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Staff identification – the nursing perspective

Date: February 02, 2018

Category: Industry news

In the first of our series of insight articles on our conference breakouts, this session brings together three of the country’s leading nurses to discuss staff identification and why it’s not just patients we should be scanning:

  • Mandie Sunderland, Chief Nurse, Nottingham University Hospitals NHS Trust
  • Lorna Wilkinson, Director of Nursing, ‎Salisbury NHS Foundation Trust
  • Jackie Whittle, ‎Chief Clinical Information Officer, ‎Leeds Teaching Hospitals NHS Trust

Right from the beginning of the session, the importance of getting nurses involved in staff identification was established – they’re the largest profession in the NHS and they’re there 24/7. This session was a real opportunity to share some of the work already being done around staff identification and put nurses forward as candidates to push this project forward.

Adoption at Salisbury NHS Foundation Trust

As one of the Scan4Safety demonstrator sites, Salisbury NHS Foundation Trust (Salisbury), are on their journey to linking the 4 P’s: Patient, Product, Place and Process. But for Lorna Wilkinson, what it’s missing is staff and so the first ‘P’ should be about ‘Person’ i.e. patient and staff.

One of the main reasons for this is the many benefits of positively identifying staff:

  1. First and foremost, the potential to improve patient safety – we’d know what our staff are trained to do and if they’re potentially about to do something they’re not trained in
  2. It provides a clear record of who is involved in what
  3. Helps with managing availability e.g. if there’s an emergency in our hospital, how do we know who is where?
  4. It helps to reduce clinical variation by giving us data on our approaches across systems and procedures. That way, we can reduce variation across teams and the individuals
  5. In a skills mix review, it helps to capture what staff are doing and how our staff are spending their time. At the moment it’s very labour intensive process that could be improved by linking staff identification to the processes and procedures they’re directly involved in
  6. It helps with using resources most effectively. It can show where we get our most efficient outputs and make sure we’re getting the most out of our staff

What currently exists at Salisbury and how is it changing?

Staff at Salisbury currently juggle a mixture of systems that all require an individualised pin, some scanning with some staff barcodes and some are manual with passes. Beginning to use GS1 standards for staff identification is an incremental process. At the moment, the project is being scoped out, seeing what systems are in place and how they’re currently being used.

For Salisbury, the question is can there be a national solution for staff identification? If not, everyone develops their own systems and they all remain fragmented.

Staff identification at Leeds Teaching Hospitals NHS Trust

Leeds Teaching Hospitals NHS Trust (Leeds) is one of the biggest Trusts in the country with 1.6m patients, 17,000 staff and £1.17bn turnover. They’re self-builders from an Electronic Patient Record (EPR) perspective, but with patient information in almost 300 systems, new technology is a challenge.

Understandably, interoperability is key and they work really hard to make sure their systems can talk to each other. Being self-builders, staff identification also provides a big opportunity for Leeds because they can build patient and staff IDs straight into the patient record. Their care record also links across all health and social care providers across the city. It’s an important consideration because it means that anything that changes impacts all of their partners across the city.

Why is staff identification important at Leeds?

The NHS as a whole is being asked to increase the quality of care they provide, whilst saving money. For Jackie Whittle, the best way to do that is to have clinical care supported by technology. There are number of examples at Leeds of how this is already working. Looking at their cardio cath labs, for example, they knew that setting up a Percutaneous Coronary Intervention (PCI) took six minutes 32 seconds of a nurse’s time. With new handheld scanning technology, they’ve now reduced that to 1 minute 53 seconds with a cost saving of £4,000 per procedure. When you think of applying that across a whole hospital, you start to see the scale of what could be achieved.

For staff identification, the implications are the same and it’s at ward level that clinicians really want to see it working. From the beginning, Leeds knew what they wanted - for everything to be within one visit to a computer as much as possible and to need access to just one system. So far, the rollout means that all patients now have a GS1 wristband and they’ve rolled out e-observations within their own platform, including Apple devices to do all the scanning. They’ve also made sure it’s been a gradual approach to improve digital literacy for nurses, so that it’s not anything for anyone to be scared of.

They’re already seeing the benefits of linking every person, product and place. A pilot in their breast unit is doing exactly that, including a barcode at every bed space, meaning they can track the patient’s journey through the department and it all goes directly onto the EPR. And it automatically updates their whiteboard so ward nurses can know exactly where patients are and which staff have looked after them.

Successful implementation has meant having a team that includes project nurses as well as non-clinical informatics staff. Everything is also sponsored by a clinical person - if a clinician doesn’t want it, it doesn’t get developed. They’ve also stopped calling projects like Scan4Safety pilots and now call them early adopters - it gets a better response and encourages ownership.

Looking ahead

Mandie’s summary towards the end of the session was that the room was in agreement that staff identification is the right thing for patients and the right thing for staff. It’s now just about convincing hearts and minds that it’s not about policing, it’s about reducing risks for staff and patients. At Nottingham University Hospitals NHS Trust, they’ve definitely seen a generational shift across staff when it comes to technology.

The newly qualified, younger nurses have no problem whatsoever, but for the older generation it’s a lot scarier. But as was pointed out by Jackie, if you sit and talk to the older nurses and help them see that they already use a lot of technology at home – they do go online, they shop online and this just the same principle. It’s what the whole world is moving towards and it’s time for the NHS to move with it.


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