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Nurses in Scotland given list of ‘essential actions’


A list of 10 patient safety “essentials” are to be rolled out for use by all NHS staff in Scotland, ministers have announced.

The list sets out 10 of the most successful elements of NHS Scotland’s patient safety programme, which have already been implemented widely.

The Scottish government said the new list was intended to ensure all of the elements would now be implemented by every member of staff, for every patient receiving hospital care.

Health secretary Alex Neil is due to launch the initiative at a conference on the Scottish Patient Safety Programme on Wednesday.

Speaking ahead of the conference, Mr Neil said: “These ten patient safety essentials encompass the principles of our safety programme and are measures which are evidence based and proven to help ensure patient safety.

“The Scottish Patient Safety Programme has worked with NHS boards to create and test these actions and they are ready to be rolled out across Scotland.”

The list includes a number of areas where good practice should be followed, such as hand washing, as well as a number of evidence-based care bundles.

Susan Went, director of evidence and improvement for Healthcare Improvement Scotland, which manages the Scottish Patient Safety Programme, said: “As a result of the first five years’ work to embed safety within our acute hospitals, the 10 essentials are the actions that have been shown to work most consistently and comprehensively.

“Based upon this information, we are confident to recommend to the Scottish Government that these actions be moved from testing and become patient safety ‘must dos’ for NHS Scotland.”

The list of patient safety essentials encompasses the following 10 areas:

  1. Hand Washing – hands will be washed at all of the World Health Organization “5 Moments”
  2. Leadership Walk Rounds – walk rounds will take place to strengthen the opportunity for senior leaders to obtain learning and oversight of the safety issues, and work closely with patients and front line carers to further create and support the capability for leaning
  3. Surgical Pause and Brief – a pre-operative list briefing will be held including all members of the surgical team and a pre-operative pause will take place before every surgery
  4. General Ward Safety Brief – on every ward, every day a short team briefing will take place when ward staff will gather together to highlight any patient or equipment safety issues for the day or shift
  5. Intensive Care Unit Daily Goals – every patient in an Intensive Care Unit will have a set of daily goals agreed and documented in the case notes
  6. Ventilator Associated Pneumonia (VAP) Bundle – this evidence based bundle of care will be administered
  7. Early Warning Scoring – a simple series of observations used by nursing and medical staff to determine the degree of illness of a patient, identify patients who may need closer monitoring or more intensive levels of treatment
  8. Central Venous Catheter (CVC) Insertion – an evidence based CVC insertion bundle to prevent central line associated blood steam infections will be used every time central lines are inserted
  9. CVC Maintenance – an evidence based CVC maintenance bundle to prevent central line associated blood steam infections will be used every day on every patient
  10. Peripheral Venous Cannula (PVC) Bundle – an evidence based PVC maintenance bundle to prevent blood steam infections will be used every day on every patient

Readers' comments (4)

  • Are these not the things that nurses do already, as a matter of course, and in addition to compassion and caring?

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  • Yes David, they are. But we have to keep the sweethearts at Healthcare Improvement Scotland in their undeserved salaries whilst the rest of us just get on with it. I thought that we had been able to remain at a relative distance from all the launching of lists and other such daft initiatives in stating the bloody obvious that have been going on south of the border. It appears that the infection is spreading.

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  • Much as these actions should ensure patient safety they missed the point. Having recently suffered the indignities of being a patient in an NHS hospital in Scotland, care/compassion need addressing first. A caring nurse will seek to provide patient safety; safety without care can still do considerable harm. From when I asked about call buzzers being told they didn't have them '& why would you need to call us anyway', writing 'refused' on the obs chart when hadn't even woken me, monitoring being disconnected for an hour without apparently being noticed (despite a BP/P which gave SEWS that should have triggered immediate medical call just before disconnected), being refused access to the toilet being told I couldn't need the toilet (time for someone to revise their A&P)(unlockable & no working vacant/engaged sign anyway), refusing to call a chaplain when asked, discharge being delayed for several hours as nurses only had verbally from 2 sets of doctors (& so I missed the community appt Drs had wanted me discharged for) etc etc it was a horrible experience. (Aside from the other patients and the cleaner who appeared to care more than nursing staff). But it's obviously all ok as, 4hrs post missed appt/meant to be discharge, over a shouted conversation to colleague about 'have you had the care rounding training' my 'care rounding' sheet was retrospectively filled in for whole admission & I have no recollection of over half the 'care' I apparently had received, nor (strangely) being told after each round the time the nurse would return!). My 'patient safety'/inc PVC care bundle charts will exist as 'evidence' of my safe care.
    There may have been circumstantial/busyness issues for some of it, but I was left ashamed of my profession, yet knowing no point in complaining as the paperwork would contradict reality.

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  • snowy_owl | 30-Aug-2013 0:03 am

    sounds horrendous and very frightening that this is happening. if you can't complain for the very obvious reasons you state perhaps you could do good service by publishing your comment where it will be more widely read and hopefully taken note of by those in power to make the vital changes.

    it seems this whole situation is destined to get a whole lot worse as we move into an increasing robotic world which favours AI over human values and relations.

    it looks as if the young are being bought up and trained with too much emphasis on the skills of IT and clerical work rather than caring and the main focus seems to have moved onto producing completed records with pressure and judgement from above by non-clinical management on their performance in this rather than centring their work around the understanding and meeting the basic, clinical and personal needs of their patients! The question now is how are things going to be moved forward so this does not continue to be allowed to happen.

    "Artificial intelligence 'will take the place of humans within five years’

    Salespeople, call centre staff and customer service personnel could all be replaced by computers within the next few years, claims one technology entrepreneur."

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