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Nurses develop ‘bay watch’ safety programme


Hospital nurses in Southampton have taken inspiration from lifeguards on the beaches of California to help further reduce the number of preventable falls among older patients.

The patient safety team at University Hospital Southampton NHS Foundation Trust has taken inspiration from popular US TV series Baywatch to launch a new safety initiative – “bay watch”.

“We looked at how we could combat some of the problems being witnessed on our wards”

Juliet Pearce

The project, which includes information materials printed in the famed red and yellow combination synonymous with the era of David Hasselhoff and Pamela Anderson, is designed to ensure uninterrupted monitoring of vulnerable patients in a dedicated area on the ward 24-hours day.

Staff refer to a six-point list that stipulates the rules to be adhered to on the designated bay (see box and PDF file attached below).

The points include the nurse-in-charge designating any bay on the ward a “bay watch” zone and reviewing which patients would benefit, ensuring a “bay watcher” is always present to prevent falls and that they are not a member of staff on a drugs round.

The “bay watcher” must position themselves to enable maximum observation at all times, assess if it is safe to provide care behind curtains or if they require support, be identifiable at all times by wearing a lanyard and rotate every hour if clinically appropriate.

Staff, patients and visitors are made aware of a bay under continuous monitoring via a poster (see attached PDF file below) on closed doors, which details the process in a similar way to signage indicating a ward closed due to infection prevention.

“This is precisely the type of innovative idea we want to see more of”

Gail Byrne

The project is currently subject to a pilot study on two medicine for older people wards at Southampton General Hospital and, depending on its success, could be rolled out across the department in the coming months.

In the first month of the project, one ward saw only two falls, said the trust. One happened when the “bay watcher” was disturbed and the other involved a patient who had not been selected to move to the “bay watch” bay.

Juliet Pearce, head of patient safety at the trust, said: “Following some of the problems being witnessed on our wards, such as staff quickly stepping out of bays where patients are being observed in and colleagues disturbing the staff members trying to watch over their patients, we looked at how we could combat those issues.

“The idea with the ‘bay watch’ model is to strengthen and enhance some of the work, such as the cohorting of vulnerable patients, which already exists while adding a bit of 1980s fun to teaching sessions to increase engagement in the project,” she said.

Ms Pearce added: “We are really pleased with the initial results and the positive way in which the campaign has been adopted, but it is early days and we obviously need to continue working towards our goal of trying to eliminate all preventable falls in this patient group.”

Gail Byrne, the trust’s director of nursing, said: “This is precisely the type of innovative idea we want to see more of – something which engages staff, patients and visitors while helping us to improve safety for vulnerable patients.”

Bay watch falls prevention – the model

  1. The nurse in charge can designate any bay on the ward a “bay watch” bay and must review at least daily which patients would benefit from this care
  2. A bay watch bay must always have a “bay watcher” who provides observation within the bay to prevent falls both during the day and night. The bay watcher must be a member of UHS staff as often as possible. The bay watcher must not be a staff member doing a drugs round
  3. The bay watcher must position themselves in the bay to ensure maximum observation of all patients (e.g. moving to ensure they do not have their back to patients)
  4. The bay watcher must risk assess if it is safe for them to provide care behind curtains and either minimise the amount of time they spend behind curtains or request other staff members to support them to ensure that observation within the bay is not reduced
  5. The bay watcher must be identifiable at all times by wearing the bay watch lanyard. The member of staff holding the lanyard is responsible for falls observation within the bay at all times until the lanyard is handed over to a colleague
  6. Where appropriate, the bay watcher should rotate every hour according to the rota unless clinical exceptions arise. The bay watch rota should be drawn up at the beginning of the shift

Related files

Readers' comments (3)

  • Extra cognitive and physical workload for nurses - just provide 1-1 specialling for patient's at risk for falls by using falls risk assessment and provide the necessary nursing staff.

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  • Load of rubbish! What about infectious patients at risk of falls who can't be nursed in a bay? Just staff wards properly rather than forcing your staff to use pointless models. Oh sorry we can't allow Nurses to use common sense now can we!

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  • .Ludicrous....Oh hang on bed manager, you're going to have to let that patient breach so I can rearrange all my fallers in one bay...that ok??

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