A&E doctors or senior house officers who did not have the right orthopaedic or spinal knowledge,' Ms Bellinger said.

'We were seeing patients who had got spinal injuries, even though they had spinal clearance. We had a whole spate of them.'

Nursing care also fell short of the mark, said Ms Bellinger, with spinally injured patients left on boards or in collars for days at a time without being moved, causing the development of pressure ulcers.

'We would like to get patients off these spinal boards – that is what nurses don't realise. They don't always have correct training in moving and handling,' she said.

The bundle has already been adopted by six hospitals in the North West Midlands Critical Care Network.

The neighbouring Birmingham and Black Country Critical Care Network is looking into adopting it.

Ms Bellinger has also been approached by hospitals in Leicester and East Anglia.