#WeDNs - Wednesday 1st March 2017 8pm (GMT Standard Time) Ways of Working in Community Nursing

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During the last few years community nursing has seen a number of imperatives that drive the changes that need to be adopted in practice delivery. Government policies in all 4 countries reinforce the message that keeping people out of hospital and at home is preferable. However these changes along with the changing demographics have resulted in complex demands on resources within community nursing. It is vital, therefore, that District Nurses are able to manage care that meets the needs of the population, reflects on the reality of health economics and anticipates future needs and demands.

Maybin et a l(2016) investigated what ‘good’ district nursing care looks like from the perspectives of people receiving the care, unpaid carers, and the staff. This work identified nine characteristics of good quality care in district nursing. Of these characteristics four can explicitly be related to ways of working and caseload management:

·        Continuity of care

·        Scheduling and reliability of appointments

·        Being available between appointments

·        Nurses acting as coordinators and advocates of care.

Therefore ways of working and caseload management can be described is an organisational technique that involves the individuals’ and the families’ healthcare needs being met by the appropriate person at the appropriate time. However, the District Nurse’s caseload is not easy to define and it is often described as a ‘ward without walls’ (Haycock-Stuart et al. 2008). In order to address some of the challenges some areas of the UK have focussed on reviewing their workforce in order to establish where practitioners are spending their time and how resources can be implemented accordingly in order to deliver a safe and effective nurse led service.  This has resulted in the adoption and piloting of different models of care delivery such as Buurtzorg Nederland (2011) .

This chat will provide an opportunity explore these aspects and consider the following:

  • Do you think the demand for community nursing services is managed well inyour local area?
  • What are the advantages of working geographically?
  • What are the advantages of being GP attached?
  • How does your caseload management systems support the integration agenda?
  • How is workforce planning undertaken for the nursing and midwifery workforce in your place of employment?
  • Is anyone piloting any models of care delivery and can share their experience?
  • Does your delivery model support continuity of care?
  • If you were advising your organisation on what could be improved to advance services, what would you advise?

References

BUURTZORG NEDERLAND 2011, ‘A new perspective on elder care in the Netherlands’ available at: http://omahasystem.org/AARPTheJournal_Summer2011_deBlok.pdf (accessed: 1 Aug2016)

HAYCOCK-STUART,E., JARVIS, A. and DANIEL, K., 2008. A ward without walls? district nurses’perceptions of their workload management priorities and job satisfaction.Journal of Clinical Nursing, 17 (22), pp. 3012 – 3020.

MAYBIN. J, CHARLES, A and HONEYMAN, M. 2016. Understanding quality in district nursing services Learning from patients, carers and staff London: The King’s Fund. Available at: www.kingsfund.org.uk/publications/quality-district-nursing (accessed 01 Sept.2016).

Further Reading

ADDICOTT,  R, MAGUIRE, D, HONEYMAN, M, JABBAL, J, 2015. Workforceplanning in the NHS. [online]. London: The King’s Fund. Available from: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Workforce-planning-NHS-Kings-Fund-Apr-15.pdf

JACKSON, C. et al. 2015. Making the complexity of community nursing visible: the Cassandra project. British Journal of Community Nursing, 20(3), pp. 126-133.

KANE, K.2014. Capturing district nursing through a knowledge based electronic caseload analysis tool. British Journal of Community Nursing, 19(3), pp. 116 - 124.

QNI, 2014. The district nursingworkforce planning project. Literature review. [online]. QNI: London.Available from: http://www.qni.org.uk/docs/DN_Workforce_Literature_Review_Web.pdf





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 #WeDNs transcript

 
@WeCommNurses
01 March 2017 20:00
Hello everyone give us a wave and tell us where you are from #WeDNs
@WeCommNurses
01 March 2017 20:02
add #wedns to ytour tweet ann https://t.co/6BlCRlOAYA
@HeatherBain9
01 March 2017 20:02
Sunny Aberdeen #wedns https://t.co/vF8tlfa1DH
@erinfAPDN
01 March 2017 20:02
Hello from Glasgow (Costa ha) #WeDNs
@WeCommNurses
01 March 2017 20:02
#wedns https://t.co/R1liGjlXUz
@davidpugh25
01 March 2017 20:02
@WeDistrictNurse hello from Bristol #WeDNs
@WeCommNurses
01 March 2017 20:03
welcome ann just remember to use the hashtag #wedns and follow the chat on this stream https://twitter.com/laineym24/status/837030288463171587
@WeCommNurses
01 March 2017 20:03
Good to see we have a mix of Areas #WeDNs
@MrsMurphoid
01 March 2017 20:03
@WeDistrictNurse CSP from Manchester #weDNs
@j_blease
01 March 2017 20:03
@WeDistrictNurse DN trainee in Aberdeen #WeDNs
@WeCommNurses
01 March 2017 20:03
So let's get started and hope more join #WeDNs
@JillYGld
01 March 2017 20:04
@WeDistrictNurse #wedns Hello from Derbyshire.
@traceyhardy789
01 March 2017 20:04
Hello from the city of culture Hull #weDNs
@flood3_lorraine
01 March 2017 20:04
@WeDistrictNurse #WeDNs community nurse in Forth Valley
@Helenakelly73
01 March 2017 20:04
???? from Edinburgh evening all #WeDNs
@WeCommNurses
01 March 2017 20:04
Q1 is the demand for community nursing services managed well in your area? #WeDNs
@jkeyes22
01 March 2017 20:05
Hello from Leeds #weDNs
@StevoKeyes
01 March 2017 20:06
RT @WeDistrictNurse: So let's get started and hope more join #WeDNs
@MrsMurphoid
01 March 2017 20:06
@WeDistrictNurse managed well will limited and depleting resources, could go so much more if invested in #WeDNs
@jkeyes22
01 March 2017 20:06
It is a challenge to manage demand from all referral pathways #weDNs
@davidpugh25
01 March 2017 20:06
@WeDistrictNurse it is a challenge but we are looking at ways of managing increased demand #WeDNs
@HeatherBain9
01 March 2017 20:07
#wedns our students report different practices even within a city. Challenging times https://twitter.com/wedistrictnurse/status/837030852513173510
@j_blease
01 March 2017 20:07
@WeDistrictNurse we currently have a substantial vacancy issue impacts service #WeDNs
@jkeyes22
01 March 2017 20:07
We are also focussing on increasing capacity where we can #weDNs
@erinfAPDN
01 March 2017 20:07
I think its managed fairly well, however workload/sickness/changes are beginning to have a negative impact, prob will get worse #WeDNs
@JillYGld
01 March 2017 20:07
Are we allowed to answer re: the national picture> eg.. the answer being a resounding no! #WeDNs https://twitter.com/wedistrictnurse/status/837030852513173510
@WeCommNurses
01 March 2017 20:08
#wedns have others looked at ways of managing increased demand https://twitter.com/davidpugh25/status/837031328822530048
@JillYGld
01 March 2017 20:08
RT @j_blease: @WeDistrictNurse we currently have a substantial vacancy issue impacts service #WeDNs
@flood3_lorraine
01 March 2017 20:08
I agree it can be very challenging with limited resources #WeDNs
@AdamBowen1990
01 March 2017 20:08
@WeDistrictNurse I can see a clear gap in my area, as we are always full to capacity bt management have no further ?? for more posts! #WeDNs
@erinfAPDN
01 March 2017 20:08
@HeatherBain9 Yes I agree, should be #standardcare throughout Glasgow areas #WeDNs
@jkeyes22
01 March 2017 20:08
Yes vacancirs an issue as is Gen Z who want good work life balance and nore flexible working #weDNs
@traceyhardy789
01 March 2017 20:08
#weDNs It is a challenge and pressures are felt but managing
@WeCommNurses
01 March 2017 20:08
#wedns https://t.co/muxXhhlaxy
@HeatherBain9
01 March 2017 20:08
RT @jkeyes22: We are also focussing on increasing capacity where we can #weDNs
@GTomalin
01 March 2017 20:09
@WeDistrictNurse Hello from Highland #WeDNs
@WeCommNurses
01 March 2017 20:09
#wedns can you share some solutions to increase capacity https://twitter.com/jkeyes22/status/837031580333924352
@davidpugh25
01 March 2017 20:09
@carla00 @WeDistrictNurse Yes we are too and the different pathways for managing planned and unplanned #WeDNs
@WeCommNurses
01 March 2017 20:09
Of course you can #wedns we can learn from different areas https://twitter.com/jillygld/status/837031610813976584
@jkeyes22
01 March 2017 20:10
Well trained band 3 support workers increase capacity #weDNs
@kazamca80
01 March 2017 20:10
#weDNs sunny east kilbride
@WeCommNurses
01 March 2017 20:10
#wedns https://t.co/FkP7cW0zdD
@susie_gamble
01 March 2017 20:10
#WeDNs hello from Glasgow and sorry I'm late!
@traceyhardy789
01 March 2017 20:10
RT @WeDistrictNurse: #wedns have others looked at ways of managing increased demand https://t.co/QfnP6LU372
@jkeyes22
01 March 2017 20:10
How do you all measure demand? #weDNs
@WeCommNurses
01 March 2017 20:11
@carla00 add in the #wedns to your tweets Carla
@WeCommNurses
01 March 2017 20:11
#wedns are other areas changing skill mix to address capacity https://t.co/5DzfuTn3p0
@j_blease
01 March 2017 20:11
@WeDistrictNurse more detailed recruitment programme. Encourage nurses to come back to profession #weDNs
@laineym24
01 March 2017 20:11
@WeDistrictNurse managed well to an extent due to the large geographical area and not enough staff for areas #WeDNS
@davidpugh25
01 March 2017 20:11
@WeDistrictNurse Ensuring correct criteria and appropriate caseload management are some of the key solutions #WeDNs
@WeCommNurses
01 March 2017 20:11
#wedns good question Jo https://t.co/8l9DYwDLnk
@jkeyes22
01 March 2017 20:12
Regular caseload review #weDNs
@AdamBowen1990
01 March 2017 20:12
@WeDistrictNurse we have just had shift times changed to extend service and relieve pressure from eve nursing team #weDNs
@mamdadboys
01 March 2017 20:12
@WeDistrictNurse given the overall depletion of staff in many areas, i don't know how it can? #WeDNs
@davidpugh25
01 March 2017 20:12
@carla00 @WeDistrictNurse Still in planning phase :) #WeDNs
@kazamca80
01 March 2017 20:13
#weDNs I feel it is managed well in my area. we are part of the ICST. it has had teething problems but on a whole it's working well
@WeCommNurses
01 March 2017 20:13
So do most of you work geographically or gp attached or Within integrated teams? #WeDNs
@erinfAPDN
01 March 2017 20:13
@jkeyes22 In Ggow we complete a workload analysis audit annually. Effective when staff have time and knowledge to complete correctly #WeDNs
@jkeyes22
01 March 2017 20:13
We have issues about clearly measuring travel time in the city and in other areas #weDNs
@AdamBowen1990
01 March 2017 20:13
@WeDistrictNurse we have just created 2 more band 4 posts at my base to help with demand/capacity #weDNs
@j_blease
01 March 2017 20:13
@WeDistrictNurse to my knowledge it is not measured as we are firefighting. Could be wrong though.#WeDNs
@jkeyes22
01 March 2017 20:13
Yesvwe have done that and ut definitely helped with twilight capacity #weDNs
@WeCommNurses
01 March 2017 20:13
#WeDNs is there a difference between rural and urban areas? https://t.co/Yy2biuPYP4
@traceyhardy789
01 March 2017 20:14
#weDNs Encouraging self management with ppl with LTCs.. joint working with pts
@davidpugh25
01 March 2017 20:14
RT @WeDistrictNurse: #wedns are other areas changing skill mix to address capacity https://t.co/5DzfuTn3p0
@WeCommNurses
01 March 2017 20:14
RT @davidpugh25: @WeDistrictNurse Ensuring correct criteria and appropriate caseload management are some of the key solutions #WeDNs
@JiveEdinburgh
01 March 2017 20:14
RT @Helenakelly73: ???? from Edinburgh evening all #WeDNs
@WeCommNurses
01 March 2017 20:14
@AdamBowen1990 is this new model working well Adam? Real concern from DNS within Lothian facing similar change #wedns
@j_blease
01 March 2017 20:14
@WeDistrictNurse I am Practiced Attached but cover a large geographical area of city #WeDNs
@WeCommNurses
01 March 2017 20:14
#wedns have you tools you use to review your caseload https://t.co/XX2QztLPMc
@loulaw06
01 March 2017 20:14
Hello everyone #weDNs
@kazamca80
01 March 2017 20:14
#weDNs we work geographically. I feel it was better GP aligned.
@JillYGld
01 March 2017 20:14
RT @traceyhardy789: #weDNs Encouraging self management with ppl with LTCs.. joint working with pts
@jkeyes22
01 March 2017 20:14
We are aligned to gp practices but recently have taken a geographical approach as well to save time #weDNs
@laineym24
01 March 2017 20:15
@erinforsy I agree the resoursces seem to be getting worse so this is going to have an impact on patient care #WeDNs
@WeCommNurses
01 March 2017 20:15
#wedns can you tell us more on the ICST https://t.co/aRQSv07S0w
@JillYGld
01 March 2017 20:15
RT @kazamca80: #weDNs we work geographically. I feel it was better GP aligned.
@HeatherBain9
01 March 2017 20:15
RT @j_blease: @WeDistrictNurse more detailed recruitment programme. Encourage nurses to come back to profession #weDNs
@mjosiris
01 March 2017 20:15
@erinforsy @jkeyes22 #wedns but does the workload analysis tool capture the complexities of our practice?
@WeCommNurses
01 March 2017 20:15
@jkeyes22 are you using a caseload weighting tool? #WeDNs
@HeatherBain9
01 March 2017 20:15
RT @davidpugh25: @WeDistrictNurse Ensuring correct criteria and appropriate caseload management are some of the key solutions #WeDNs
@JillYGld
01 March 2017 20:15
RT @WeDistrictNurse: #wedns have you tools you use to review your caseload https://t.co/XX2QztLPMc
@MrsMurphoid
01 March 2017 20:15
@jkeyes22 we have just returned to units to try and monitor capacity and demand #weDNs
@HeatherBain9
01 March 2017 20:16
#wedns how have staff perceived this change? https://t.co/rOhOX9l2MQ
@davidpugh25
01 March 2017 20:16
@WeDistrictNurse Combination of GP attached and now working towards geographical zonal working #weDNs
@flood3_lorraine
01 March 2017 20:16
We are GP attached however will take on patients from other practices if living in our area to save money on mileage #WeDNs
@loulaw06
01 March 2017 20:16
Geographical in my area. Which has some positives and negatives. #weDNs
@erinfAPDN
01 March 2017 20:16
This is an idea for Glasgow #WeDNs https://t.co/OACzB62UKe
@WeCommNurses
01 March 2017 20:17
#wedns is this electronic Erin https://t.co/N13udfYSvj
@loulaw06
01 March 2017 20:17
Regular caseload audit/reviews in our area #weDNs
@laineym24
01 March 2017 20:17
@flood3_lorraine this also has an effect on staff morale as they try there hardest to provide quality care with limited resources #WeDNs
@j_blease
01 March 2017 20:17
@HeatherBain9 I think this is a positive move. To provide the care expected in the community now we have to be more flexible #wedns
@WeCommNurses
01 March 2017 20:17
#wedns https://twitter.com/RivkahMiar/status/837033737825189888
@knox_alisonknox
01 March 2017 20:17
RT @WeDistrictNurse: Are you ready to chat tonight #weDNs https://t.co/DLTCSKOSam
@carla00
01 March 2017 20:18
@WeDistrictNurse #wedns will do ??
@WeCommNurses
01 March 2017 20:18
#WeDNs @NuffieldTrust report published today highlighted selfcare as a strategy #ebp https://twitter.com/traceyhardy789/status/837033201625333763
@jkeyes22
01 March 2017 20:18
Yes we use units but not perfect, are goong to use a combination of units and estimation of time required #weDNs
@WeCommNurses
01 March 2017 20:18
#wedns https://t.co/OCeJuG6oto
@WeCommNurses
01 March 2017 20:18
#wedns https://t.co/vu9qRDLMrB
@RivkahMiar
01 March 2017 20:18
@WeDistrictNurse Have been suggesting we include visit/travel/record writing/messages/allocation & meetings. Need 2reflect what we do #wedns
@carla00
01 March 2017 20:18
#wedns https://t.co/KG2UigXSJA
@WeCommNurses
01 March 2017 20:18
#wedns can you share the advantages of this https://t.co/HAE1Irokfu
@WeCommNurses
01 March 2017 20:18
#wedns https://t.co/8FOd6NcICk
@j_blease
01 March 2017 20:19
@HeatherBain9 speaking to colleagues they are open to a shift pattern of early/lates #WeDNs
@WeCommNurses
01 March 2017 20:19
#wedns https://t.co/kMtiIEI4RZ
@WeCommNurses
01 March 2017 20:19
#wedns can you tell us why? https://twitter.com/kazamca80/status/837033407062376449
@WeCommNurses
01 March 2017 20:19
#wedns https://t.co/jhhT0V20Q1
@flood3_lorraine
01 March 2017 20:19
Also complete workload tool periodically but can be very time consuming to complete on top of daily workload #WeDNs
@MrsMurphoid
01 March 2017 20:19
@WeDistrictNurse we have but still require expertise of a csp #wedns
@kazamca80
01 March 2017 20:19
#weDNs patients have highlighted on the number of nurses visiting them however was not the case when gp aligned.
@WeCommNurses
01 March 2017 20:20
#wedns what do you think the people you look after prefer? https://t.co/vF8dZZIAR2
@WeCommNurses
01 March 2017 20:20
#wedns https://t.co/6HQRIXzhJh
@JillYGld
01 March 2017 20:20
@WeDistrictNurse #wedns HSCIC stats: worrying; need to raise awareness of DN work-important to keep caseload data.… https://t.co/VH2ftuwLOQ
@HeatherBain9
01 March 2017 20:20
Remember #wedns https://t.co/LcSfqu94xs
@kazamca80
01 March 2017 20:20
#weDNs one day I could be in one area and the next another. continuity not the same
@loulaw06
01 March 2017 20:20
@RivkahMiar @WeDistrictNurse same in my area. Although very challenging to complete when faced with an increasing workload #WeDNs
@HeatherBain9
01 March 2017 20:20
#wedns https://t.co/YFsGgNy0bt
@AdamBowen1990
01 March 2017 20:20
@WeDistrictNurse apologies ?? I keep forgetting #WeDNs
@RivkahMiar
01 March 2017 20:21
RT @JillYGld: @WeDistrictNurse #wedns HSCIC stats: worrying; need to raise awareness of DN work-important to keep caseload data. So much we…
@WeCommNurses
01 March 2017 20:21
#wedns https://t.co/V0705tjel6
@WeCommNurses
01 March 2017 20:21
RT @mjosiris: @erinforsy @jkeyes22 #wedns but does the workload analysis tool capture the complexities of our practice?
@davidpugh25
01 March 2017 20:21
RT @WeDistrictNurse: #WeDNs @NuffieldTrust report published today highlighted selfcare as a strategy #ebp https://t.co/DG6QSKS4xm
@WeCommNurses
01 March 2017 20:21
#wedns https://t.co/cKHvXDVnnI
@laineym24
01 March 2017 20:21
@WeDistrict some rural areas do not have access to the same resources as urban areas #WeDNs
@WeCommNurses
01 March 2017 20:21
#wedns what do you mean by units? https://t.co/rnLfWpgebk
@davidpugh25
01 March 2017 20:22
RT @carla00: #wedns https://t.co/KG2UigXSJA
@GlasgowJives
01 March 2017 20:22
RT @erinforsy: This is an idea for Glasgow #WeDNs https://t.co/OACzB62UKe
@matthew_sunter
01 March 2017 20:22
RT @JillYGld: @WeDistrictNurse #wedns HSCIC stats: worrying; need to raise awareness of DN work-important to keep caseload data. So much we…
@WeCommNurses
01 March 2017 20:22
Please remember to add #wedns to your tweet
@carolinegame
01 March 2017 20:22
@kazamca80 We are GP attached in a geog. area & the area is split into 4 teams - cross working but predominantly cover own patch #WeDNs
@AdamBowen1990
01 March 2017 20:22
RT @JillYGld: @WeDistrictNurse #wedns HSCIC stats: worrying; need to raise awareness of DN work-important to keep caseload data. So much we…
@j_blease
01 March 2017 20:22
@WeDistrictNurse advantages are close working with GP The aging demographic feel safer in their care knowing we closely work with GP #WeDNs
@RivkahMiar
01 March 2017 20:22
@loulaw06 @WeDistrictNurse Have been encouraging ppl to complete on RIO so reports can be pulled centrally rather than paper audit #wedns
@JillYGld
01 March 2017 20:22
RT @WeDistrictNurse: #wedns https://t.co/V0705tjel6
@JillYGld
01 March 2017 20:23
RT @WeDistrictNurse: #wedns https://t.co/cKHvXDVnnI
@laineym24
01 March 2017 20:23
@kazamca80 to true no continuity with patients as nurses covering several areas different days of week due to lack of resources #WeDNs
@JillYGld
01 March 2017 20:23
RT @laineym24: @WeDistrict some rural areas do not have access to the same resources as urban areas #WeDNs
@carla00
01 March 2017 20:23
RT @WeDistrictNurse: #wedns https://t.co/cKHvXDVnnI
@j_blease
01 March 2017 20:23
@WeDistrictNurse better access to patient records #WeDNs
@WeCommNurses
01 March 2017 20:23
#wedns will this suit all? And be compulsory https://t.co/DOV0uodpAE
@MrsMurphoid
01 March 2017 20:23
@WeDistrictNurse without complexity ect how many visits are staff undertaking in your area? #wedns
@mjosiris
01 March 2017 20:23
@erinforsy @jkeyes22 yes we do 1 like that too but very recently read about Jackson et al (2015) the cassandra project #wedns
@AdamBowen1990
01 March 2017 20:23
@WeDistrictNurse we are attached to GP surgeries, I think this works well as built good relationships with my GP's #wedns
@davidpugh25
01 March 2017 20:23
RT @WeDistrictNurse: #wedns what do you think the people you look after prefer? https://t.co/vF8dZZIAR2
@carla00
01 March 2017 20:23
RT @WeDistrictNurse: #WeDNs @NuffieldTrust report published today highlighted selfcare as a strategy #ebp https://t.co/DG6QSKS4xm
@LynneBowers2
01 March 2017 20:23
RT @JillYGld: @WeDistrictNurse #wedns HSCIC stats: worrying; need to raise awareness of DN work-important to keep caseload data. So much we…
@WeCommNurses
01 March 2017 20:24
RT @JillYGld: @WeDistrictNurse #wedns HSCIC stats: worrying; need to raise awareness of DN work-important to keep caseload data. So much we…
@DrUmeshPrabhu
01 March 2017 20:24
RT @WeDistrictNurse: #wedns https://t.co/kMtiIEI4RZ
@nurseneets
01 March 2017 20:24
@WeDistrictNurse #wedns definitely a need for more trained staff and nurses to complete competences to meet the complex need of the patient
@loulaw06
01 March 2017 20:24
Gp attached means better working relationships with GPs but geographical means better control over stopping staff overlapping areas #weDNs
@traceyhardy789
01 March 2017 20:24
RT @WeDistrictNurse: #wedns https://t.co/cKHvXDVnnI
@RivkahMiar
01 March 2017 20:24
@jkeyes22 @WeDistrictNurse 5.5hrs clinical face to face time/day? #wedns
@mdrumm88
01 March 2017 20:24
#wedns GP attached gives continuity, workload tool says Glasgow North East spend too long on travel. Typical day 20-30 miles, more at wkends
@WeCommNurses
01 March 2017 20:24
#wedns https://t.co/QTFungGOmv
@kazamca80
01 March 2017 20:24
@laineym24 Exactly. I say bring back GP alignment. better for staff and patients. #WeDNs
@carla00
01 March 2017 20:24
@WeDistrictNurse @davidpugh25 @NuffieldTrust #WeDNs i need to read then ????
@carolinegame
01 March 2017 20:25
@AdamBowen1990 @WeDistrictNurse we do but to a geographical area as the GP areas seemed to be massive and mileage was a big problem #WeDNs
@WeCommNurses
01 March 2017 20:25
#wedns is this working.? https://t.co/xayjJKkmSz
@GTomalin
01 March 2017 20:25
@davidpugh25 @WeDistrictNurse Rural areas benefit of GP attached time management an issue #WeDNs
@laineym24
01 March 2017 20:25
@WeDistrictNurse @NuffieldTrust I dont think we encourage self management enough in the commmunity due to patient expectations #wedns
@WeCommNurses
01 March 2017 20:25
RT @MrsMurphoid: @WeDistrictNurse without complexity ect how many visits are staff undertaking in your area? #wedns
@WeCommNurses
01 March 2017 20:25
#wedns https://t.co/ixPLC3rney
@WeCommNurses
01 March 2017 20:25
RT @AdamBowen1990: @WeDistrictNurse we are attached to GP surgeries, I think this works well as built good relationships with my GP's #wedns
@WeCommNurses
01 March 2017 20:25
RT @Neeeeeetss: @WeDistrictNurse #wedns definitely a need for more trained staff and nurses to complete competences to meet the complex nee…
@WeCommNurses
01 March 2017 20:25
RT @kazamca80: @laineym24 Exactly. I say bring back GP alignment. better for staff and patients. #WeDNs
@RivkahMiar
01 March 2017 20:26
RT @kazamca80: @laineym24 Exactly. I say bring back GP alignment. better for staff and patients. #WeDNs
@erinfAPDN
01 March 2017 20:26
@mjosiris @jkeyes22 oh must read this . Is it an article on workload tools? #WeDNs
@carla00
01 March 2017 20:26
@leeandra60 @WeDistrictNurse #WeDNs we are looking at the apprentice role
@kazamca80
01 March 2017 20:26
@loulaw06 but has it?? both of us where in ek and some nurses from hunter were in same Street at sane time. wee debate lol #WeDNs
@loulaw06
01 March 2017 20:26
@RivkahMiar @WeDistrictNurse sorry what is RIO?We have these time diaries on computer system (MiDis) but the system itself is slow #weDNs
@WeCommNurses
01 March 2017 20:26
#wedns how can we do this better. https://t.co/47RgjN0tfy
@AdamBowen1990
01 March 2017 20:26
@carolinegame @WeDistrictNurse yeah deffinetly! I regularly pass colleagues in my car, and sometimes even same street! #WeDNs
@JillYGld
01 March 2017 20:26
RT @Neeeeeetss: @WeDistrictNurse #wedns definitely a need for more trained staff and nurses to complete competences to meet the complex nee…
@carolinegame
01 March 2017 20:26
@WeDistrictNurse @kazamca80 works really well - and then each DN team picks up any out of area GP patients that fall in their area #WeDNs
@WeCommNurses
01 March 2017 20:27
Some reference to rio , what other systems are being used #WeDNs
@j_blease
01 March 2017 20:27
@WeDistrictNurse in my experience you can't please everyone but the service we deliver 24hr 7day Primary care should be no different #WeDNs
@laineym24
01 March 2017 20:27
@kazamca80 @WeDistrictNurse it was better for safe and effective care now staff dont know on a daily basis what area they will be in #wedns
@traceyhardy789
01 March 2017 20:27
@kazamca80 @laineym24 Having a good working relationship with GPs works better for pts #weDNs
@RivkahMiar
01 March 2017 20:27
@kazamca80 @laineym24 Went 2 meeting about future of primary care yest & they were saying the same & how they miss the rx w the DN's #wedns
@mdrumm88
01 March 2017 20:27
@laineym24 @WeDistrictNurse it must be a priority to meet growing demands bt it takes time that unfortunately too often we don't have #wedns
@HeatherBain9
01 March 2017 20:27
RT @WeDistrictNurse: #wedns will this suit all? And be compulsory https://t.co/DOV0uodpAE
@loulaw06
01 March 2017 20:27
@kazamca80 it might have happened at times due to error but not as often as it did when GP attached ??#weDNs
@WeCommNurses
01 March 2017 20:28
#WeDNs who works with this that can advise https://t.co/k1zqhB4lUp
@DrUmeshPrabhu
01 March 2017 20:28
RT @WeDistrictNurse: #wedns how can we do this better. https://t.co/47RgjN0tfy
@traceyhardy789
01 March 2017 20:28
RT @WeDistrictNurse: #wedns how can we do this better. https://t.co/47RgjN0tfy
@RivkahMiar
01 March 2017 20:28
@loulaw06 @WeDistrictNurse Sorry our clinical system with our diaries #wedns
@WeCommNurses
01 March 2017 20:29
#wedns https://t.co/5hSZQjK5TA
@kazamca80
01 March 2017 20:29
@traceyhardy789 @laineym24 I totally agree but I do not know a lot of the GPs now. Gp are frustrated too with the amount of nurses #WeDNs
@nurseneets
01 March 2017 20:29
@WeDistrictNurse #wedns I have just worked in a very diverse area in Birmingham. We have constantly worked with GP's to deliver quality care
@WeCommNurses
01 March 2017 20:29
#wedns https://t.co/CQkWhucVNk
@WeCommNurses
01 March 2017 20:29
RT @Neeeeeetss: @WeDistrictNurse #wedns I have just worked in a very diverse area in Birmingham. We have constantly worked with GP's to del…
@j_blease
01 March 2017 20:29
#WeDNs https://t.co/4r1dZWaAj2
@erinfAPDN
01 March 2017 20:30
Could a solution to the geography issues be resolved by making it mandatory for patients to move GP when they move home? #WeDNs
@RivkahMiar
01 March 2017 20:30
@jkeyes22 @WeDistrictNurse Why such a big differential? #wedns
@loulaw06
01 March 2017 20:30
@RivkahMiar @WeDistrictNurse sounds similar but our system itself is challenging and adds to the pressure and workload #WeDNs
@carolinegame
01 March 2017 20:30
@WeDistrictNurse @jkeyes22 we used to say 15 minutes was 1 unit ? What's your guidance #WeDNs
@WeCommNurses
01 March 2017 20:30
#wedns https://twitter.com/j_blease/status/837037070166159368
@laineym24
01 March 2017 20:30
@kazamca80 @loulaw06 this seems to happen alot you could be going into one house and a staff member is going in across the street #WeDNs
@mjosiris
01 March 2017 20:31
@erinforsy @jkeyes22 yip phase 1 of a trial published. The tool is very comprehensive on our practice,early days but ++potential#wedns
@loulaw06
01 March 2017 20:31
RT @kazamca80: @laineym24 Exactly. I say bring back GP alignment. better for staff and patients. #WeDNs
@matthew_sunter
01 March 2017 20:31
#wedns in my experience working practice attached encourages relationships between DNs, GPs and social work - important for H&SC integration
@HeatherBain9
01 March 2017 20:31
#wedns I think long term GPS as we know them will be a thing of past and we will work in small neighbourhoods https://twitter.com/kazamca80/status/837037053737070599
@RivkahMiar
01 March 2017 20:31
RT @loulaw06: @RivkahMiar @WeDistrictNurse sounds similar but our system itself is challenging and adds to the pressure and workload #WeDNs
@AdamBowen1990
01 March 2017 20:31
@WeDistrictNurse we use 1 unit=10 minutes, but sometimes this is abused, with visits being overlapped, etc #WeDNs
@carla00
01 March 2017 20:31
@WeDistrictNurse #wedns we use SystmOne and currently are reconfiguring our DN templates https://t.co/yQ9YKckj5G
@RivkahMiar
01 March 2017 20:31
RT @matthew_sunter: #wedns in my experience working practice attached encourages relationships between DNs, GPs and social work - important…
@jkeyes22
01 March 2017 20:32
We have a fab performance team and are starting a capacity and demand project tomorrow #weDNs
@WeCommNurses
01 March 2017 20:32
#wedns what do others think? https://twitter.com/erinforsy/status/837037264400175105
@WeCommNurses
01 March 2017 20:32
#wedns https://twitter.com/jkeyes22/status/837037524145033221
@nurseneets
01 March 2017 20:32
@WeDistrictNurse #wedns district nurses are the frontline service that prevent admissions. More staff are needed to deliver this safely!
@traceyhardy789
01 March 2017 20:32
@WeDistrictNurse Giving time which unfortunately we have precious little of #weDNs
@WeCommNurses
01 March 2017 20:32
RT @carolinegame: @WeDistrictNurse @jkeyes22 we used to say 15 minutes was 1 unit ? What's your guidance #WeDNs
@laineym24
01 March 2017 20:32
@GTomalin @davidpugh25 @WeDistrictNurse our rural area doesnt benefit as gps arent geographical so travelling is an issue #weDns
@LynneBowers2
01 March 2017 20:32
RT @matthew_sunter: #wedns in my experience working practice attached encourages relationships between DNs, GPs and social work - important…
@HeatherBain9
01 March 2017 20:32
RT @matthew_sunter: #wedns in my experience working practice attached encourages relationships between DNs, GPs and social work - important…
@loulaw06
01 March 2017 20:32
@kazamca80 @laineym24 totally http://agree.How can we engage in shared decision making when there is no professional rapport? #WeDNs
@AdamBowen1990
01 March 2017 20:32
@laineym24 @WeDistrictNurse in my team we have 2 surgeries but both v small, can understand what you mean, that would be a challenge #wedns
@carolinegame
01 March 2017 20:32
@laineym24 @kazamca80 @loulaw06 we have reduced this by combining GP attachment in a geographical area but maybe GP comm is less #WeDNs
@kazamca80
01 March 2017 20:33
@RivkahMiar @laineym24 even phoning GPs for advise has became difficult as they do not know who u are. it's about building trust #WeDNs
@erinfAPDN
01 March 2017 20:33
The future indicates there will be more nursing power than GP's, therefore it makes sense to be aligned to your DN instead #WeDNs
@GTomalin
01 March 2017 20:33
@j_blease I agree and the Multidisciplinary team #WeDNS
@WeCommNurses
01 March 2017 20:33
#wedns leads to next question , how do your systems and processes support integration https://t.co/F0TlZbsnbw
@j_blease
01 March 2017 20:33
@WeDistrictNurse I believe gp areas should have tight geographical boundaries. #WeDNs
@WeCommNurses
01 March 2017 20:33
@WeDistrictNurse Emis #WeDNs
@laineym24
01 March 2017 20:33
@carolinegame @AdamBowen1990 @WeDistrictNurse travelling time to gp suergerys can be atleast 45 mins,which affects patient care #WeDNs
@carolinegame
01 March 2017 20:34
@jkeyes22 @WeDistrictNurse and even though where I am now don't weight activities -I do subconsciously when allocating #WeDNs
@JillYGld
01 March 2017 20:34
RT @matthew_sunter: #wedns in my experience working practice attached encourages relationships between DNs, GPs and social work - important…
@MrsMurphoid
01 March 2017 20:34
@jkeyes22 @WeDistrictNurse units or patients? #WeDNs
@AdamBowen1990
01 March 2017 20:34
@WeDistrictNurse deffinetly, geographical boundaries should be looked into regularly #WeDNs
@WeCommNurses
01 March 2017 20:34
#wedns what do others think? https://twitter.com/heatherbain9/status/837037591056822272
@erinfAPDN
01 March 2017 20:34
@jkeyes22 This sounds interesting, a capacity project. Id be interested to hear more about what this entails #WeDNs
@WeCommNurses
01 March 2017 20:34
@WeDistrictNurse Emis which is the same system as the GP practices which is great for sharing information #WeDNs
@WeCommNurses
01 March 2017 20:34
RT @carla00: @WeDistrictNurse #wedns we use SystmOne and currently are reconfiguring our DN templates https://t.co/yQ9YKckj5G
@WeCommNurses
01 March 2017 20:34
RT @Neeeeeetss: @WeDistrictNurse #wedns district nurses are the frontline service that prevent admissions. More staff are needed to deliver…
@JillYGld
01 March 2017 20:34
RT @Neeeeeetss: @WeDistrictNurse #wedns district nurses are the frontline service that prevent admissions. More staff are needed to deliver…
@kazamca80
01 March 2017 20:35
#weDNs we are fully integrated. works well within the same team
@HeatherBain9
01 March 2017 20:35
RT @Neeeeeetss: @WeDistrictNurse #wedns district nurses are the frontline service that prevent admissions. More staff are needed to deliver…
@AdamBowen1990
01 March 2017 20:35
@laineym24 @carolinegame @WeDistrictNurse wow that's a massive travel time! Is that because it's rural? #WeDNs
@RivkahMiar
01 March 2017 20:35
@kazamca80 @laineym24 Yes! This is fundamental. I want to work closely w' my GP colleagues keeps patients & staff safe #wedns
@HeatherBain9
01 March 2017 20:35
#wedns and could DNs with advanced skills not do more of this ? https://t.co/jrV30iz3Xf
@j_blease
01 March 2017 20:36
@WeDistrictNurse integration is positive step however can not fully integrate when staffing is so short #WeDNs
@carolinegame
01 March 2017 20:36
@JillYGld @WeDistrictNurse @jkeyes22 interesting now agile & use laptops in the home, care units the same but what about the I.T. #WeDNs
@jkeyes22
01 March 2017 20:36
We have integrated our DN teams, ICT, community matrons and sicial workers in same base, some fantastic results #weDNs
@JiveBirmingham
01 March 2017 20:36
RT @Neeeeeetss: @WeDistrictNurse #wedns I have just worked in a very diverse area in Birmingham. We have constantly worked with GP's to del…
@WeCommNurses
01 March 2017 20:36
RT @j_blease: @WeDistrictNurse I believe gp areas should have tight geographical boundaries. #WeDNs
@WeCommNurses
01 March 2017 20:36
RT @AdamBowen1990: @WeDistrictNurse deffinetly, geographical boundaries should be looked into regularly #WeDNs
@WeCommNurses
01 March 2017 20:36
RT @erinforsy: @jkeyes22 This sounds interesting, a capacity project. Id be interested to hear more about what this entails #WeDNs
@MrsMurphoid
01 March 2017 20:36
@jkeyes22 @WeDistrictNurse sorry new to this,12-25 for us it's does capture the complexity though often feel task orientated #WeDNs
@kazamca80
01 March 2017 20:36
@laineym24 @carolinegame @AdamBowen1990 @WeDistrictNurse yeah and if you need 3 prescription charts from 3 surgeries it adds up #WeDNs
@traceyhardy789
01 March 2017 20:36
@kazamca80 Can I ask what professions are integrated in you team? #weDNs
@WeCommNurses
01 March 2017 20:37
#wedns https://twitter.com/Helenakelly73/status/837038960249556992
@AdamBowen1990
01 March 2017 20:37
@kazamca80 @laineym24 @carolinegame @WeDistrictNurse prescription charts? As in like MAR sheets? #WeDNs
@WeCommNurses
01 March 2017 20:37
#wedns sounds a great model, has it been evaluated https://twitter.com/jkeyes22/status/837038756762955776
@loulaw06
01 March 2017 20:37
@kazamca80 although we have integrated teams I still feel there is a big gap with social work. No integration there #WeDNs
@matthew_sunter
01 March 2017 20:37
@WeDistrictNurse Virtual Community Ward has enhanced close working of health and SW in my area daily contact & hosp. admis avoided #wedns
@j_blease
01 March 2017 20:38
@HeatherBain9 definitely role for advanced DN. Though education and adequate signposting needed to make aware of skills #WeDNs
@RivkahMiar
01 March 2017 20:38
@WeDistrictNurse Devp of the SuperPartnership/Federation model of GP. Yet still sense of local community 45k pop key @HeatherBain9 #wedns
@WeCommNurses
01 March 2017 20:38
RT @traceyhardy789: @kazamca80 Can I ask what professions are integrated in you team? #weDNs
@carolinegame
01 March 2017 20:38
@jkeyes22 we have now for a year - great team input and professional guidance from all disciplines to enhance pt experience @NELFT #WeDNs
@laineym24
01 March 2017 20:38
@RivkahMiar @kazamca80 yes its hard to build a relationship with gp when rescources make that hard and travelling time is an issue. #weDns
@nurseneets
01 March 2017 20:38
@WeDistrictNurse #wedns we're using the RIO system to share information. Rio works consistently well within the trust, and it's accessible!
@kazamca80
01 March 2017 20:38
@HeatherBain9 yes 100% that's why I'm on the apdn course. it will be more beneficial for patient care #WeDNs
@traceyhardy789
01 March 2017 20:38
#weDNs We are now up and running with mobile working def starting to feel more efficient
@MrsMurphoid
01 March 2017 20:38
@WeDistrictNurse patient choice I wonder if ICO's will shift the balance, it would reduce confusion for all #weDNs
@WeCommNurses
01 March 2017 20:38
We were waiting for the Buurtzorg model to be brought up ??#wedns https://t.co/zsiOvfKcsr
@laineym24
01 March 2017 20:39
@kazamca80 @RivkahMiar i think if we had more contact with gps on a regular basis this would improve patient care #weDns
@AdamBowen1990
01 March 2017 20:39
@matthew_sunter @WeDistrictNurse they closed our virtual ward a couple of years ago! Huge mistake.... #WeDNs
@WeCommNurses
01 March 2017 20:39
So what principles of Buurtzorg fit with the DN role? Is anyone involved in the pilots #WeDNs
@matthew_sunter
01 March 2017 20:39
@HeatherBain9 There is definitely scope to expand roles of DNs with advanced skills taking pressure off GPs #wedns
@davidpugh25
01 March 2017 20:39
@WeDistrictNurse Our IT system is the same system as the GPs and we have sharing agreements in place which supports care delivery #WeDNs
@carolinegame
01 March 2017 20:39
@Neeeeeetss @WeDistrictNurse we have RIO too but doesn't link to our GP's or acute sector - shame as so much more could be achieved #WeDNs
@laineym24
01 March 2017 20:39
@AdamBowen1990 @WeDistrictNurse the area i am at just now covers over ten surgerys some can be atleast 20 mile apart. #weDns
@RivkahMiar
01 March 2017 20:39
@jkeyes22 @WeDistrictNurse What's your ratio of bands in your team & daily visit no? #wedns
@j_blease
01 March 2017 20:40
@WeDistrictNurse our locality are exploring Buurtzorg. I am excited and see the potential in this #weDNs
@matthew_sunter
01 March 2017 20:40
RT @j_blease: @HeatherBain9 definitely role for advanced DN. Though education and adequate signposting needed to make aware of skills #WeDNs
@LynneBowers2
01 March 2017 20:40
RT @MrsMurphoid: @WeDistrictNurse patient choice I wonder if ICO's will shift the balance, it would reduce confusion for all #weDNs
@RivkahMiar
01 March 2017 20:40
RT @matthew_sunter: @HeatherBain9 There is definitely scope to expand roles of DNs with advanced skills taking pressure off GPs #wedns
@RivkahMiar
01 March 2017 20:41
RT @laineym24: @kazamca80 @RivkahMiar i think if we had more contact with gps on a regular basis this would improve patient care #weDns
@AdamBowen1990
01 March 2017 20:41
@laineym24 @WeDistrictNurse wow! Our 2 surgeries are about 500 metres apart, so area quite small, but we work in sub teams #WeDNs
@erinfAPDN
01 March 2017 20:41
@jkeyes22 need to lookinto this more #WeDNs
@WeCommNurses
01 March 2017 20:41
RT @kazamca80: @HeatherBain9 yes 100% that's why I'm on the apdn course. it will be more beneficial for patient care #WeDNs
@carolinegame
01 March 2017 20:41
@loulaw06 @kazamca80 maybe it will come - we have sw in our office and we have to still refer formally, but they give lots of advice #WeDNs
@WeCommNurses
01 March 2017 20:41
RT @Neeeeeetss: @WeDistrictNurse #wedns we're using the RIO system to share information. Rio works consistently well within the trust, and…
@traceyhardy789
01 March 2017 20:41
RT @matthew_sunter: #wedns in my experience working practice attached encourages relationships between DNs, GPs and social work - important…
@Helenakelly73
01 March 2017 20:41
@jkeyes22 @WeDistrictNurse #wedns yes 12 covering a neighbourhood of around 5000. Some areas of Scotland are piloting anyone in pilot?
@LynneBowers2
01 March 2017 20:42
#WeDNs Tweets from AQuA #Buurtzorg conference today https://t.co/BnEs6Q1lTq
@WeCommNurses
01 March 2017 20:42
#WeDNs did you note the evidence for virtual wards is unclear in today's publication by Nuffield https://twitter.com/matthew_sunter/status/837039202583908352
@WeCommNurses
01 March 2017 20:42
#wedns https://twitter.com/Neeeeeetss/status/837039926042587140
@kazamca80
01 March 2017 20:42
#wedns reforming the whole district nursing service sounds great. is it feasible
@WeCommNurses
01 March 2017 20:42
RT @Helenakelly73: @jkeyes22 @WeDistrictNurse #wedns yes 12 covering a neighbourhood of around 5000. Some areas of Scotland are piloting an…
@erinfAPDN
01 March 2017 20:42
@carolinegame @Neeeeeetss @WeDistrictNurse We have a similar situation with CNIS, so much potential to connect to the wider MDT. #WeDNs
@KWebbNurse
01 March 2017 20:42
@j_blease @WeDistrictNurse #WeDNs what about patient choice? They may choose someone else as their GP
@loulaw06
01 March 2017 20:42
@davidpugh25 @WeDistrictNurse this is where I feel my area fails. No communication with systems which is very challenging. #WeDNs
@laineym24
01 March 2017 20:42
@loulaw06 @kazamca80shared if resoures improve there would be more clinical supervision between staff to improve this #weDns
@carolinegame
01 March 2017 20:42
@davidpugh25 @WeDistrictNurse that's a real smart way to work #WeDNs
@AdamBowen1990
01 March 2017 20:42
@carolinegame @loulaw06 @kazamca80 our SW's are based in a city 15 miles away, and v difficult to get hold of! #WeDNs
@davidpugh25
01 March 2017 20:42
RT @WeDistrictNurse: #wedns sounds a great model, has it been evaluated https://twitter.com/jkeyes22/status/837038756762955776
@WeCommNurses
01 March 2017 20:43
Or is anyone in any other pilots #WeDNs
@leeandra60
01 March 2017 20:43
@traceyhardy789 @WeDistrictNurse @kazamca80 we have nurses, therapists social worker mental health nurse specialist nurse matron #wedns
@traceyhardy789
01 March 2017 20:43
RT @kazamca80: #wedns reforming the whole district nursing service sounds great. is it feasible
@traceyhardy789
01 March 2017 20:43
RT @WeDistrictNurse: #WeDNs did you note the evidence for virtual wards is unclear in today's publication by Nuffield https://t.co/Wzgn3Zhd…
@matthew_sunter
01 March 2017 20:43
@j_blease @WeDistrictNurse How do DN advanced skills fit into the buurtzorg model? #wedns
@carolinegame
01 March 2017 20:43
@AdamBowen1990 @loulaw06 @kazamca80 we have had to work on professional boundaries and barriers but have to say it has been worth it #WeDNs
@laineym24
01 March 2017 20:43
@AdamBowen1990 @WeDistrictNurse yeah alot of time spent travelling and you could be at same gp surgery if emergency in one day #wedns
@davidpugh25
01 March 2017 20:44
RT @carolinegame: @davidpugh25 @WeDistrictNurse that's a real smart way to work #WeDNs
@nurseneets
01 March 2017 20:44
@WeDistrictNurse #wedns the buurtzorg system should be integrated within England and the UK. What a great approach to district nursing
@AdamBowen1990
01 March 2017 20:44
@erinforsy both surgeries in town centre in Rugby, Warwickshire ?? #WeDNs
@albiongirl68
01 March 2017 20:44
@WeDistrictNurse woops #WeDNs
@WeCommNurses
01 March 2017 20:45
#WeDNs what do others think? Is Buurtzorg a district nurse module or a social model ? https://twitter.com/matthew_sunter/status/837040553523048448
@j_blease
01 March 2017 20:45
@KWebbNurse @WeDistrictNurse most GP have several working under 1 roof choice is there. #WeDNs
@AdamBowen1990
01 March 2017 20:45
@carolinegame @loulaw06 @kazamca80 would be such an advantage!And more pt centred too, instead of a wide gap between health + social #WeDNs
@leeandra60
01 March 2017 20:45
@WeDistrictNurse found that our virtual ward is very rarely busy. DN patients more complex #wedns
@traceyhardy789
01 March 2017 20:45
RT @WeDistrictNurse: #WeDNs what do others think? Is Buurtzorg a district nurse module or a social model ? https://twitter.com/matthew_sunter/status/837040553523048448
@kazamca80
01 March 2017 20:45
#wedns I'm all for the buurtzog model. how would it work within NHS. the Netherlands have a different health care system.
@loulaw06
01 March 2017 20:46
@AdamBowen1990 @carolinegame @kazamca80 totally agree. Lots of barriers from SW and it's very frustrating for us and patients #WeDNs
@matthew_sunter
01 March 2017 20:46
@WeDistrictNurse ? need for more research into how they are developed and implemented - could DNs with advanced skills take a role? #WeDNs
@LynneBowers2
01 March 2017 20:46
RT @WeDistrictNurse: #WeDNs what do others think? Is Buurtzorg a district nurse module or a social model ? https://twitter.com/matthew_sunter/status/837040553523048448
@WeCommNurses
01 March 2017 20:46
RT @kazamca80: #wedns I'm all for the buurtzog model. how would it work within NHS. the Netherlands have a different health care system.
@loulaw06
01 March 2017 20:46
RT @Neeeeeetss: @WeDistrictNurse #wedns district nurses are the frontline service that prevent admissions. More staff are needed to deliver…
@WeCommNurses
01 March 2017 20:46
RT @leeandra60: @WeDistrictNurse found that our virtual ward is very rarely busy. DN patients more complex #wedns
@laineym24
01 March 2017 20:46
@AdamBowen1990 @kazamca80 @carolinegame #wednsprescriptions yes to get signed it is an afternoon travelling and less patient contact #wedns
@j_blease
01 March 2017 20:47
@KWebbNurse @WeDistrictNurse continuity of care short response times require patients to be geographically close #WeDNs
@erinfAPDN
01 March 2017 20:47
@WeDistrictNurse Well lets adapt the Buurtzrorg model to incorporate advanced skills. Ive nvr heard of it i'll need to have a nosey #WeDNs
@kazamca80
01 March 2017 20:47
@laineym24 @loulaw06 yes and therefore would lead to better patient outcomes and satisfaction. #WeDNs
@j_blease
01 March 2017 20:47
@WeDistrictNurse surely it's both #WeDNs
@RivkahMiar
01 March 2017 20:47
@jkeyes22 @WeDistrictNurse How does the SN:HCA ratio work? #wedns
@carolinegame
01 March 2017 20:48
@AdamBowen1990 @loulaw06 @kazamca80 we still have gaps but that's more the strategic element - operationally defo better @NELFT #WeDns
@Helenakelly73
01 March 2017 20:48
#WeDNs the nurse uses advanced communication, assessment, decision making to build a community of support around the pt to self mg
@leeandra60
01 March 2017 20:48
@WeDistrictNurse find integrated care team works well for DN patients. Have improved outcomes #wedns
@HeatherBain9
01 March 2017 20:48
#wedns I bet you can guess my answer??focus on principles of buurtzorg that would benefit the U.K. System but it's n… https://t.co/FWrReMHj0o
@davidpugh25
01 March 2017 20:48
@leeandra60 @WeDistrictNurse that's interesting do you know the reasons why the virtual ward is rarely busy #wedns
@WeCommNurses
01 March 2017 20:49
#wedns this is what some are suggesting...think differently https://twitter.com/erinforsy/status/837041593861435395
@JillYGld
01 March 2017 20:49
RT @leeandra60: @WeDistrictNurse find integrated care team works well for DN patients. Have improved outcomes #wedns
@WeCommNurses
01 March 2017 20:49
RT @RivkahMiar: @jkeyes22 @WeDistrictNurse How does the SN:HCA ratio work? #wedns
@AdamBowen1990
01 March 2017 20:49
@laineym24 @kazamca80 @carolinegame we use MAR's, and transcribe from either a fax or discharge summary- so no signature needed! #WeDNs
@LynneBowers2
01 March 2017 20:49
#WeDNs crazy waste of time. Role for prescribing DNs or e.g prescribing pharmacists or PGDs? https://t.co/nj1Q9T4Zys
@HeatherBain9
01 March 2017 20:49
RT @Helenakelly73: #WeDNs the nurse uses advanced communication, assessment, decision making to build a community of support around the pt…
@RivkahMiar
01 March 2017 20:49
@JillYGld Has addressed the fragmentation & task orientated approach by offering holistic care #wedns
@traceyhardy789
01 March 2017 20:49
#weDNs More and more complex, palliative and EOL pts not just dressings, insulins not sure if com nursing is really understood by other HCP
@WeCommNurses
01 March 2017 20:50
RT @Helenakelly73: #WeDNs the nurse uses advanced communication, assessment, decision making to build a community of support around the pt…
@WeCommNurses
01 March 2017 20:50
RT @davidpugh25: @leeandra60 @WeDistrictNurse that's interesting do you know the reasons why the virtual ward is rarely busy #wedns
@flood3_lorraine
01 March 2017 20:50
I think the buurtzorg model would help bridge encourage more joint working and improve patient outcomes #wedns
@AdamBowen1990
01 March 2017 20:50
RT @laineym24: @kazamca80 @RivkahMiar i think if we had more contact with gps on a regular basis this would improve patient care #weDns
@traceyhardy789
01 March 2017 20:50
RT @leeandra60: @WeDistrictNurse find integrated care team works well for DN patients. Have improved outcomes #wedns
@traceyhardy789
01 March 2017 20:50
RT @Helenakelly73: #WeDNs the nurse uses advanced communication, assessment, decision making to build a community of support around the pt…
@mdrumm88
01 March 2017 20:50
@WeDistrictNurse why cant diff bands work differently? Band 3 & 5 geographic to meet high demand band 6 to give continuity to complex #wedns
@j_blease
01 March 2017 20:50
@HeatherBain9 buurtzorg model allows adv DN to assess efficiently & become a proactive not reactive service #WeDNs
@WeCommNurses
01 March 2017 20:50
#WeDNs can you tell us what MARs is https://twitter.com/adambowen1990/status/837042118791151617
@leeandra60
01 March 2017 20:50
@davidpugh25 @WeDistrictNurse not sure they are identifying right patients. Also have a new rapid response team now across locality #wedns
@HeatherBain9
01 March 2017 20:50
#wedns we agree for once ?? https://t.co/0UWkbZfajg
@RivkahMiar
01 March 2017 20:51
RT @LynneBowers2: #WeDNs crazy waste of time. Role for prescribing DNs or e.g prescribing pharmacists or PGDs? https://t.co/nj1Q9T4Zys
@WeCommNurses
01 March 2017 20:51
#WeDNs how can we make ourselves understood? https://t.co/KvFFJLQdVT
@j_blease
01 March 2017 20:51
@HeatherBain9 using adv skills to ensure proper assessment reducing patients in crisis. Using ACP tool etc #WeDNs
@erinfAPDN
01 March 2017 20:51
@traceyhardy789 I agree, how can we make other HCP more aware about what DN's do? #WeDNs
@WeCommNurses
01 March 2017 20:51
Some great sharing tonight and some sidetracking but all good #WeDNs
@laineym24
01 March 2017 20:52
@leeandra60 @WeDistrictNurse some areas in lanarkshire not integrated and this would be better to integrate to improve patient care #weDns
@traceyhardy789
01 March 2017 20:52
RT @WeDistrictNurse: #WeDNs how can we make ourselves understood? https://twitter.com/traceyhardy789/status/837042250915975169
@jkeyes22
01 March 2017 20:52
RT @j_blease: @HeatherBain9 buurtzorg model allows adv DN to assess efficiently & become a proactive not reactive service #WeDNs
@matthew_sunter
01 March 2017 20:52
@HeatherBain9 Seems it would be better suited to a social care model rather than nursing - core principles of Buurtzorg are positive #WeDNs
@LynneBowers2
01 March 2017 20:52
#WeDNs And Band 7 & 8 https://t.co/sWaJSUBrRL
@AdamBowen1990
01 March 2017 20:52
@WeDistrictNurse Medication Administration Record #WeDNs
@kazamca80
01 March 2017 20:52
@WeDistrictNurse leadership and education ?? #WeDNs
@carolinegame
01 March 2017 20:53
@erinforsy @traceyhardy789 sharing and promoting our SOP's and awareness on GP commissioning #WeDNs
@jkeyes22
01 March 2017 20:53
@j_blease @HeatherBain9 #wedns not sure we need buurtzog fir that
@RivkahMiar
01 March 2017 20:53
@melliott88 @WeDistrictNurse I wouldn't want to just do 'high demand', complexity/holistic care is why I chose community practice #wedns
@WeCommNurses
01 March 2017 20:53
RT @j_blease: @HeatherBain9 using adv skills to ensure proper assessment reducing patients in crisis. Using ACP tool etc #WeDNs
@Helenakelly73
01 March 2017 20:53
Absolutely and more advancing practice within district nursing is key to developing and working in new ways #wedns https://twitter.com/jkeyes22/status/837042323624194054
@WeCommNurses
01 March 2017 20:53
#wedns great point https://t.co/81DHFVMTi0
@WeCommNurses
01 March 2017 20:54
So does your current delivery model support continuity of care #WeDNs
@davidpugh25
01 March 2017 20:54
@WeDistrictNurse Being understood is key to the future of the DN and the unique role that DNs play #WeDNs
@laineym24
01 March 2017 20:54
@j_blease @WeDistrictNurse if gps had better geog boundaries there would not be as much a strain on dns as this impacts service #weDns
@WeCommNurses
01 March 2017 20:54
#WeDNs do others share this view https://t.co/1ujRwvSepL
@loulaw06
01 March 2017 20:54
RT @davidpugh25: @WeDistrictNurse Being understood is key to the future of the DN and the unique role that DNs play #WeDNs
@HeatherBain9
01 March 2017 20:55
#WeDNs so is the DN inside the model or going across buurtzorg teams https://t.co/bPuHREoZGz
@davidpugh25
01 March 2017 20:55
@WeDistrictNurse Solution is evidencing the unique role with support of organisations like @TheQNI and @TheKingsFund #WeDNs
@HeatherBain9
01 March 2017 20:55
RT @j_blease: @HeatherBain9 using adv skills to ensure proper assessment reducing patients in crisis. Using ACP tool etc #WeDNs
@mdrumm88
01 March 2017 20:55
@RivkahMiar need to find a way to meet growing demand of service & increased complexity. Bands have different role & responsibilities #wedns
@HeatherBain9
01 March 2017 20:55
RT @Helenakelly73: Absolutely and more advancing practice within district nursing is key to developing and working in new ways #wedns http…
@hamble1967
01 March 2017 20:56
RT @Neeeeeetss: @WeDistrictNurse #wedns district nurses are the frontline service that prevent admissions. More staff are needed to deliver…
@WeCommNurses
01 March 2017 20:56
Not long left, what one improvement would you advise in your service #WeDNs
@s9tmt
01 March 2017 20:56
RT @WeDistrictNurse: #wedns how can we do this better. https://t.co/47RgjN0tfy
@MrsMurphoid
01 March 2017 20:56
@jkeyes22 @WeDistrictNurse sounds great, does it enable equitable service provision? #WeDNs
@traceyhardy789
01 March 2017 20:57
@WeDistrictNurse Initiating MDTs, attending GSF meetings, and using these chats to get ourselves heard #weDNs
@kazamca80
01 March 2017 20:57
@WeDistrictNurse yes I agree however I feel it's important to allow band 5 to progress and also be able to carry out complex visits #WeDNs
@laineym24
01 March 2017 20:57
@Helenakelly73 over the next few years with changes in advancing practice we will see better patient outcomes and improved care #weDns
@HeatherBain9
01 March 2017 20:57
@davidpugh25 @WeDistrictNurse @TheQNI @TheKingsFund don't forget Scottish organisations @QNI_Scotland #wedns
@JillYGld
01 March 2017 20:57
RT @WeDistrictNurse: Not long left, what one improvement would you advise in your service #WeDNs
@CherylCassidy80
01 March 2017 20:57
RT @Neeeeeetss: @WeDistrictNurse #wedns district nurses are the frontline service that prevent admissions. More staff are needed to deliver…
@RivkahMiar
01 March 2017 20:58
@WeDistrictNurse Write about what happens through blogs etc use @TheQNI @nursingtimesed @hsj to promote roles #wedns
@traceyhardy789
01 March 2017 20:58
RT @WeDistrictNurse: Not long left, what one improvement would you advise in your service #WeDNs
@kazamca80
01 March 2017 20:58
@WeDistrictNurse more clinical supervision. however that requires time which is precious at the moment #WeDNs
@loulaw06
01 March 2017 20:58
@davidpugh25 @WeDistrictNurse @TheQNI @TheKingsFund & articulating it to our patients and colleagues.DNs have a habit of downplaying #WeDNs
@LynneBowers2
01 March 2017 20:58
#WeDNs Create an unassailable narrative from data/knowledge shown tonight by DN leaders.Why have Community Nurses f… https://twitter.com/i/web/status/837044390954692616
@laineym24
01 March 2017 20:58
@davidpugh25 @WeDistrictNurse Our IT system is different from GP and have no access to gp records. #weDns
@davidpugh25
01 March 2017 20:58
@WeDistrictNurse The need for appropriate caseload management and ongoing review #WeDNs
@traceyhardy789
01 March 2017 20:59
@WeDistrictNurse support each other #weDNs
@carolinegame
01 March 2017 20:59
@WeDistrictNurse improved communication with the acute sector and invites to attend more MDT's to support complex discharges #WeDNs @NELFT
@davidpugh25
01 March 2017 20:59
@HeatherBain9 @WeDistrictNurse @TheQNI @TheKingsFund @QNI_Scotland Oops I do apologise ??#WeDNs
@CoordMyCare
01 March 2017 20:59
RT @leeandra60: @WeDistrictNurse find integrated care team works well for DN patients. Have improved outcomes #wedns
@JillYGld
01 March 2017 20:59
@WeDistrictNurse #WeDNs One thing to improve the service: joined up, easy to use IT systems (suggested by a student today)
@WeCommNurses
01 March 2017 20:59
You hanks all for great sharing see the word loud soon..#WeDNs
@traceyhardy789
01 March 2017 20:59
RT @davidpugh25: @WeDistrictNurse The need for appropriate caseload management and ongoing review #WeDNs
@loulaw06
01 March 2017 20:59
@WeDistrictNurse communication communication communication #WeDNs
@laineym24
01 March 2017 20:59
@WeDistrictNurse being a service that promotes self management and empowerment to each individual to allow them to manage their LTC #WeDNs
@carolinegame
01 March 2017 20:59
@laineym24 @davidpugh25 @WeDistrictNurse a big stumbling block some days ?? #WeDNs




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