Maternity Effective Handover Week Commencing W/C 26.02.2024
Trust
Trust
Trust The QI Network for Early Career and Newly Qualified Nurses and Midwives meetings are taking place on: •4th March 2024, 15:30 - 17:00 •18th April 2024, 14:00-15:30
Trust
Trust
Trust
K2 From the new SBLv3 requirements we please have to complete a smoking assessment & CO on ALL women at 35+0-36+6 – this should just be a very quick question as to whether the woman smokes/doesn’t smoke following a CO check . Please document this under : Profile : Smoking : Add New Smoking assessment . This is now one of our mandatory audits which contributes to our CNST payments .
K2
Maternity Immediate learning from a recent incident: Please can we ensure, if a woman is referred to either FWBU or LWT- This must be telephoned through and communicated with the department, This includes referrals from Community and ANC. The telephone calls must be recorded on K2 so that the department can follow up if the woman DNA’s. And you ask the woman TCI – this wizard here, this recommendation page
Maternity Hi all, Going forward can you all email any K2 or digital queries to [email protected] This will ensure we are able to cover the workload when team members have A/L etc. Kayleigh Astley Specialist Digital Midwife: Better Births
Maternity
Maternity The Electronic Document Management (EDM) system is now LIVE. Legacy case notes for booked Maternity patients will now be sent to be scanned and made available electronically on EDM the next working day by 1pm (excluding weekends and bank holidays). How will this affect us? Maternity data clerks only: The records requested by the Maternity data clerks via the dedicated spreadsheet will now be requesting for paper records to be scanned onto EDM. The MROS team ([email protected]) will need to be cc’d when emailing the spreadsheet to Restore. The Maternity reception will be provided with the next volume (thin folder) to add new paperwork generated during the patient’s pregnancy. Please note this next volume will have a sticker on the front of the case note reminding Trust staff the patients legacy records are available on EDM. If you have access to the IPM system, you will notice that Restore has tracked the patients case notes to the scanning bureau when the case notes are in transit to be scanned.
Maternity
Maternity Further to several recent medication incidents please can I ask for your support with the following medication requests: • To ensure that women who take regular medications are prescribed these at the point of admission – this helps the ward to ensure that medications are administered in a timely manner, and women are not self- administering or missing their needed medicine. • To ensure that when booking an induction that the medication is prescribed, this will help to reduce the pressure when asking the medical team on the day of admission.
Maternity
Maternity
Maternity In order to support the Trust’s Green Plan and our environment generally, we will be replacing our plastic dispensing bags with paper ones – see image of examples attached. These have been tried and tested by our team and are in use in multiple other Trusts. This will be introduced gradually, starting with just the TTO bags initially from Thursday 22/02/2024. To accompany the new bags, we will be attaching bag labels containing date, patient name, hospital number and ward. Multiple bags for the same patient will be indicated e.g. 1 of 2 and attached together where possible. For One Stop Dispensed items (OSD) – the new bags will have both a bag label and the red OSD label attached. We will introduce more paper bags for other items and at St Cross hospital in due course.
Maternity
Maternity Good Morning, There has been some confusion around NEWTT2 going live. Please note this chart is NOT live yet as we need ensure an adequate amount of staff are trained using the chart which we have not yet achieved. Until you are advised of a date to go live with the NEWTT2 charts, please continue to use the current observation documents. If you have not yet completed your training, please do this ASAP and send a screenshot to [email protected]
Maternity MEBS have developed an online reporting app for ease when we have a faulty piece of equipment in our areas. So now staff are able to report equipment directly to MEBS following the link on TrustNav (image of link below). You’ll need to know the asset number of the device as its one of the mandatory fields. This is a great saver of time for everyone concerned.
Maternity As we now have more staff, I hope we will be using Lucina more often. You might find that you are rostered to work here even if you haven't done so before. I have prepared some information that will help you get familiar with Lucina and feel more confident. I will print and laminate this information and leave it along with the admissions book and birth register on Lucina for easy reference. Please collect keys from Labour Ward Co-ordinator. The treatment room is locked and the code is on the key fob. Syntometrine locked in fridge. Emergency equipment – PPH box; Cord Prolapse box; pool evacuation net are kept in treatment room Please check resuscitaire and neonatal emergency trolley using My Kit Check Please put patient label in the blue admissions book We need to audit all Lucina use. Please add a note if transferred to LW. Storeroom is unlocked Linen and other equipment is well stocked and all labelled. Birthing Rooms Birthing equipment on changing trolleys Neonatal resuscitation on bottom of trolleys Equipment checklist under the changing mat – please re-stock trolleys after use Anything not on the changing trolley will be in the cupboards in the room – again all well labelled and stocked. Birthing Pools Pools have built in thermometer, please switch on in cupboard that contains oxygen/suction/Entonox. Please “swish” water frequently as the temperature sensor is quite low in the pool. Care of women in labour in birthing pool printed and laminated for quick reference.
Maternity Fetal Surveillance Study Day: • As everyone is now aware we no longer complete K2 online learning: it is essential everyone remains in date with their training, once your compliance expires you will not be able to provide any care that requires you assess the fetal heart either antenatally or during the intrapartum period. • Currently everyone is rostered to attend the study day every 8-10 months to help maintain your compliance. If you notice this is on your roster and you are not able to attend the day due to annual leave, please let me know asap as the study days get booked up very quickly. • If you are off on sick leave this will automatically be re-booked for you when you return.
Maternity Precept: • Please can you complete as much detail on the perinatal Optimisation Passport for preterm admissions and ensure the booklet remains in the mothers notes. • You must also complete the Magnesium Sulphate & Steroids wizard once administered. This vital information is then transferred across to Badger Net for the neonatal team. This is audited monthly, currently only about 40% of staff complete the wizard. Fresh eyes: • Please continue to complete fresh eyes hourly you are all doing extremely well with compliancy we are on average 95% compliant. • Please remember fresh eyes they are done on the hour by a different practioner, if there is no one to complete the review due to a clinical emergency you may complete it yourself, but you must document the reason why you have completed it and then ask a colleague to complete it asap (this will mean there are two reviews completed for this Hour!)
Maternity Computerised CTG: •All admissions with RFM alone after 26/40 must have a computerised. •Women presenting with second or recurrent episodes of RFM should be offered a Growth USS which should be carried out within 24 hours of attendance (During the weekend or over a public holiday a daily cCTG must be performed until a scan can be completed on the next working day) A referral to obstetrician is required for a future plan of care. This is being audited each month as it is part of Saving Babies Lives criteria which we must be achieving. •Please use the contemporaneous notes on K2 to document your actions following episodes of RFM including date of scan you have booked. •Please remember to discuss fetal movements at every contact and document discussion that has taken place. •Please refer to the RFM Guideline for more details on the management of RFM
Maternity- Risk Key messages: • Please ensure correct documentation is placed in red books when completing NIPE • Please make sure you review notes and Kardex for information and ensure Kardex is crossed through to avoid medication errors. • Please ensure all sharps are removed from instruments at the end of the procedure, at the time of the swab count and only the instruments to be returned to sterile supplies • Please ensure NEWTT observations and blood sugar monitoring are when mother is on labetalol • CRRS to be checked at every patient contact and blood group checked and recorded • Please ensure K2 documentation is checked to ensure accurate gestation is confirmed • Inpatient medication chart to be reviewed prior to discharge to ensure all medications have been prescribed at point of discharge. • Please ensure that the TTO tracker is viewed and ward fail safe used • Please ensure you dispose of patient identifiable information, theatre lists and handover forms via confidential waste. • When cannulas are inserted please add it to the wizard at the time of insertion • All ICR records to be reviewed before any administration • Medication is not to be signed for until it is administered. Learning identified following some of the recent baby readmission for jaundice and weight loss. • Feeding assessment prior to discharge for all babies. Discuss positioning and ensure effective attachment, please document this. • If mother ever states painful feeding then attachment is ineffective regardless of how it may appear so will need further investigation/referral • Please discuss CHINS and signs of effective milk transfer • To observe and document feeds at PN visits • If mother and baby are separated, support mothers to express EBM within 2 hours of birth • Weight loss of 9% would require a feeding assessment, as weight loss may be due to ineffective attachment. • If baby is on phototherapy it is key to assess breastfeeding and observe as effective feeding contributes to jaundice reduction.