Hi-tech help on the job for district nurses

Staff in the Welsh NHS are using the latest technology to improve the way they work. Here, Julia McWatt from Cwm Taf University Health Board explains how district nurses are enhancing patient care with Chromebooks

AS technology develops and changes the ways in which we live our lives, the NHS needs to look at how it keeps pace with digital advancements.

Communities are at the heart of the South Wales Valleys and the passion of those living in the area is second to none.

Cwm Taf University Health Board knows people want to stay in their communities – areas that are familiar to them and close to their friends and families – as much as possible.

As the health board strives to support more people in their own homes, it needs to make sure community teams are geared up to deliver a safe and efficient service to patients.

The district nursing service has been looking at using digital technology to transform the way it works.

In May 2015, it launched its Mobile Working in the Community project thanks to a successful bid for Welsh Government funding from the Health Technology and Telehealth Fund and Invest to Save Fund.

Under this initiative, Chromebooks have been rolled out to district nursing teams and all district nurses are now using the devices as part of their normal daily duties.

This equates to around 225 district nurses using the devices to carry out administrative duties, access clinical systems and patient records.

Two years on and mobile working has now become part of their daily lives and the benefits are being seen on a number of levels.

Most importantly, patients appreciate the fact that their district nurse can access information immediately to improve their care and manage their conditions better.

They also can be reassured that their information is being put into a system that can be accessed by both their GP and their district nurse.

The team has also reported an improvement in the care they can provide to patients and less travel time as they can access information remotely.

Figures have shown that, since the introduction of the Chromebooks, levels of activity have dramatically risen.

For example, April to June 2016 showed a 23.4% increase in activity compared to the previous year and there was a 26.9% increase in the number of treatments.

Looking at October to December 2016 compared with the same period the year before, there was a 22.6% increase in the number of activity, and a massive 61% increase in the number of treatments.

The project has also made financial savings, with £150,000 of district nursing productivity realised in 2016-17 (with a further £150,000 anticipated for 2017-18). Meanwhile, £26,000 of travel savings have been recorded each year.

IT development nurse Rhys Roberts said: “Lots of the nurses say they could not do without their Chromebooks now. “It’s been a real culture change. “The biggest benefit for the nurses is having key information at the point of visit. Previously they would have to contact GP surgeries, relatives, etc, to gain relevant clinical information, which was very time-consuming. Efficiency savings such as this are allowing them to have more patient contact time.

“District nurses are now able to undertake true partnership working with their GP practices as they have access to their patient record systems via the Chromebook.”

Data protection has been a key priority. Nothing is actually stored on the Chromebook. You can only use it by logging into the system – and that’s two sets of logins. There is then a further two sets of log-ins for the GP record.

One of the key things the use of the technology has allowed for is the creation of a virtual INR clinic.

INR monitoring is vital for patients who are on long-term anti-coagulation therapy. In the past, a patient’s INR results had to be transcribed on to paper records and transferred from person to person. Now, nurses access the INR Clinic list using the mobile device.

The INR result can then be recorded straight on to the patient’s GP patient record and is instantly available to the dosing clinician, who can then make any necessary changes in medication to take place within hours of testing.

Lesley Lewis, head of nursing localities Rhondda and Taf Ely, said: “For the first time, our district nursing teams have access to an up-to-date patient record within our patients’ homes.

“This allows the district nurse to have access to investigation results, treatments and consultations with both the GP practice and hospital doctors.

The team is keen to continue looking at new ways of working.

The project team is now providing advice and support to other community services managers on the benefits of the implemention of mobile working, and the rollout of devices has already begun in some of the health visiting teams. They are also working closely with GPs to demonstrate the benefits for patients, GP partners and district nurse teams.