Nurses have been told how to fulfil their “professional and moral responsibility” to help the NHS cut waste and save money, in comprehensive guidance shared exclusively with Nursing Times.
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The 260-page document has been published to show nurses how they can implement and measure the eight “high impact actions” aimed at saving more than £9bn.
It states: “A few nurses and midwives may still think that money is someone else’s business, but those that think this are, quite frankly, out of touch with reality - opting out isn’t an option.
“Addressing financial inefficiencies is a key personal, professional and moral responsibility.”
The “high impact actions” were announced last November and include areas such as improving patient nutrition, reducing pressure sores and falls and cutting staff absence.
A major theme in the document is the importance of good communication methods. At one trust, infection control teams carried out trolley dashes through the wards, handing out themed “goodies” to get people talking about catheter care.
Another trust designed a giant floor game to disseminate important information.
The guide also sets out how cost benefits can be calculated. For example, by using the Department of Health’s estimate that the daily cost of care for a patient awaiting hospital discharge is £100, nurses can identify savings from reducing delays.
She said: “We have seen that’s the case from productive ward work, where ward sisters and ward leaders at that level have really taken it on and made it their own.”
She told Nursing Times that successful pilots had often addressed two or three areas together such as pressure ulcers, falls and nutrition.
But work to date had also shown that nursing leaders also needed the backing from their organisations to ensure change actually happened, she stressed.
She said: “Nurses have got to get involved otherwise we will suffer.” Unless senior nurses were engaged, “others haven’t got a chance.”
Some might be worried about schemes appearing to pit ward against ward, but Ms Fenton said the work had shown nurses could be “energised” by an element of competition.
However some improvements, such as nurse led discharge and nutrition, had proved particularly tough to crack, she said.
NHS County Durham and Darlington took action on nutrition, involving enforcing protected meal times, gathering patient feedback on menus and ensuring hot, fresh meals were available 24 hours a day.
Modern matron Karen Dyson said patients were happier and catering costs had fallen.
Another case study in the guide is East Kent Hospitals University NHS Foundation Trust, which used routine falls risk assessments, sensor alarms and falls “champions”. One ward reduced its falls rate by 85 per cent in a year.