#WeNurses - Tuesday 23rd February 2016 8pm (GMT Standard Time) Nurse staffing levels

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This chat is guest hosted by @workforcesoton @lexia14 @anyadei

Nurse staffing levels, missed vital signs observations and mortality in hospital wards: Modelling the costs of variation


In a study funded by the NIHR HS&DR programme, we are looking at the link between nurse staffing levels, vital signs observations and mortality. Our study focusses on ‘general’ hospital wards. Although this has no precise definition it would include the wards that most adult medical and surgical patients are treated on. This includes wards for older people but not intensive care units. A full summary can be read here: http://www.nets.nihr.ac.uk/projects/hsdr/1311417.

One application of our study is the development of economic models to inform the cost of varying nurse staffing as one of the factors influencing that vital signs observations (pulse,blood pressure, temperature, and respiration rate) get done. Thus leading to the early identification of a deteriorating patient’s condition.

This is a great opportunity for people participating in the chat to share their thoughts and views of the skill mix on wards and how much compliance with vital sign observations there should be. The two key aspects that we would like to discuss:

We will highly appreciate your time to discuss your views and expertise. 


About our guest hosts

Professor Peter Griffiths is Chair of Health Services Research within the Faculty of Health Sciences, University of Southampton. He also leads the fundamental care theme of the National Institute for Health Research’s Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Wessex. His research focusses on the healthcare workforce, and in particular safe and effective nurse staffing.

Alejandra Recio-Saucedo is a research fellow in the CLAHRC Wessex. She is managing the study looking at the associations between nurse staffing levels, vital signs observations and mortality. 

Anya de Longh works as a self-management coach for the NHS in Dorset, supporting people with long term health conditions, and involved with the self-management movement at a national level. She lectures medical and healthcare students, and supports patient and public involvement in research projects. In June 2013, she was awarded the College of Medicine Self-Care Award for Individuals, acknowledging her personal self-management and her professional work.






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 Chat Summary

 

Over 60 people joined us to discuss the issue of safe staffing, and the role of skill mixes and observations as an indicator for safe staff levels.

Starting off discussing on the mixof HCA and RNs, there were few hard numbers presented (50:50 to 70:30 HCA:RN,one RN to 4 patients or 1 to 7). The discussion quickly moved on to who is best suited to do observations. There was no consensus on who, but the clear message was that there needs to be systems in place for abnormal observations to be escalated. With the role of HCA being helpful and practical, training was raised as important to help people make sure obs are done properly and escalated when appropriate. Delegating responsibility for completion of obsstill lies with nurses, as does follow-up.

While focusing on observations,it became clear that the quality of obs done is important, as opposed to itjust being a tick box exercise. One individual noted that “I can tell more about my patient by doing a bed bath than the obs”, and another that “having 100% compliance doesn’t mean it is done well”. The notion of a complete or incomplete set of obs was also raised.

Electronic obs systems were discussed, and whilst they can help measuring and monitoring, there were points raised about complacency and not interacting with the patient, and getting the full picture of them whilst distracted by a tablet.

The scope of the chat focused on obs because of the remit of the research by the CLARHC Wessex team, but the wider components of safe staff were raised – “caring safely for someone is not just about obs”.

The question that prompted the most activity was about what level of obs it was safe to miss or delay. There was a strong feeling that 100% compliance is needed, because you can’t be sure a patient won’t deteriorate, “we don’t accept 90% compliance with drugs for example, there is evidence, and it’s deemed to be needed so needs to be done”.Interestingly, one individual noted that obs were most likely to be missed or late on those patients who were the most ill. But the practical dilemma was summed up by one tweet; “We were scolded for missing obs – but the alternative was leaving a 20yr old covered in faeces. Not defined by %”

Furthermore, with a target of 100%, one person noted that “risk hitting the target, but missing the point”.

 





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 #WeNurses transcript

 
@WeNurses
23 February 2016 20:00
Hello and welcome to tonights #wenurses Please say hello if you are joining us this evening
@AgencyNurse
23 February 2016 20:00
Hi Teresa here #Wenurses
@Gemma_Smith1990
23 February 2016 20:00
RT @WeNurses: The NMC have some great social media guidance > https://t.co/FgkduwxXD7 #WeNurses
@anyadei
23 February 2016 20:00
RT @WeNurses: Hello and welcome to tonights #wenurses Please say hello if you are joining us this evening
@shizc1
23 February 2016 20:00
#WeNurses hi joining you from cambs this evening.
@workforcesoton
23 February 2016 20:00
#wenurses Peter Here. Hello everyone
@PamelaSmith035
23 February 2016 20:01
Pam also joining #WeNurses
@lexia14
23 February 2016 20:01
@WeNurses Hello Alex here! #WeNurses
@WeNurses
23 February 2016 20:01
Tonights discussion is all about Nurse Staffing levels #Wenurses And we have some fab guest hosts @workforcesoton @lexia14 @anyadei
@Gemma_Smith1990
23 February 2016 20:01
@WeNurses Hello! I'm joining in before I start night shift ???? #WeNurses
@anyadei
23 February 2016 20:01
@WeNurses #wenurses I'm co-hosting with @lexia14 and @workforcesoton - I'vw got a patient and public involvement role within the project!
@WeNurses
23 February 2016 20:01
Sooooo @workforcesoton @lexia14 @anyadei ... over to you :D #Wenurses
@TrishaL8
23 February 2016 20:02
RT @WeNurses: Tonights discussion is all about Nurse Staffing levels #Wenurses And we have some fab guest hosts @workforcesoton @lexia14 …
@WeNurses
23 February 2016 20:02
Nice to have you join us #Wenurses https://t.co/37LJtjPfpl
@NRCUK
23 February 2016 20:02
Interesting #wenurses on staffing levels now @CrystalOldman @davidpugh25 not sure if it will cover community acuity/demand/workforc planning
@anyadei
23 February 2016 20:02
#wenurses! https://t.co/qrtF46MZ2H
@DianeScuderi
23 February 2016 20:02
RT @WeNurses: Hello and welcome to tonights #wenurses Please say hello if you are joining us this evening
@WeNurses
23 February 2016 20:02
Thanks for joining us #Wenurses https://t.co/ikjuzTm8ja
@JJackson_RN
23 February 2016 20:02
@WeNurses Hi everyone, Jennifer from London (via Canada) #wenurses
@WeNurses
23 February 2016 20:03
Lovely to have you here #Wenurses https://t.co/b9xx4kKBPl
@ora_dall
23 February 2016 20:03
RT @WeNurses: Tonights discussion is all about Nurse Staffing levels #Wenurses And we have some fab guest hosts @workforcesoton @lexia14 …
@lexia14
23 February 2016 20:03
@Gemma_Smith1990 @WeNurses Thanks for joining us on a weekday! #WeNurses
@WeNurses
23 February 2016 20:03
Great to have you here #WeNurses https://t.co/yBoVyonQWz
@angelabinkee2
23 February 2016 20:03
RT @WeNurses: Tonights discussion is all about Nurse Staffing levels #Wenurses And we have some fab guest hosts @workforcesoton @lexia14 …
@anyadei
23 February 2016 20:03
@Gemma_Smith1990 @WeNurses welcome! That is true dedication #wenurses
@JaneEBall
23 February 2016 20:03
#wenurses jane here - have nurse staffing research interest
@WeNurses
23 February 2016 20:04
FIRST QUESTION #WeNurses https://t.co/BQneFoXxkP
@anyadei
23 February 2016 20:04
@PamelaSmith035 welcome! #wenurses
@anyadei
23 February 2016 20:04
Great to see so many people joining us! Would be great to hear what clinical roles you have! #wenurses https://t.co/Ny0R7ejbus
@AgencyNurse
23 February 2016 20:05
Hi I'm Teresa and I work in a care home on the bank #WeNurses
@WeNurses
23 February 2016 20:05
RT @JaneEBall: #wenurses jane here - have nurse staffing research interest
@ora_dall
23 February 2016 20:05
@anyadei I am a doctoral student looking at how the workforce organisation can impact on outcomes #wenurses
@workforcesoton
23 February 2016 20:05
#wenurses : talking about our acute care staffing project - more info at: https://t.co/IhWhRBHY32
@lexia14
23 February 2016 20:05
Our first question tonight! #WeNurses https://t.co/qlJ1ztycED
@WeNurses
23 February 2016 20:05
RT @ora_dall: @anyadei I am a doctoral student looking at how the workforce organisation can impact on outcomes #wenurses
@WeNurses
23 February 2016 20:05
RT @workforcesoton: #wenurses : talking about our acute care staffing project - more info at: https://t.co/IhWhRBHY32
@ora_dall
23 February 2016 20:06
RT @workforcesoton: #wenurses : talking about our acute care staffing project - more info at: https://t.co/IhWhRBHY32
@BrownNhsdeb
23 February 2016 20:06
RT @WeNurses: The NMC have some great social media guidance > https://t.co/FgkduwxXD7 #WeNurses
@anyadei
23 February 2016 20:06
@PamelaSmith035 there is first time for everything! You'll get the hang of it soon enough! : ) #wenurses @AgencyNurse has great advice too!
@JJackson_RN
23 February 2016 20:06
@anyadei I am a researcher, with a clinical practice background in ICU #wenurses
@AgencyNurse
23 February 2016 20:06
RT @anyadei: Great to see so many people joining us! Would be great to hear what clinical roles you have! #wenurses https://t.co/Ny0R7ejbus
@WeNurses
23 February 2016 20:06
RT @JJackson_RN: @anyadei I am a researcher, with a clinical practice background in ICU #wenurses
@WeNurses
23 February 2016 20:07
Great to have you here #WeNurses https://t.co/Ixv6IyJmqG
@workforcesoton
23 February 2016 20:07
Hi - I'm Peter Griffiths Prof of Health Services Research - workforce researcher and nurse #wenurses
@EllzSummary
23 February 2016 20:07
Evening, currently senior respiratory nurse, leading on Asthma provision, strong primary care & teaching in practice background #WeNurses
@WeNurses
23 February 2016 20:07
RT @workforcesoton: Hi - I'm Peter Griffiths Prof of Health Services Research - workforce researcher and nurse #wenurses
@train2care
23 February 2016 20:07
@WeNurses Hi, Carmel here! Just finished 12 shift, on way home! #wenurses
@WeNurses
23 February 2016 20:07
#WeNurses > https://t.co/ZsPefsyi5A
@shizc1
23 February 2016 20:07
#WeNurses manager to multi disciplinary team in community, not sure if this will apply to me but will lurk with interest
@ora_dall
23 February 2016 20:07
@JJackson_RN Great to get in touch! #wenurses
@anyadei
23 February 2016 20:07
This is what we are really interested in and what want to talk about today! #wenurses https://t.co/LmLUPzx9T1
@WeNurses
23 February 2016 20:08
Lovely to have you join us #WeNurses https://t.co/Cm7ZsQpIFH
@WeNurses
23 February 2016 20:08
NEXT QUESTION #WeNurses https://t.co/QDw26NtQDL
@anyadei
23 February 2016 20:08
@train2care @WeNurses safe travels and tweeting! #wenurses
@Gemma_Smith1990
23 February 2016 20:08
@WeNurses I'm Gemma, a sister on a 35 bedded acute general medical ward ?? #wenurses
@WeNurses
23 February 2016 20:08
RT @Gemma_Smith1990: @WeNurses I'm Gemma, a sister on a 35 bedded acute general medical ward ?? #wenurses
@WeNurses
23 February 2016 20:08
#WeNurses > https://t.co/pEo4byW3Rm
@sharp_lena
23 February 2016 20:08
RT @workforcesoton: #wenurses : talking about our acute care staffing project - more info at: https://t.co/IhWhRBHY32
@LynneBowers2
23 February 2016 20:08
#wenurses *waves* passionate about quality of nursing care in all sectors.
@workforcesoton
23 February 2016 20:08
RT @WeNurses: NEXT QUESTION #WeNurses https://t.co/QDw26NtQDL
@sroo91
23 February 2016 20:08
@WeNurses Shauna here nurse in a care home! #wenurses
@lexia14
23 February 2016 20:08
RT @anyadei: This is what we are really interested in and what want to talk about today! #wenurses https://t.co/LmLUPzx9T1
@workforcesoton
23 February 2016 20:09
RT @anyadei: @train2care @WeNurses safe travels and tweeting! #wenurses
@ora_dall
23 February 2016 20:09
RT @anyadei: This is what we are really interested in and what want to talk about today! #wenurses https://t.co/LmLUPzx9T1
@WeNurses
23 February 2016 20:09
RT @sroo91: @WeNurses Shauna here nurse in a care home! #wenurses
@WeNurses
23 February 2016 20:09
RT @LynneBowers2: #wenurses *waves* passionate about quality of nursing care in all sectors.
@ora_dall
23 February 2016 20:09
@anyadei great topic!!! #wenurses
@anyadei
23 February 2016 20:09
NEXT QUESTION... #wenurses https://t.co/y9Wk8qntyL
@aptaim
23 February 2016 20:09
Hi #wenurses - I'm James, a pharmacist lurking as this topic has implications for some of my services & the safe use of medicines...
@anyadei
23 February 2016 20:10
@sroo91 @WeNurses great to have you joining! #wenurses
@lexia14
23 February 2016 20:10
@train2care @WeNurses Welcome! And thanks for joining in after a long day! #WeNurses
@iamnursecamila
23 February 2016 20:10
RT https://t.co/WYHrfSWiej #wenurses *waves* passionate about quality of nursing care in all sectors. LynneBowers2
@workforcesoton
23 February 2016 20:10
RT @aptaim: Hi #wenurses - I'm James, a pharmacist lurking as this topic has implications for some of my services & the safe use of medicin…
@ora_dall
23 February 2016 20:10
RT @anyadei: NEXT QUESTION... #wenurses https://t.co/y9Wk8qntyL
@WeNurses
23 February 2016 20:10
#WeNurses NEXT QUESTION https://t.co/Tb9pbjdEnH
@anyadei
23 February 2016 20:10
@LynneBowers2 *waves* #wenurses
@WeNurses
23 February 2016 20:10
RT @aptaim: Hi #wenurses - I'm James, a pharmacist lurking as this topic has implications for some of my services & the safe use of medicin…
@lexia14
23 February 2016 20:10
We would love to know what your thoughts are on the next question #WeNurses https://t.co/6He92FQLno
@Kean1S
23 February 2016 20:10
RT @WeNurses: NEXT QUESTION #WeNurses https://t.co/QDw26NtQDL
@anyadei
23 February 2016 20:11
@Gemma_Smith1990 @WeNurses Thanks for tweeting in and joining! The next question has been tweeted! #wenurses https://t.co/AHTbUCVHxs
@workforcesoton
23 February 2016 20:11
Interested to hear your thought on skill mix and vital signs obs. Who does the obs in your experience? #wenurses https://t.co/G9Z5psHu6v
@JJackson_RN
23 February 2016 20:11
On the wards in Canada, we had a registered nurse or practical nurse to 4 patients on days, and 6 on nights (excepting ICU etc) #wenurses
@LearnPEOLC
23 February 2016 20:11
RT @anyadei: @Gemma_Smith1990 @WeNurses Thanks for tweeting in and joining! The next question has been tweeted! #wenurses https://t.co/AHTb…
@anyadei
23 February 2016 20:12
@PamelaSmith035 @WeNurses sounds interesting! Don't forget to include #wenurses in each tweet so everyone else can see them!
@ora_dall
23 February 2016 20:12
RT @workforcesoton: Interested to hear your thought on skill mix and vital signs obs. Who does the obs in your experience? #wenurses https…
@Kean1S
23 February 2016 20:12
RT @workforcesoton: #wenurses : talking about our acute care staffing project - more info at: https://t.co/IhWhRBHY32
@AgencyNurse
23 February 2016 20:12
@anyadei I work in a setting where there are many HCA's a care home so not acute, think the ration has to suit the setting #WeNurses
@AgencyNurse
23 February 2016 20:12
RT @lexia14: We would love to know what your thoughts are on the next question #WeNurses https://t.co/6He92FQLno
@JJackson_RN
23 February 2016 20:13
HCA's don't assess vitals in Canada, only registered practitioners #wenurses
@JaneEBall
23 February 2016 20:13
@JJackson_RN How does that compare to your time nursing in London? #wenurses
@anyadei
23 February 2016 20:13
Good question! Any one got any ideas? #wenurses https://t.co/EH9GNOJzDq
@louisapower
23 February 2016 20:13
RT @aptaim: Hi #wenurses - I'm James, a pharmacist lurking as this topic has implications for some of my services & the safe use of medicin…
@lexia14
23 February 2016 20:13
@AgencyNurse @anyadei Indeed. How does the setting impact on the monitoring of patients? #WeNurses
@AgencyNurse
23 February 2016 20:13
Thats interesting - HCA's who are trained to can here #WeNurses https://t.co/Dcd8YSOe9O
@Sunshyn___
23 February 2016 20:14
Hello #wenurses ??
@JJackson_RN
23 February 2016 20:14
@JaneEBall I haven't worked in clinical practice here in the UK. My colleagues say the ratios are higher #wenurses
@AgencyNurse
23 February 2016 20:14
RT @lexia14: @AgencyNurse @anyadei Indeed. How does the setting impact on the monitoring of patients? #WeNurses
@Kean1S
23 February 2016 20:14
RT @WeNurses: The NMC have some great social media guidance > https://t.co/FgkduwxXD7 #WeNurses
@EllzSummary
23 February 2016 20:14
@workforcesoton In my experience, in ward settings & primary care often a combination of HCAs and Registered nurses doing Obs #WeNurses
@Nurse1730
23 February 2016 20:14
@WeNurses I'm Tori, Sister in A&E at an acute district general hospital #wenurses
@AgencyNurse
23 February 2016 20:14
@lexia14 @anyadei in less acute settings we monitor less ... in a care home obs only done once a month or when needed #WeNurses
@aptaim
23 February 2016 20:15
#WeNurses are "daily work" tasks consistent across trusts, i.e are all individual tasks already allocated to appropriate mixed skill roles?
@anyadei
23 February 2016 20:15
@100_rida Thanks for joining! We are just starting with this question! What are your thoughts? #wenurses https://t.co/NOQJ5Pu0tl
@LynneBowers2
23 February 2016 20:15
#wenurses @ShaunLintern has tweeted good info.Signif variation in total numbers & mix.Not criticism of good HCAs https://t.co/xxxSz76NqQ
@sroo91
23 February 2016 20:15
Care home sector would be differently staffed; depends on dependency of patients. Higher ratio of HCA to nurses #wenurses
@JaneEBall
23 February 2016 20:15
In England is it mainly HCAs that do vitalsigns obs, or mostly RNs? @JJackson_RN #wenurses
@dorcaselambert
23 February 2016 20:15
@workforcesoton @anyadei At my trust the HCAs do obs. At the other local trust it's the RNs job. #wenurses
@workforcesoton
23 February 2016 20:15
Debbie, maybe more an issue of quality than safety: more GPNs associated with better chronic disease care #wenurses https://t.co/9tXcFxrLD0
@JJackson_RN
23 February 2016 20:15
@AgencyNurse logic is someone who's regulated has to interpret abnormalities in vitals, and has prof responsibility to follow up #wenurses
@anyadei
23 February 2016 20:15
@BricknellTori @WeNurses Hi! #wenurses!
@JJackson_RN
23 February 2016 20:16
@JaneEBall not sure- other input? #wenurses
@AgencyNurse
23 February 2016 20:16
Where i work its always the RNs - but have worked in paces where its the HCAs who do routine obs #WeNurses https://t.co/D9V2YTm9EE
@lexia14
23 February 2016 20:16
@JJackson_RN How are days different that nights? Does that impact on the obs of patients? #WeNurses
@aptaim
23 February 2016 20:16
RT @lexia14: @AgencyNurse @anyadei Indeed. How does the setting impact on the monitoring of patients? #WeNurses
@WeNurses
23 February 2016 20:16
RT @sroo91: Care home sector would be differently staffed; depends on dependency of patients. Higher ratio of HCA to nurses #wenurses
@Gemma_Smith1990
23 February 2016 20:16
Our ideal staffing nos. should be 6 SN's and 6 HCA's, we actively promote HCA's to go on obs training to support SN's and patients #WeNurses
@mccarthy_ph
23 February 2016 20:16
I'm Sam a Clinical Education Nurse - lurking this evening. Interesting topic ...@WeNurses #wenurses
@EllzSummary
23 February 2016 20:17
@JJackson_RN Thats sounds ideal. Wales have just passed a safe staffing bill, though unsure of patient to registered nurse ratio #WeNurses
@WeNurses
23 February 2016 20:17
#WeNurses good question > https://t.co/UsNiXuA1uu
@AgencyNurse
23 February 2016 20:17
This makes sense to me - its not so much the obs but the interpretation #WeNurses https://t.co/MOl5PcHKps
@anyadei
23 February 2016 20:17
@EllzSummary @workforcesoton what combination do you find most helpful? #wenurses
@shizc1
23 February 2016 20:17
@anyadei #wenurses mum in law in hosp recently obs done by HCA interesting to see no chart at end of bed & obs recorded on hand held device
@ora_dall
23 February 2016 20:17
RT @WeNurses: #WeNurses good question > https://t.co/UsNiXuA1uu
@anyadei
23 February 2016 20:17
.@EllzSummary @workforcesoton what combination do you find most helpful? #wenurses
@JJackson_RN
23 February 2016 20:17
@lexia14 More patients sleeping, fewer tasks. Generally less observation on nights, universal trade off for sleep I think #wenurses
@PamelaSmith035
23 February 2016 20:17
@anyadei @100_rida in my role I see increased incidents due to failed escalation or recognition of sick pt due to low staffing #wenurses
@maxwele2
23 February 2016 20:18
@WeNurses @anyadei surely the question is how well the work is done, not just whether tasks completed? #WeNurses
@nightingale2612
23 February 2016 20:18
RT @WeNurses: #WeNurses good question > https://t.co/UsNiXuA1uu
@anyadei
23 February 2016 20:18
@mccarthy_ph @WeNurses thanks! We think its interesting too! Feel free to add your opinion to the mix! #wenurses https://t.co/QHYhvpYAb9
@lexia14
23 February 2016 20:18
@EllzSummary @JJackson_RN Do you know what guidelines were used to inform the ratios? #WeNurses
@ora_dall
23 February 2016 20:18
@shizc1 @anyadei what did you think of that? #wenurses
@WeNurses
23 February 2016 20:18
Interesting question - what do others think ? #Wenurses https://t.co/y05P8TwH44
@JaneEBall
23 February 2016 20:18
Does the RCN recommendation of a skill-mix of 65% RNs still seem like the right mix to be aiming for on an acute ward? #wenurses
@anyadei
23 February 2016 20:19
@shizc1 #wenurses very high tec! Do you think that helped with her care? Being done by HCA or done electronically? #wenurses
@Allelesbelges
23 February 2016 20:19
@WeDistrictNurse @WeNurses Anyone involved in acuity and safe staffing in Community Teams ? #wenurses
@WeNurses
23 February 2016 20:19
RT @shizc1: @anyadei #wenurses mum in law in hosp recently obs done by HCA interesting to see no chart at end of bed & obs recorded on hand…
@SarahBrechon
23 February 2016 20:19
RT @martina_davies: Great blog, must share with colleagues who I am trying to convince of benefits of #wenurses,be there for each other. ht…
@anyadei
23 February 2016 20:19
Good question! How can we measure that? #wenurses https://t.co/VJknZoAI5G
@ora_dall
23 February 2016 20:19
RT @WeNurses: Interesting question - what do others think ? #Wenurses https://t.co/y05P8TwH44
@WeNurses
23 February 2016 20:19
#WeNurses anyone from the community out there ? https://t.co/wFLjWyNPlM
@sircwn
23 February 2016 20:19
RT @WeNurses: #WeNurses good question > https://t.co/UsNiXuA1uu
@Gemma_Smith1990
23 February 2016 20:20
@WeNurses Everywhere has recommended staffing levels, are these being met most of the time? We all know there is SN shortage #wenurses
@WeNurses
23 February 2016 20:20
What are peoples thoughts ? #WeNurses https://t.co/R90grtQQdu
@mccarthy_ph
23 February 2016 20:20
@anyadei @WeNurses we stopped all HCAs doing obs as our RNs weren't even doing them correctly and developed a training programme #wenurses
@selenam738
23 February 2016 20:20
#wenurses are you using Hurst or Shelford to monitor acuity? RCN guidelines 1:7 I feel minimal standard not gold. Increases nocte. 1/1
@ora_dall
23 February 2016 20:20
@WeNurses @maxwele2 @anyadei true but to me something incomplete sounds like something not well done! #wenurses
@WeNurses
23 February 2016 20:20
RT @anyadei: @shizc1 #wenurses very high tec! Do you think that helped with her care? Being done by HCA or done electronically? #wenurses
@anyadei
23 February 2016 20:20
@Gemma_Smith1990 does that help make sure that obs aren't missed? #wenurses
@Nurse1730
23 February 2016 20:20
@anyadei @WeNurses In an acute setting such as A&E the % of staff has a major impact on daily work esp. with increasing pressures #wenurses
@JaneEBall
23 February 2016 20:20
@maxwele2 @WeNurses @anyadei I think its both - but 'care left undone' can be an indicator of insufficient staffing #wenurses
@WeNurses
23 February 2016 20:21
RT @JaneEBall: @maxwele2 @WeNurses @anyadei I think its both - but 'care left undone' can be an indicator of insufficient staffing #wenurses
@PamelaSmith035
23 February 2016 20:21
@JaneEBall #wenurses no I think we are seeing far too many quality issues and should be aiming for higher levels of staffing safety first .
@EllzSummary
23 February 2016 20:21
@workforcesoton @agencynurse is right, ratio dependent on setting, more acute setting require more RNs #Obsinterpretation crucial #WeNurses
@aptaim
23 February 2016 20:21
Fab; why not?! MT @shizc1: @anyadei #wenurses MIL in hosp; obs done by HCA - no chart at end of bed & obs recorded on hand held device
@maxwele2
23 February 2016 20:21
@anyadei @WeNurses we need to develop more sophisticated models recognising interrelationships #WeNurses
@selenam738
23 February 2016 20:21
#wenurses dearth of band 5s nationally has huge implications for workforce design.use Vitalpac for obs, EW score alerts, less ritualistic
@Gemma_Smith1990
23 February 2016 20:22
@anyadei @WeNurses It's invaluable to us, without the help of HCA's I would end up working a lot longer then I should #wenurses
@anyadei
23 February 2016 20:22
Quite a few mentions of % and ratio of staff, so NEXT QUESTION....#wenurses https://t.co/VY1DR2TvFd
@WeNurses
23 February 2016 20:22
NEXT QUESTION #WeNurses https://t.co/huVWTRDuaU
@ora_dall
23 February 2016 20:22
RT @JaneEBall: @maxwele2 @WeNurses @anyadei I think its both - but 'care left undone' can be an indicator of insufficient staffing #wenurses
@EllzSummary
23 February 2016 20:22
@maxwele2 @WeNurses @anyadei and correct interpretation and actioning of results #WeNurses
@lexia14
23 February 2016 20:23
@selenam738 How are obs and EWS alerts less ritualistic? #WeNurses
@WeNurses
23 February 2016 20:23
RT @EllzSummary: @maxwele2 @WeNurses @anyadei and correct interpretation and actioning of results #WeNurses
@anyadei
23 February 2016 20:23
@EllzSummary @workforcesoton @AgencyNurse does focusing on obs potentially ignore care that follows? #wenurses
@ora_dall
23 February 2016 20:23
RT @anyadei: Quite a few mentions of % and ratio of staff, so NEXT QUESTION....#wenurses https://t.co/VY1DR2TvFd
@maxwele2
23 February 2016 20:23
@lexia14 @WeNurses @anyadei if use e obs systems that can b measured & more importantly linked 2 whether appropriate action taken #WeNurses
@workforcesoton
23 February 2016 20:23
Does vital pac automatically escalate for you or is RN action still required? #wenurses https://t.co/9u0qNcogl9
@anyadei
23 February 2016 20:23
@ora_dall @WeNurses @maxwele2 what would make an ob incomplete? And how incomplete is adequate? #wenurses
@WeNurses
23 February 2016 20:24
Great question #WeNurses https://t.co/GpsquAfuPH
@MaxineSimmons15
23 February 2016 20:24
RT @AgencyNurse: Where i work its always the RNs - but have worked in paces where its the HCAs who do routine obs #WeNurses https://t.co/D9…
@Nurse1730
23 February 2016 20:24
@anyadei @WeNurses Quality not quantity, competent in completing asked tasks, effective communication between RN's & HCA's #wenurses
@WeNurses
23 February 2016 20:24
what are peoples thoughts ? #Wenurses https://t.co/WRaF0kPjbA
@MaxineSimmons15
23 February 2016 20:25
RT @aptaim: Hi #wenurses - I'm James, a pharmacist lurking as this topic has implications for some of my services & the safe use of medicin…
@Gemrose84
23 February 2016 20:25
@Gemma_Smith1990 @WeNurses wow what area of nursing is this? #wenurses
@anyadei
23 February 2016 20:25
@Gemma_Smith1990 @WeNurses so skill mix sounds important? What is the right balance when it comes to obs? #wenurses
@workforcesoton
23 February 2016 20:25
HCA essential - agree: is there a maximum % on acute wards though? #wenurses https://t.co/pAEzWKHqtT
@WeNurses
23 February 2016 20:26
Another interesting question #Wenurses https://t.co/AeFLTIV3JJ
@PamelaSmith035
23 February 2016 20:26
@maxwele2 @lexia14 @WeNurses @anyadei I agree it is also about taking appropriate actions and not just recording on a chart #Wenurses
@ora_dall
23 February 2016 20:26
RT @anyadei: @Gemma_Smith1990 @WeNurses so skill mix sounds important? What is the right balance when it comes to obs? #wenurses
@anyadei
23 February 2016 20:26
#wenurses does this feel appropriate for patients? Better that obs done regularly more than by who? https://t.co/xpibM4V15N
@workforcesoton
23 February 2016 20:26
How many patients I wonder? #wenurses https://t.co/SigZwCw3mE
@ora_dall
23 February 2016 20:26
RT @workforcesoton: HCA essential - agree: is there a maximum % on acute wards though? #wenurses https://t.co/pAEzWKHqtT
@Richardthenurse
23 February 2016 20:27
We have robust obs training for our CSWs plus eObs that reminds when obs required, mandates full set & auto bleeps our doc's #wenurses
@AgencyNurse
23 February 2016 20:27
@anyadei @Gemma_Smith1990 again not so sure its that simple - very dependent on setting ? #WeNurses
@mccarthy_ph
23 February 2016 20:27
@anyadei @ora_dall @WeNurses @maxwele2 6 physiological signs to complete as well as fluid balance if required any thing less fail #wenurses
@JaneEBall
23 February 2016 20:27
@Gemrose84 @Gemma_Smith1990 @WeNurses Take it that those numbers are different from where you work? #wenurses
@WeNurses
23 February 2016 20:28
RT @anyadei: #wenurses does this feel appropriate for patients? Better that obs done regularly more than by who? https://t.co/xpibM4V15N
@Gemrose84
23 February 2016 20:28
@WeNurses @anyadei hi I'm Gemma. A ward manager on a acute adult admission psychiatric ward. 20 beds. #WeNurses
@workforcesoton
23 February 2016 20:28
...is there an issue with HCAs not taking appropriate action? #wenurses https://t.co/YVtxj3OEOo
@selenam738
23 February 2016 20:28
@workforcesoton #WeNurses Vitalpac the tool, but ultimately verbal SBAR escalation to senior nurse then Dr, Outreach it's an adjunct
@anyadei
23 February 2016 20:28
Is there standardise obs training across country? Sounds like hard to do incomplete obs with that system? #wenurses https://t.co/4pXYe2HuOx
@lexia14
23 February 2016 20:29
@Richardthenurse Does training enhance obs completion? #WeNurses
@ora_dall
23 February 2016 20:29
RT @anyadei: Is there standardise obs training across country? Sounds like hard to do incomplete obs with that system? #wenurses https://t.…
@anyadei
23 February 2016 20:29
#wenurses https://t.co/Z5ZACy6Bql
@AgencyNurse
23 February 2016 20:29
@anyadei the person needs to be trained and have the confidence & competence to escalate if needed #WeNurses
@anyadei
23 February 2016 20:29
#wenurses https://t.co/CDq8o1G2mJ
@workforcesoton
23 February 2016 20:30
RT @selenam738: #wenurses dearth of band 5s nationally has huge implications for workforce design.use Vitalpac for obs, EW score alerts, le…
@anyadei
23 February 2016 20:30
#wenurses https://t.co/BO11x4aIfS
@Richardthenurse
23 February 2016 20:30
@lexia14 Yes... Ensuring we are all doing obs at the same standard and rationale why we do it! #wenurses
@AnnMarieRiley10
23 February 2016 20:30
@workforcesoton @Gemma_Smith1990 @anyadei @WeNurses I think the more important indicator is Pt:RN ratio #wenurses
@Bartontd
23 February 2016 20:30
Late to the Party - thats what Grandchildren do for you !! #wenurses - Hi Team - #davewave #swansea
@AgencyNurse
23 February 2016 20:30
@anyadei so its both frequency and who IMO #WeNurses
@Gemrose84
23 February 2016 20:30
@JaneEBall @Gemma_Smith1990 @WeNurses yes and I'm in psychiatry. We have 20 beds and work on 7. More when required #wenurses
@ora_dall
23 February 2016 20:30
RT @anyadei: #wenurses https://t.co/CDq8o1G2mJ
@anyadei
23 February 2016 20:30
@AgencyNurse if right training in place, does that mean more HCA/less RN can be on duty? #wenurses
@workforcesoton
23 February 2016 20:30
RT @WeNurses: What are peoples thoughts ? #WeNurses https://t.co/R90grtQQdu
@lexia14
23 February 2016 20:31
What is the time required on avg to complete a full assessment? #WeNurses https://t.co/a8U2xFJI4r
@ora_dall
23 February 2016 20:31
RT @lexia14: @Richardthenurse Does training enhance obs completion? #WeNurses
@Bartontd
23 February 2016 20:31
RT @workforcesoton: ...is there an issue with HCAs not taking appropriate action? #wenurses https://t.co/YVtxj3OEOo
@Bartontd
23 February 2016 20:31
RT @Gemrose84: @WeNurses @anyadei hi I'm Gemma. A ward manager on a acute adult admission psychiatric ward. 20 beds. #WeNurses
@mccarthy_ph
23 February 2016 20:31
@anyadei @Richardthenurse we provide training and competency assessment and we expect that standard to be maintained but is it? ??.#wenurses
@PamelaSmith035
23 February 2016 20:31
@workforcesoton @maxwele2 @lexia14 @WeNurses @anyadei #wenurses not unique to individual roles seen across all and staffing level impacts
@Bartontd
23 February 2016 20:31
RT @AgencyNurse: @anyadei @Gemma_Smith1990 again not so sure its that simple - very dependent on setting ? #WeNurses
@anyadei
23 February 2016 20:31
Better late than never! Welcome! We're talking about safe staffing levels, HCA/RN ratio's and doing obs #wenurses https://t.co/8HWfBXAJec
@lexia14
23 February 2016 20:31
@Bartontd Never too late! HEllo #WeNurses
@workforcesoton
23 February 2016 20:31
RT @AnnMarieRiley10: @workforcesoton @Gemma_Smith1990 @anyadei @WeNurses I think the more important indicator is Pt:RN ratio #wenurses
@AgencyNurse
23 February 2016 20:31
No because caring safely for someone is not just about obs #WeNurses https://t.co/KZtcXWPoAt
@Richardthenurse
23 February 2016 20:32
@anyadei 100% complete set of obs each time! Our agency csws do our obs training before being permitted to perform independently #wenurses
@WeNurses
23 February 2016 20:32
RT @lexia14: @Richardthenurse Does training enhance obs completion? #WeNurses
@sroo91
23 February 2016 20:32
@anyadei @sphams @workforcesoton if the person is competent and is able to interpret the results, and will act accordingly #wenurses
@workforcesoton
23 February 2016 20:32
In acute wards is there an absolute minimum RN:Pt ratio? Still need HCAs as well? #wenurses https://t.co/OWIRFkbxsO
@NursingEmma
23 February 2016 20:32
RT @AgencyNurse: No because caring safely for someone is not just about obs #WeNurses https://t.co/KZtcXWPoAt
@Bartontd
23 February 2016 20:33
RT @AgencyNurse: No because caring safely for someone is not just about obs #WeNurses https://t.co/KZtcXWPoAt
@kind_curious
23 February 2016 20:33
RT @AgencyNurse: No because caring safely for someone is not just about obs #WeNurses https://t.co/KZtcXWPoAt
@lexia14
23 February 2016 20:33
Are there staffing factors that affect standards to be maintained? #WeNurses https://t.co/XmVJrVoOpp
@anyadei
23 February 2016 20:33
NEXT QUESTION.... #wenurses https://t.co/YILBSQdfOL
@Bartontd
23 February 2016 20:33
RT @anyadei: Better late than never! Welcome! We're talking about safe staffing levels, HCA/RN ratio's and doing obs #wenurses https://t.co…
@selenam738
23 February 2016 20:33
#wenurses Any feedback re degree nurses? I have been impressed with my NQ nurses. Firmly believe mortality will reduce with more on a ward.
@sroo91
23 February 2016 20:33
@anyadei @sphams @workforcesoton but who will be accountable if deterioration is missed in a patient? #wenurses
@Nurse1730
23 February 2016 20:33
@WeNurses Is our practice of doing the obs based on ritualisation? #wenurses
@WeNurses
23 February 2016 20:34
Interesting question #Wenurses https://t.co/JceVpxV5pS
@JaneEBall
23 February 2016 20:34
RT @AnnMarieRiley10: @workforcesoton @Gemma_Smith1990 @anyadei @WeNurses I think the more important indicator is Pt:RN ratio #wenurses
@anyadei
23 February 2016 20:34
#wenurses https://t.co/VllYJS9Pbo
@Bartontd
23 February 2016 20:34
RT @anyadei: NEXT QUESTION.... #wenurses https://t.co/YILBSQdfOL
@WeNurses
23 February 2016 20:34
Ooooh interesting question #WeNurses https://t.co/D29iEYB5AE
@shizc1
23 February 2016 20:34
@anyadei #wenurses no we still need enough RN's to oversee HCA's as RN delegating task of Obs to HCA so should have awareness of results
@anyadei
23 February 2016 20:34
#wenurses https://t.co/InJqXa1xub
@anyadei
23 February 2016 20:34
#wenurses https://t.co/JLg4r916JE
@PamelaSmith035
23 February 2016 20:34
@BricknellTori @WeNurses in some cases I do believe it is #WeNurses
@sphams
23 February 2016 20:34
@sroo91 @anyadei @workforcesoton the RN of course, the Code gives clear guidance on delegation #WeNurses
@anyadei
23 February 2016 20:35
#wenurses https://t.co/Z553XH5fMr
@AgencyNurse
23 February 2016 20:35
@anyadei surely if it is deemed that they need to be done then the answer is none ! #WeNurses
@anyadei
23 February 2016 20:35
#wenurses https://t.co/3ilF2C30vs
@ora_dall
23 February 2016 20:35
RT @anyadei: #wenurses https://t.co/InJqXa1xub
@AgencyNurse
23 February 2016 20:35
#WeNurses https://t.co/AnIg3Dx7wy
@JaneEBall
23 February 2016 20:35
Its long while since I was clinical nurse... when HCAs are doing obs, how do RNs keep up with condition of their patients? #wenurses
@AgencyNurse
23 February 2016 20:35
#WeNurses https://t.co/N2BL4ZT9zZ
@TigerSJR65
23 February 2016 20:35
@anyadei @Bartontd Not sure it's just about safe staffing levels. Need to make sure of competencies o/wise numbers won't matter #wenurses
@anyadei
23 February 2016 20:35
#wenurses https://t.co/ywhT475Osu
@AnnMarieRiley10
23 February 2016 20:35
@workforcesoton @Gemma_Smith1990 @anyadei @WeNurses although pt:RN ratio the same #wenurses
@Richardthenurse
23 February 2016 20:35
@mccarthy_ph @anyadei hence the reason for reg training, support, role modelling & audit..we're human shortcuts maybe made. #trust #wenurses
@anyadei
23 February 2016 20:35
#wenurses https://t.co/NtDRjLQGh4
@Gemrose84
23 February 2016 20:36
@sphams @workforcesoton @anyadei how did this make you feel? #WeNurses
@WeNurses
23 February 2016 20:36
RT @shizc1: @anyadei #wenurses no we still need enough RN's to oversee HCA's as RN delegating task of Obs to HCA so should have awareness o…
@RachelDoubleday
23 February 2016 20:36
Worrying measure proposed for nursing in Carter report- not applicable for community #WeNurses @WeDistrictNurse @ADNEuk
@mccarthy_ph
23 February 2016 20:36
@lexia14 @anyadei @Richardthenurse yes and no, honestly sometimes it's just old habits die hard #wenurses
@mynameisAndyJ
23 February 2016 20:36
RT @shizc1: @anyadei #wenurses mum in law in hosp recently obs done by HCA interesting to see no chart at end of bed & obs recorded on hand…
@WeNurses
23 February 2016 20:36
RT @sphams: @sroo91 @anyadei @workforcesoton the RN of course, the Code gives clear guidance on delegation #WeNurses
@workforcesoton
23 February 2016 20:36
RT @anyadei: #wenurses https://t.co/NtDRjLQGh4
@sphams
23 February 2016 20:36
@anyadei None #WeNurses As a patient I would want nurses to follow evidence - it's there for a reason
@Bartontd
23 February 2016 20:36
@anyadei Depends on Patient, Situation, Context, #wenurses Assess, Plan, Imlpement, Evaluate
@ora_dall
23 February 2016 20:36
RT @AgencyNurse: @anyadei surely if it is deemed that they need to be done then the answer is none ! #WeNurses
@workforcesoton
23 February 2016 20:36
RT @sphams: @anyadei None #WeNurses As a patient I would want nurses to follow evidence - it's there for a reason
@AgencyNurse
23 February 2016 20:37
@lexia14 yes because surely the patient has been assessed on what needs to be done #WeNurses
@Gemrose84
23 February 2016 20:37
@sroo91 @anyadei @sphams @workforcesoton my area of work both hca / s/n take obs. The nurse in charge is responsible for checking #Wenurses
@sroo91
23 February 2016 20:37
RT @Bartontd: @anyadei Depends on Patient, Situation, Context, #wenurses Assess, Plan, Imlpement, Evaluate
@ora_dall
23 February 2016 20:37
RT @sphams: @anyadei None #WeNurses As a patient I would want nurses to follow evidence - it's there for a reason
@anyadei
23 February 2016 20:37
@sphams As a patient, me too! But is there is a difference between what we want, and what is safe? #wenurses
@anyadei
23 February 2016 20:37
#wenurses https://twitter.com/bee_bucket/status/702230770685968384
@lexia14
23 February 2016 20:37
@Gemrose84 @sphams @workforcesoton @anyadei Missed this messages. Do you want to add details please? #WeNurses
@jancollett
23 February 2016 20:37
RT @AgencyNurse: #WeNurses https://twitter.com/Ismalia_S/status/702230159257169922
@WeNurses
23 February 2016 20:38
#WeNurses https://twitter.com/BoranSue/status/702230931562741760
@louisebrady17
23 February 2016 20:38
@BrownNhsdeb @anyadei based on 'medical' model only #wenurses
@sphams
23 February 2016 20:38
@Gemrose84 @workforcesoton @anyadei they appeared very competent, but I couldn't see how adults were being shared with RNs #wenurses
@ora_dall
23 February 2016 20:38
@Gemrose84 @sroo91 @anyadei @sphams @workforcesoton Does this add a lot of work for the RNs? #wenurses
@jancollett
23 February 2016 20:38
RT @AgencyNurse: #WeNurses https://twitter.com/Ismalia_S/status/702230018999656450
@anyadei
23 February 2016 20:38
@Bartontd profoundly true, but any specifics you want to share? When does it matter most that obs are missed! #wenurses
@li22ieR
23 February 2016 20:38
Not part of ritual / task - obs part of individual care and not just about the competency & interpretation - but dignity / care #wenurses
@BrownNhsdeb
23 February 2016 20:38
RT @louisebrady17: @BrownNhsdeb @anyadei based on 'medical' model only #wenurses
@Nurse1730
23 February 2016 20:39
@anyadei @WeNurses In A&E frequency is based upon clinical judgement, the standardised obs chart is not created for such a setting #wenurses
@sphams
23 February 2016 20:39
@anyadei if I'm a patient I expect the healthcare professional to do the right thing, not cut corners #wenurses
@Richardthenurse
23 February 2016 20:39
@workforcesoton @anyadei locally agreed -Unfortunately not much evidence.Depending on the regularity depends on window of lateness #wenurses
@anyadei
23 February 2016 20:39
#wenurses https://twitter.com/BoranSue/status/702230931562741760
@Bartontd
23 February 2016 20:39
National Assembly for Wales Bill Summary The Safe Nurse Staffing Levels (Wales) Bill February 2015 http://www.assembly.wales/Research%20Documents/The%20Safe%20Nurse%20Staffing%20Levels%20(Wales)%20Bill/15-005.pdf #wenurses
@Bartontd
23 February 2016 20:39
National Assembly for Wales Bill Summary The Safe Nurse Staffing Levels (Wales) Bill February 2015 http://ln.is/www.assembly.wales/R/WBvV8 #wenurses
@selenam738
23 February 2016 20:39
#wenurses if you're a team, WMs, Sisters, HCAS, APs students we all do obs! Communication with acutely I'll, deteriorating pt.
@WeNurses
23 February 2016 20:39
RT @sphams: @anyadei if I'm a patient I expect the healthcare professional to do the right thing, not cut corners #wenurses
@JJackson_RN
23 February 2016 20:39
@lexia14 @EllzSummary We used Dr. Ginette Rodger's model of patient care, and also the mandates from the nursing union contract #wenurses
@lexia14
23 February 2016 20:39
Some details of the medical model? #WeNurses https://twitter.com/louisebrady17/status/702231009228681216
@JaneEBall
23 February 2016 20:39
@bee_bucket @anyadei @WeNurses @sphams @workforcesoton Takes clinical judgement to decide on 'abnormal'? #wenurses
@mccarthy_ph
23 February 2016 20:40
@AgencyNurse @anyadei I agree and I can tell more about my patient by doing a bed bath than the obs. Look listen and feel #wenurses
@BrownNhsdeb
23 February 2016 20:40
RT @sphams: @sroo91 @anyadei @workforcesoton the RN of course, the Code gives clear guidance on delegation #WeNurses
@sroo91
23 February 2016 20:40
RT @JaneEBall: @bee_bucket @anyadei @WeNurses @sphams @workforcesoton Takes clinical judgement to decide on 'abnormal'? #wenurses
@maxwele2
23 February 2016 20:40
#WeNurses https://twitter.com/boransue/status/702230931562741760
@Gemrose84
23 February 2016 20:40
@ora_dall @sroo91 @anyadei @sphams @workforcesoton no it doesn't #WeNurses
@Richardthenurse
23 February 2016 20:40
@mccarthy_ph @lexia14 @anyadei agreed..RN's have overarching responsibility as delegated task. Acutely ill should receive RN obs #wenurses
@lexia14
23 February 2016 20:40
A&E a different context altogether? Are there any guidelines on obs compliance for this setting? #WeNurses https://twitter.com/BricknellTori/status/702231203974406149
@AgencyNurse
23 February 2016 20:41
I agree #WeNurses https://twitter.com/mccarthy_ph/status/702231490273345536
@EllzSummary
23 February 2016 20:41
@anyadei @AgencyNurse No, RNs autonomously monitor & interpret patients, offer appropriate/timely action as needed, plan ahead #WeNurses
@Bartontd
23 February 2016 20:41
@anyadei Fair point - Prioritising interventions a skill based on long experience - Obs may be missed if others lives are at risk #wenurses
@JJackson_RN
23 February 2016 20:41
@lexia14 @EllzSummary Many unions/jurisdictions in Canada now creating regulations capping at 4 pts per nurse on day shift #wenurses
@WeNurses
23 February 2016 20:41
RT @lexia14: A&E a different context altogether? Are there any guidelines on obs compliance for this setting? #WeNurses https://t.co/VeHkk…
@anyadei
23 February 2016 20:41
@mccarthy_ph @AgencyNurse so if other contact/interactions, is it ever ok that obs get missed/delayed? #wenurses
@sroo91
23 February 2016 20:41
@JaneEBall @bee_bucket @anyadei @WeNurses also the nurse is accountable if a task is delegated and something isn't picked up #wenurses
@maxwele2
23 February 2016 20:41
@anyadei @BoranSue @WeNurses @lexia14 bizarre reductionist questions, depends on individual patient #WeNurses
@WeNurses
23 February 2016 20:41
RT @selenam738: #wenurses if you're a team, WMs, Sisters, HCAS, APs students we all do obs! Communication with acutely I'll, deteriorating …
@NRCUK
23 February 2016 20:41
#lurking NHS = 1/2m docs/nurses + 1m patients every 36hrs How much more info is needed to nail this? Complex yes Its only lives! #wenurses
@Bartontd
23 February 2016 20:41
RT @lexia14: A&E a different context altogether? Are there any guidelines on obs compliance for this setting? #WeNurses https://t.co/VeHkk…
@Richardthenurse
23 February 2016 20:42
@AgencyNurse @anyadei easier said than done... eObs with alerting can remove the 'umming and ahhing' #wenurses
@sphams
23 February 2016 20:42
@anyadei @Gemrose84 it's about clinical judgement, RNs have to follow @nmcnews Code failure to detect deterioration isn't good! #wenurses
@AnnMarieRiley10
23 February 2016 20:42
@anyadei @sphams each pt will have the frequency of obs determined by clinical team so none should be missed #wenurses
@JaneEBall
23 February 2016 20:42
Do you see it as an RN activity, an HCA activity - or is the 'who' less important than holistic approach? #wenurses https://twitter.com/li22ieR/status/702231174060625920
@lexia14
23 February 2016 20:42
@JJackson_RN @EllzSummary Would this be across all settings? #WeNurses
@anyadei
23 February 2016 20:42
@maxwele2 @BoranSue @WeNurses @lexia14 always hard in 140 characters! Important to think for modelling safe staffing though! #wenurses
@MandyyWilson
23 February 2016 20:43
@WeNurses Why will Government/DoH/NMC not commit to mandatory safe staffing levels? The evidence is there! #wenurses http://press.psprings.co.uk/Open/february/bmjopen008751.pdf
@workforcesoton
23 February 2016 20:43
If we developed an economic model for staffing levels to get 90% compliance with required obs, what would you think? #wenurses
@RachelDoubleday
23 February 2016 20:43
Does mechanisation of taking obs enhance accuracy or lead to complacency? #EBP? #wenurses @WeDistrictNurse @ADNEuk
@Nurse1730
23 February 2016 20:43
@lexia14 NICE have published guidelines on the frequency of neuro obs post head injury #wenurses
@anyadei
23 February 2016 20:43
#wenurses https://twitter.com/E_arnotsmith/status/702231762315960321
@JJackson_RN
23 February 2016 20:44
If you are busy and can't get to a patient for obs, another nurse should be able to cover for you. Not to be missed beyond crisis #wenurses
@louisebrady17
23 February 2016 20:44
@lexia14 @BrownNhsdeb @anyadei reflected as clinical activity may not account 4 coaching PT time, referrals social prescribing #wenurses
@WeGPNs
23 February 2016 20:44
RT @AgencyNurse: I agree #WeNurses https://twitter.com/mccarthy_ph/status/702231490273345536
@WeNurses
23 February 2016 20:44
Good question - thoughts ? #Wenurses https://twitter.com/workforcesoton/status/702232392887566341
@anyadei
23 February 2016 20:44
#wenurses https://twitter.com/bee_bucket/status/702231589418352640
@selenam738
23 February 2016 20:44
@anyadei #WeNurses data recently in our trust suggested we were late doing the obs of those who were most unwell. Perverse but true.
@Gill_hospicenn
23 February 2016 20:44
@Bartontd #wenurses interestingly bill has now lost the word 'safe'....
@JaneEBall
23 February 2016 20:44
RT @AnnMarieRiley10: @anyadei @sphams each pt will have the frequency of obs determined by clinical team so none should be missed #wenurses
@Emmie_Jessicax
23 February 2016 20:44
RT @kennygibsonnhs: @WeNurses #WeNurses how to be productive, how to take a break & how to be creative https://t.co/IVK2z7dXNz
@Richardthenurse
23 February 2016 20:44
Training & support is a must we have to understand the obs and also the skills to react to them..Acute care training at all levels #wenurses
@Marie_Batey
23 February 2016 20:44
@mccarthy_ph @AgencyNurse @anyadei Totally agree with this - expert practitioners use all their senses... inc their 6th sense. #WeNurses
@mccarthy_ph
23 February 2016 20:44
@anyadei @AgencyNurse policy would say no, I would say each patient is individual and should be treated so. #wenurses
@nicolabell25
23 February 2016 20:45
@Richardthenurse @AgencyNurse @anyadei agree but eobs also risk nurse looking at tablet not pt....#wenurses
@anyadei
23 February 2016 20:45
NEXT QUESTION.... #wenurses https://twitter.com/workforcesoton/status/702232392887566341
@JJackson_RN
23 February 2016 20:45
@JaneEBall I think the person doing obs has to have the knowledge, skills, and judgement to respond to results. RN activity to me #wenurses
@anyadei
23 February 2016 20:45
#wenurses https://twitter.com/E_arnotsmith/status/702232730793279488
@anyadei
23 February 2016 20:45
#wenurses https://twitter.com/sphams/status/702232671079034881
@ora_dall
23 February 2016 20:45
@selenam738 @anyadei very interesting finding! and why do you think it's that? #wenurses
@Gill_hospicenn
23 February 2016 20:45
@workforcesoton #wenurses is this not more productivity (a la Carter) than quality - are the 2 mutually exclusive?
@selenam738
23 February 2016 20:46
@workforcesoton #wenurses what's an economic model?
@Bartontd
23 February 2016 20:46
Safe Staffing Levels must be founded in Safe & Best Patient Care - this will be responsive to context #wenurses and be reflexive to change
@JJackson_RN
23 February 2016 20:46
@lexia14 @EllzSummary yes for inpatients, excepting areas like ICU/ED where ratio may be 1:1, 1:2 etc #wenurses
@anyadei
23 February 2016 20:46
@selenam738 thats interesting! How late is stilll ok and safe? #wenurses
@Sian_NP
23 February 2016 20:46
RT @AgencyNurse: No because caring safely for someone is not just about obs #WeNurses https://twitter.com/anyadei/status/702229142218084352
@lexia14
23 February 2016 20:46
#WeNurses https://twitter.com/workforcesoton/status/702232392887566341
@anyadei
23 February 2016 20:46
I'm sure you aren't alone? Other Trusts find this? #wenurses https://twitter.com/selenam738/status/702232529877803008
@JaneEBall
23 February 2016 20:46
@selenam738 @anyadei Was workload/staffing a factor do you think or something else? #wenurses
@HealthUKTD
23 February 2016 20:46
RT @lexia14: A&E a different context altogether? Are there any guidelines on obs compliance for this setting? #WeNurses https://t.co/VeHkk…
@SusanHSinclair
23 February 2016 20:46
#wenurses doesn't it depend on the patient and their status
@anyadei
23 February 2016 20:46
#wenurses love tricky subjects, esp in 140 characters! https://twitter.com/bee_bucket/status/702232466719907841
@Richardthenurse
23 February 2016 20:46
@nicolabell25 @AgencyNurse @anyadei if it's a poor implementation yes..Hence need for robust acute care training to respond to pt #wenurses
@anyadei
23 February 2016 20:47
#wenurses https://twitter.com/sphams/status/702232912654180352
@anyadei
23 February 2016 20:47
#wenurses https://twitter.com/bee_bucket/status/702232898339008512
@JJackson_RN
23 February 2016 20:47
@workforcesoton I'd say, if you're responding to a code blue etc, and there is limited capacity for coverage. Very rare cases #wenurses
@selenam738
23 February 2016 20:47
@workforcesoton @anyadei absolutely critical, sepsis management but one example where timely punctual obs can be life saving #wenurses
@lexia14
23 February 2016 20:47
We are exploring costs of different establishments without compromising patient safety #WeNurses https://twitter.com/selenam738/status/702232976860565504
@CustoperSmith
23 February 2016 20:47
RT @sphams: @anyadei if I'm a patient I expect the healthcare professional to do the right thing, not cut corners #wenurses
@WeNurses
23 February 2016 20:48
Good point #WeNurses https://twitter.com/selenam738/status/702233368134606848
@AnnMarieRiley10
23 February 2016 20:48
@workforcesoton we already have models to determine safe staffing, how would yours differ #wenurses
@JJackson_RN
23 February 2016 20:48
@workforcesoton If a crisis is a the norm vs an exception, there are issues with staffing, workplace quality etc. #wenurses
@anyadei
23 February 2016 20:48
@Bartontd good points. If obs compliance was model for safe levels, would 90% compliance be acceptable? #wenurses
@ora_dall
23 February 2016 20:48
RT @WeNurses: Good point #WeNurses https://twitter.com/selenam738/status/702233368134606848
@nicolabell25
23 February 2016 20:48
@ora_dall @selenam738 @anyadei were they needing obs more frequently? #wenurses
@lexia14
23 February 2016 20:48
@Richardthenurse @nicolabell25 @AgencyNurse @anyadei Beyond doing observations, taking appropriate action #WeNurses
@WeNurses
23 February 2016 20:48
What are peoples thoughts #WeNurses https://twitter.com/anyadei/status/702233554860843008
@ora_dall
23 February 2016 20:49
RT @lexia14: We are exploring costs of different establishments without compromising patient safety #WeNurses https://twitter.com/selenam738/status/702232976860565504
@louisebrady17
23 February 2016 20:49
that's the key! #wenurses https://twitter.com/Bartontd/status/702232984775172096
@selenam738
23 February 2016 20:49
@JaneEBall @anyadei #wenurses, yes, workload, acuity but also experience of team. Very junior workforce on most of our wards. EU nurses etc
@anyadei
23 February 2016 20:49
@SusanHSinclair yes, so many variables! As a general rule of thumb, what would you suggest? #wenurses
@RobBrownAuthor
23 February 2016 20:49
RT @louisebrady17: that's the key! #wenurses https://twitter.com/Bartontd/status/702232984775172096
@Richardthenurse
23 February 2016 20:49
eObs has to be seen as an investment not a complete solution #wenurses
@EllzSummary
23 February 2016 20:50
@WeNurses @WeGPNs I'd like to see higher nurse/patient ratio in primary care too, current model seems lopsided #LTC monitoring #WeNurses
@JJackson_RN
23 February 2016 20:50
@anyadei @Bartontd it's hard to have one measure to determine safety. Need to staff based on pt acuity, a complex factor #wenurses
@workforcesoton
23 February 2016 20:50
RT @JJackson_RN: @workforcesoton If a crisis is a the norm vs an exception, there are issues with staffing, workplace quality etc. #wenurses
@lexia14
23 February 2016 20:51
Multiple factors involved. Where to start trying to solve the issues? #WeNurses https://twitter.com/JJackson_RN/status/702233512485715969
@EllzSummary
23 February 2016 20:51
RT @Bartontd: Safe Staffing Levels must be founded in Safe & Best Patient Care - this will be responsive to context #wenurses and be reflex…
@selenam738
23 February 2016 20:51
@nicolabell25 @ora_dall @anyadei#wenurses combination factorsVitalpac can suggest 30 min obs and if you're 10 mins over cumulative effect
@anyadei
23 February 2016 20:51
@EllzSummary @WeNurses @WeGPNs as a self-management coach, I'd agree, but also higher number of non-clinical support staff! #wenurses
@JJackson_RN
23 February 2016 20:51
@Richardthenurse agree- no good taking the vitals if no one is there to interpret them! #wenurses
@DrSMarkham
23 February 2016 20:51
RT @louisebrady17: that's the key! #wenurses https://twitter.com/Bartontd/status/702232984775172096
@nicolabell25
23 February 2016 20:51
@JJackson_RN @workforcesoton but that is a given here,there are issues wth staffing...obs are late cos theres not enough RNs #wenurses
@lexia14
23 February 2016 20:51
What would be other components of the solution? #WeNurses https://twitter.com/Richardthenurse/status/702233943404367872
@Richardthenurse
23 February 2016 20:51
@lexia14 @nicolabell25 @anyadei pointless having a system telling us obs are bad if we don't have skills to do anything about them #wenurses
@AnnMarieRiley10
23 February 2016 20:51
@workforcesoton don't think the issue is the models (they are well tested) it's how we apply them #wenurses
@anyadei
23 February 2016 20:52
#wenurses https://twitter.com/ThePaedsEDNP/status/702234159608107010
@sroo91
23 February 2016 20:52
RT @AnnMarieRiley10: @workforcesoton don't think the issue is the models (they are well tested) it's how we apply them #wenurses
@JJackson_RN
23 February 2016 20:52
@lexia14 Take care of your nurses. Make sure they get breaks, and have support. Research shows supported nurses= better care #wenurses
@LynneBowers2
23 February 2016 20:52
#wenurses acuity and complexity which is not confined to one sector https://twitter.com/jjackson_rn/status/702234067178287106
@louisebrady17
23 February 2016 20:52
@RobBrownAuthor @Bartontd agree.. listening carefully to the staff & Patients experience vital! #wenurses
@anyadei
23 February 2016 20:53
@blossomsquirrel @sphams @workforcesoton did that feel ok and acceptable to you? #wenurses
@Bartontd
23 February 2016 20:53
@anyadei #wenurses I have a painful memory of missing obs on a ward because the pts were so ill - leave a pt in soiled bed or to do obs?
@WeNurses
23 February 2016 20:53
8 MINS LEFT @workforcesoton @lexia14 @anyadei what are your final thoughts and questions #WeNurses
@Richardthenurse
23 February 2016 20:53
@Richardthenurse Constant review of acute illness, obs training, acute illness mgt training, support and eObs #wenurses
@Gemrose84
23 February 2016 20:53
@nicolabell25 @JJackson_RN @workforcesoton would your Drs not complete obs in a crisis? #wenurses
@JaneEBall
23 February 2016 20:53
That's very much the theory we hope to test in our research! #wenurses #safestaffing https://twitter.com/nicolabell25/status/702234350927134720
@ruth_blackburn
23 February 2016 20:53
RT @sphams: @sroo91 @anyadei @workforcesoton the RN of course, the Code gives clear guidance on delegation #WeNurses
@ora_dall
23 February 2016 20:53
RT @LynneBowers2: #wenurses acuity and complexity which is not confined to one sector https://twitter.com/jjackson_rn/status/702234067178287106
@anyadei
23 February 2016 20:53
@Richardthenurse @lexia14 @nicolabell25 #wenurses is that about having the right skill mix?
@Kean1S
23 February 2016 20:53
RT @JaneEBall: Do you see it as an RN activity, an HCA activity - or is the 'who' less important than holistic approach? #wenurses https://…
@Richardthenurse
23 February 2016 20:53
@lexia14 Constant review of acute illness, obs training, acute illness mgt training, support and eObs #wenurses
@WeNurses
23 February 2016 20:54
RT @Bartontd: @anyadei #wenurses I have a painful memory of missing obs on a ward because the pts were so ill - leave a pt in soiled bed or…
@WeNurses
23 February 2016 20:54
RT @AnnMarieRiley10: @workforcesoton don't think the issue is the models (they are well tested) it's how we apply them #wenurses
@martina_davies
23 February 2016 20:54
#WeNurses and as much about observing as 'doing obs', a skill developed with time and practice, not learnt in a day! https://twitter.com/agencynurse/status/702229426508062724
@JaneEBall
23 February 2016 20:54
RT @JJackson_RN: @Richardthenurse agree- no good taking the vitals if no one is there to interpret them! #wenurses
@anyadei
23 February 2016 20:54
FINAL QUESTION AND REFLECTIONS.... #wenurses https://t.co/BswxrQgoDI
@JJackson_RN
23 February 2016 20:54
@nicolabell25 @workforcesoton That is a hard situation, can only do so much. Recruitment and retention don't fix right away #wenurses
@Marie_Batey
23 February 2016 20:54
We seem to be focusing a lot on obs in this discussion - what about eating, pain relief, admin'n of meds, care of carers etc? #WeNurses
@anyadei
23 February 2016 20:54
@WeNurses @workforcesoton @lexia14 #wenurses https://t.co/msOUqhwGUf
@WeNurses
23 February 2016 20:54
FINAL QUESTION #WeNurses https://twitter.com/anyadei/status/702235066248904704
@selenam738
23 February 2016 20:54
#wenurses as a leader, normalising a culture of safety on a ward is high on my agenda. Get the culture right, easier to build upon
@anyadei
23 February 2016 20:55
#wenurses good point - how can we know if done well or not? https://twitter.com/Ismalia_S/status/702234979212853248
@lexia14
23 February 2016 20:55
Amazing conversations so far! In the last minutes, what are your thoughts? #WeNurses https://twitter.com/anyadei/status/702235066248904704
@lexia14
23 February 2016 20:55
How can a culture of safety be promoted? #WeNurses https://twitter.com/selenam738/status/702235211115978757
@PamelaSmith035
23 February 2016 20:55
@Richardthenurse @lexia14 completely agree #wenurses
@JJackson_RN
23 February 2016 20:56
@lexia14 @anyadei @Bartontd As much as acuity is difficult, I think it is safer than staffing by census. Patient needs variable #wenurses
@Bartontd
23 February 2016 20:56
@anyadei We were scolded for missing obs - but the alternative was leaving a 20 yr old covered in faeces. #wenurses not defined by a %
@Gill_hospicenn
23 February 2016 20:56
@anyadei @Bartontd #wenurses so would 90% compliance be ok in ICU? - just sayin.... we dont say 90% drug accuracy is good enough...
@maxwele2
23 February 2016 20:56
@ThePaedsEDNP @lexia14 @WeNurses @anyadei PEWS don't record consequence only prescribed actions #wenurses
@anyadei
23 February 2016 20:56
@Marie_Batey Agree - obs are a part of the bigger picture, but that is what the research models are looking at! #wenurses
@WeNurses
23 February 2016 20:56
RT @anyadei: @Marie_Batey Agree - obs are a part of the bigger picture, but that is what the research models are looking at! #wenurses
@nicolabell25
23 February 2016 20:56
@JJackson_RN @workforcesoton thats right, not trying to be negative...morale very low, RNs want to do things right #wenurses
@Itstillhelen
23 February 2016 20:56
How was I ever a nurse when even my Grandson's tooth coming out turned my stomach? Didn't like teeth, eyes or nails, still don't! #wenurses
@mccarthy_ph
23 February 2016 20:57
@anyadei lack of equipment available, high number of acutely unwell patients, every day distractions #wenurses
@_jo_hope
23 February 2016 20:57
RT @anyadei: FINAL QUESTION AND REFLECTIONS.... #wenurses https://t.co/BswxrQgoDI
@anyadei
23 February 2016 20:57
Can't believe the hour has gone so quickly! #wenurses
@Bartontd
23 February 2016 20:57
@Ismalia_S @WeNurses @anyadei Hear Hear #wenurses
@MandyyWilson
23 February 2016 20:57
@Marie_Batey @WeNurses I agree,level of basic care & pain relief significantly affected by poor staffing or poorly trained staff #wenurses
@Bartontd
23 February 2016 20:57
RT @louisebrady17: @RobBrownAuthor @Bartontd agree.. listening carefully to the staff & Patients experience vital! #wenurses
@lexia14
23 February 2016 20:57
@Marie_Batey Hi! Yes, our study is at the moment focussed on obs. http://www.nets.nihr.ac.uk/projects/hsdr/1311417 We'd like to consider others in future #wenurses
@JJackson_RN
23 February 2016 20:57
@Marie_Batey if obs are being sacrificed, I assume that all of those things have been affected beforehand, further up the chain #wenurses
@anyadei
23 February 2016 20:58
@WFDManager @Bartontd interesting point! What tolerances do we have in other areas? #wenurses
@lexia14
23 February 2016 20:58
100% is the only option #WeNurses https://twitter.com/WFDManager/status/702235559780073472
@fussydolphin
23 February 2016 20:58
RT @WeNurses: Tonights discussion is all about Nurse Staffing levels #Wenurses And we have some fab guest hosts @workforcesoton @lexia14 …
@WeNurses
23 February 2016 20:58
RT @lexia14: 100% is the only option #WeNurses https://twitter.com/WFDManager/status/702235559780073472
@mccarthy_ph
23 February 2016 20:58
@anyadei thank you was just going to lurk but you dragged me in ??well done #wenurses
@Bartontd
23 February 2016 20:58
RT @anyadei: @WFDManager @Bartontd interesting point! What tolerances do we have in other areas? #wenurses
@JaneEBall
23 February 2016 20:58
Good point @Marie_Batey. Our research showed range of necessary fundamental care left undone when staffing levels low. #wenurses
@lexia14
23 February 2016 20:59
@JJackson_RN @Marie_Batey It would be a symptom of other issues! #WeNurses
@anyadei
23 February 2016 20:59
@JJackson_RN @Marie_Batey so obs not being done is an indicator that staff levels not right, but too late an indicator? #wenurses
@JJackson_RN
23 February 2016 20:59
@lexia14 promoting resilience is a start! Clinicians can respond to complex issues upfront, not only react when things go wrong #wenurses
@WeNurses
23 February 2016 20:59
@mccarthy_ph @anyadei #noisylurker #WeNurses :D
@Marie_Batey
23 February 2016 20:59
I agree - risk of hitting the target but missing the point! #WeNurses https://twitter.com/ismalia_s/status/702234979212853248
@louisebrady17
23 February 2016 20:59
@RobBrownAuthor @Bartontd multiple factors come in to play.. no easy answers! #wenurses
@JaneEBall
23 February 2016 20:59
#WeNurses our research shows nurses more likely to repory care is left undone when lower staffing levels https://t.co/CBsyAxsU7M
@anyadei
23 February 2016 20:59
#wenurses https://twitter.com/SusanHSinclair/status/702235821961834498
@workforcesoton
23 February 2016 20:59
...lots of other things we'd like to measure...trying to move away from mortality as the measure #wenurses https://twitter.com/MandyRidley/status/702235839187779584
@LynneBowers2
23 February 2016 20:59
#wenurses Yes they do! One of Demings Principles - do NOT ask your staff to do what they cannot. https://twitter.com/nicolabell25/status/702235667292667904
@WeNurses
23 February 2016 20:59
Thats all for tonight everyone #WeNurses
@anyadei
23 February 2016 21:00
@SusanHSinclair what do you mean by unnecessary? #wenurses
@JaneEBall
23 February 2016 21:00
RT @lexia14: 100% is the only option #WeNurses https://twitter.com/WFDManager/status/702235559780073472
@Gill_hospicenn
23 February 2016 21:00
@lexia14 #wenurses is an interesting debate - versus 'good enough' is social care...
@anyadei
23 February 2016 21:00
#wenurses https://twitter.com/bee_bucket/status/702235769650413568
@JJackson_RN
23 February 2016 21:00
.@lexia14 I think this is a canary in the coal mine. If you aren't able to do obs, a lot of other things are affected too #wenurses
@workforcesoton
23 February 2016 21:00
RT @Marie_Batey: I agree - risk of hitting the target but missing the point! #WeNurses https://twitter.com/ismalia_s/status/702234979212853248
@WeNurses
23 February 2016 21:00
Can we please say a huge thank you to our brilliant guest hosts @workforcesoton @lexia14 @anyadei #WeNurses THANK YOU
@anyadei
23 February 2016 21:01
Thank you to everyone for tweeting this evening! Great chat and lots of interesting points! #wenurses
@WeNurses
23 February 2016 21:01
Remember there is no #WeNurses on Thursday as we are getting ready for #WGT16 on Monday :D
@Marie_Batey
23 February 2016 21:01
@anyadei @JJackson_RN I need to percolate that as I'm not sure missed obs is my gauge for safe care. Research will be interesting# #WeNurses
@anyadei
23 February 2016 21:01
@WeNurses @workforcesoton @lexia14 great to have the opportunity! thank you! #wenurses
@WeNurses
23 February 2016 21:02
Social Media and the art of the possible! > https://t.co/aGCpiIewfp #WGT16 Online 29th Feb 3.20pm #Wenurses https://t.co/NK3sHWCNGT
@WeNurses
23 February 2016 21:02
Moving forward, how can we shape SoMe & health? https://t.co/Br9xlf6l3K #WGT16 Online 29th Feb 4pm #WeNurses https://t.co/pPlLQ6IRLT
@Bartontd
23 February 2016 21:02
RT @WeNurses: Remember there is no #WeNurses on Thursday as we are getting ready for #WGT16 on Monday :D
@lexia14
23 February 2016 21:02
Thank you Everyone! We have a lot to think about! #WeNurses
@RobBrownAuthor
23 February 2016 21:02
RT @louisebrady17: @RobBrownAuthor @Bartontd multiple factors come in to play.. no easy answers! #wenurses
@Gill_hospicenn
23 February 2016 21:02
@WeNurses @workforcesoton @lexia14 @anyadei #wenurses thank you for an excellent chat-far better than the Arsenal score... :(
@Bartontd
23 February 2016 21:02
RT @WeNurses: Can we please say a huge thank you to our brilliant guest hosts @workforcesoton @lexia14 @anyadei #WeNurses THANK YOU
@JJackson_RN
23 February 2016 21:02
.@lexia14 final thought-to ensure good patient care by any standard take care of nurses 1st. Support the professionals as priority #wenurses
@WeNurses
23 February 2016 21:02
How can we improve services & peoples lives through SoMe? > https://t.co/NTltdFyiW5 #WGT16 Mon 1.15pm #WeNurses https://t.co/9T3P6rE7hJ
@spencer_sian
23 February 2016 21:03
RT @WeNurses: Moving forward, how can we shape SoMe & health? https://t.co/Br9xlf6l3K #WGT16 Online 29th Feb 4pm #WeNurses https://t.co/…
@Bartontd
23 February 2016 21:03
@WeNurses @workforcesoton @lexia14 @anyadei Sorry to be late - most interesting #wenurses
@WeNurses
23 February 2016 21:03
What's your social media story? https://t.co/Rs2dSFWJWh #WGT16 Online Feb 29th 10.05am #WeNurses https://t.co/BnRdWkElVx
@spencer_sian
23 February 2016 21:03
RT @WeNurses: Remember there is no #WeNurses on Thursday as we are getting ready for #WGT16 on Monday :D
@_jo_hope
23 February 2016 21:03
RT @WeNurses: Can we please say a huge thank you to our brilliant guest hosts @workforcesoton @lexia14 @anyadei #WeNurses THANK YOU
@anyadei
23 February 2016 21:04
@Marie_Batey @JJackson_RN is safe care the same as safe staffing levels? #wenurses
@anyadei
23 February 2016 21:04
#WeNurses highlights and summary to follow tomorrow!
@JaneEBall
23 February 2016 21:04
RT @WeNurses: Good point #WeNurses https://t.co/C9k3QaUeV5
@JJackson_RN
23 February 2016 21:04
@anyadei @Marie_Batey Not necessarily, but I think it's hard to have one without the other #wenurses
@lexia14
23 February 2016 21:04
Training and education seems to be at the core of patient safety #WeNurses https://t.co/XV2OGCxIbB
@WeNurses
23 February 2016 21:05
Brilliant #WeNurses https://t.co/4mu2i9P8GL
@lexia14
23 February 2016 21:05
Thank you once more! Good night to all and a peaceful evening! #WeNurses
@Bartontd
23 February 2016 21:05
@WeNurses SOOOO EXCITED - SEE YOU IN SALFORD - CANT WAIT ONE BIG TWITTER FAMILY #wenurses I will be the grey haired old git in the corner
@JJackson_RN
23 February 2016 21:05
@Marie_Batey @anyadei too late of an indicator. There's a lot of other things sacrificed first- see RN4CAST #wenurses
@Marie_Batey
23 February 2016 21:05
@workforcesoton @anyadei @JJackson_RN Maybe... Bring on that evidence base. #WeNurses :)
@SchoolNurse2007
23 February 2016 21:06
RT @WeNurses: Remember there is no #WeNurses on Thursday as we are getting ready for #WGT16 on Monday :D
@sroo91
23 February 2016 21:06
Training, education and awareness are essential for patient safety as well as good communication within the team #wenurses
@NagingtonUoM
23 February 2016 21:06
RT @JaneEBall: #WeNurses our research shows nurses more likely to repory care is left undone when lower staffing levels https://t.co/CBsyAx…
@JJackson_RN
23 February 2016 21:07
@nicolabell25 @workforcesoton totally agree. No one goes to work saying, I want to give poor care today. Environment can be issue #wenurses
@maxwele2
23 February 2016 21:07
@ThePaedsEDNP @lexia14 @WeNurses @anyadei I'm sure but point is the chart itself doesn't integrate info needed for safety #WeNurses
@Bartontd
23 February 2016 21:07
RT @lexia14: Thank you once more! Good night to all and a peaceful evening! #WeNurses
@lexia14
23 February 2016 21:07
@JJackson_RN @Marie_Batey @anyadei Essential care is reported to be the most rationed/missed aspect of care #WeNurses
@Bartontd
23 February 2016 21:07
RT @WeNurses: Brilliant #WeNurses https://t.co/4mu2i9P8GL
@levylass
23 February 2016 21:07
RT @WeNurses: Remember there is no #WeNurses on Thursday as we are getting ready for #WGT16 on Monday :D
@Bartontd
23 February 2016 21:07
RT @WeNurses: What's your social media story? https://t.co/Rs2dSFWJWh #WGT16 Online Feb 29th 10.05am #WeNurses https://t.co/BnRdWkElVx
@JJackson_RN
23 February 2016 21:08
@Marie_Batey @workforcesoton @anyadei https://t.co/H4dbtXbyvO #wenurses
@Marie_Batey
23 February 2016 21:08
@JJackson_RN @anyadei Care vs staffing... what really matters is patient (but also staff) outcomes. #WeNurses
@Bartontd
23 February 2016 21:08
RT @anyadei: @WeNurses @workforcesoton @lexia14 great to have the opportunity! thank you! #wenurses
@JJackson_RN
23 February 2016 21:08
Check out RN4Cast, related to tonight's #wenurses https://t.co/H4dbtXbyvO
@Gemrose84
23 February 2016 21:09
@anyadei first time for me. Is this daily or weekly and what time? #wenurses
@upsadaisy3
23 February 2016 21:09
RT @WeNurses: Tonights discussion is all about Nurse Staffing levels #Wenurses And we have some fab guest hosts @workforcesoton @lexia14 …
@lexia14
23 February 2016 21:09
Thank you @WeNurses for the opportunity to host a chat! #WeNurses
@JJackson_RN
23 February 2016 21:09
@anyadei @lexia14 I'd say too late, There are much more subtle signs first, like increasing nursing burnout #wenurses
@JJackson_RN
23 February 2016 21:10
@lexia14 And also giving people the ability to enact safe care. Nurses need to have an environment that lets them give good care #wenurses
@JJackson_RN
23 February 2016 21:12
@Marie_Batey @anyadei This research shows staff outcomes linked directly to patient outcomes http://www.kingsfund.org.uk/events/encouraging-staff-wellbeing-health-and-care #wenurses
@Gemrose84
23 February 2016 21:13
@Ismalia_S @WeNurses @anyadei @Bartontd totally agree with this #wenurses
@JJackson_RN
23 February 2016 21:13
@maxwele2 @Marie_Batey @workforcesoton @anyadei http://www.kingsfund.org.uk/events/encouraging-staff-wellbeing-health-and-care and https://www.kcl.ac.uk/nursing/research/nnru/publications/Reports/RN4Cast-Nurse-survey-report-27-6-12-FINAL.pdf help this #wenurses
@JJackson_RN
23 February 2016 21:17
@maxwele2 @anyadei @Marie_Batey @workforcesoton Respectfully disagree. Evidence shows nurses key in patient safety, need support #wenurses
@rcnAandAbranch
23 February 2016 21:19
RT @WeNurses: How can we improve services & peoples lives through SoMe? > http://buff.ly/1p1KSTD #WGT16 Mon 1.15pm #WeNurses https://t…
@rcnAandAbranch
23 February 2016 21:19
RT @WeNurses: What's your social media story? http://buff.ly/1RllTUo #WGT16 Online Feb 29th 10.05am #WeNurses https://t.co/BnRdWkElVx
@AliRichards15
23 February 2016 21:20
RT @WeNurses: How can we improve services & peoples lives through SoMe? > https://t.co/NTltdFyiW5 #WGT16 Mon 1.15pm #WeNurses https://t…
@JJackson_RN
23 February 2016 21:21
Thank you @wenurses for the great tweetchat! #wenurses
@lhenderson231
23 February 2016 21:29
RT @sphams: @sroo91 @anyadei @workforcesoton the RN of course, the Code gives clear guidance on delegation #WeNurses




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