Under the Medway Nursing and Midwifery Accountability System (MNMAS), introduced in September 2004 by Medway NHS Trust, matrons hold regular meetings with their director of nursing on latest performance data.
The system uses 18 performance indicators – agreed between the trust and nursing staff, which include MRSA and Clostridium difficile rates, agency and bank nurse use, and pressure ulcer levels.
Matrons have to account for their weekly figures at the meetings. If performance is falling, the reasons behind this are explored and staff suggest ways to improve the situation.
Latest results from the programme include a 56% reduction in admitted and acquired MRSA bacteraemia over the last three years, an average fall in bank nurse use from 450 to 250 hours per week, and a consistent low mean percentage of patients with admitted and acquired pressure ulcers in the women’s health department.
This month, the second phase of the system will be introduced at the trust with double the number of performance indicators – including single-sex bays, commode audit, hand hygiene and protected mealtimes.
Jacqueline McKenna, the trust’s director of nursing who brought in the system, said it has helped identify problems.
‘The pressure ulcer data was showing something that was not expected – it was going up,’ she said.
‘Further investigation found it was down to patients with controlled analgesia and epidurals whose mobility was reduced. We would not have known this without doing MNMAS,’ she told NT.
‘The matron implemented an education programme and we have had very good results with very few pressure ulcers since then,’ she added.
Similar schemes have been adapted from the Kent model by Brighton and Sussex University Hospitals NHS Trust and Surrey and Sussex NHS Foundation Trust.