Heartbeat March 2020

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Mouth care pilot leads to magic in every smile MEDICINE AND EMERGENCY CARE Patients across four wards at City and Sandwell hospitals have been all smiles during the pilot of a new campaign to improve the oral health of inpatients. In January colleagues working on D11 D26, Priory 4 and Newton 4 started the Mouth Care Matters trial. This involved them receiving specific training and equipment to carry out effective mouth care on patients. Colleagues have been ensuring that every patient cleans their teeth/dentures at least twice a day and those with complex mouth care needs are assisted with more frequent care. Heartbeat caught up with Julie Thompson, Director of Nursing, Medicine and Emergency Care who told us more. “Mouth Care Matters is a guide seeking to improve the oral health of inpatients. Poor oral health of a hospitalised patient can result in an increase in hospital-acquired infections, namely hospital and ventilator acquired pneumonia, as well as poorer nutrition. This can result in an increase in the length of stay and care costs, alongside poorer quality of life and dignity for patients. “This pilot focuses on reducing the rates of hospital-acquired pneumonia (HAP). Evidence shows a clear link between a Staff Nurse, Rachel Paintin with some of the oral care products good individualised mouth care regime and the reduction in the development of HAP.” Colleagues have welcomed and supported the trial. Practice Development Nurse, Grace Omoleye told Heartbeat: “It’s important for patients to feel whole and to not feel uncomfortable about their mouths when visitors come. “The products that we use keep the mouth and gums moist so prevent sores and infections. I really like the lip gloss for that reason. Some patients need to have their teeth cleaned whilst using the suctioning tool. This is so good because you use one tool that brushes, cleans and suctions the debris away at the same time.” Grace continued, “The products are single-use only and are specially packaged so they can stay by the patient’s bedside and not a risk from an infection prevention perspective. It means that they are easily to hand when you need to perform mouth care as part of the patient’s routine. Mouth care really does matter for our patients and we should all be helping them to have healthy mouths.” Since the project started, visitors have commented on the improvement of their loved ones mouth condition. One family member (a dentist) explained how his mother had a stark contrast of attitude towards mouth care while she had been in hospital on two different occasions. He said, “My mother was admitted to a different hospital a few years ago. A few days after she was admitted, I noticed that her teeth had not been cleaned and the condition of her mouth had deteriorated significantly. Despite raising these concerns with staff, I had to buy several oral products and come into the hospital twice a day to clean her teeth and mouth. “I was shocked that mouth care was not automatic and didn’t form part of a daily general hygiene routine. Mouth care is important because if my mum has poor oral care then she won’t be able to eat well and then can’t get well. “The first thing I noticed when mum was admitted to Priory 4 was the mouth care posters promoting the use of the products with an appropriate care plan. I felt confident that my mum would receive a good level of care as a result.” The results from HAP and other data will be analysed during April and recommendations and learnings will be shared with the executive team. The plan is to roll out the programme across the organisation. Six weeks into the trial rates of HAP remained lower than the mean rate and all the pilot wards have at least halved their incidence of HAP. Average length of stay has reduced from 18 to 11 days. Sarah Peyton: Over 33 years of success Sarah Peyton, Acute Medicine Nurse Practitioner will be retiring from the Trust after dedicating over three decades to the Trust and hospital care. Sarah first began her journey at our Trust in 1987. Over years she gradually built up her career to become a ward sister which was shortly followed by her promotion to an acute medicine nurse practitioner in July 2007. Sarah has played an instrumental role alongside Dr Sarb Clare, Consultant Physician in Acute Medicine in setting up a GP area which then changed to the AMAA (acute medicine ambulatory assessment) in 2014. As a result, Sarah, Sarb and the rest of the team went on be awarded the International Award from the Society of Acute Medicine for their work in AMAA. Sarah Peyton celebrates her three decade career at the Trust Reflecting on her career, she remarked, “What I’m most proud of is my day-to-day work on the medical wards and working in AMAA. The job has changed over time, but I feel I have adapted to the changes whilst still being able to offer the best quality of care to our patients.” Sarb believes Sarah has played a vital role at the Trust and in particular AMAA. She said, “Sarah has left a legacy for the organisation from developing and leading on nurse-led weekend discharges to being pivotal in developing and making ambulatory care a success. Her work has been invaluable and endless for both patients and colleagues. “She is well-known by generations of both nurses and doctors and has supported many young doctors over the years. Sarah is loved by everyone.” Upon retirement Sarah is planning to visit Africa as well as a Caribbean cruise with her family. She also hopes to visit Nepal again as she sponsors a little girl to go to school there. Thank you for your hard work at the Trust Sarah – happy retirement! 22
Poo is no longer a taboo thanks to service It’s normally a taboo subject saved for discussions with your doctor or your most trusted friend or even keeping it entirely to yourself for fear of embarrassment. Not any more - the FINCH (Faecal INcontinence and Constipation Healthcare) team are bringing the embarrassing subject of poo into the open – highlighting the issue on national airwaves. Lead Clinical Nurse Specialist, Kelly Stackhouse and her team were the focus of the Radio 4 programme Inside Health interviewed by Trust Me I’m a Doctor presenter, Dr Saleyha Ahsan. The programme is known for discussing health issues which people struggle to understand and faecal incontinence (also known as bowel function) is certainly one of those topics. The service is for patients who have functional bowel disorders, which means the organ doesn’t work properly, leading to problems such as constipation, needing to rush to the toilet, losing control of the bowel following surgery in that area. Kelly explained, “The FINCH service wants to break the taboo around poo. Receiving this national coverage is very important as it will alert people to this vital service and raise awareness that there are different treatments available. We are here to help those who are experiencing real problems. Some of them will refuse or be unable to leave the house because it has gotten so bad. Many of our patients have told us how it really has changed their lives for the better being under the care of our service.” Set up a little over 10 years ago, the team initially comprised of just Kelly and one consultant Miss Kathryn Gill. Kelly had worked as a colorectal nurse at the Trust. She explained, “Miss Gill wanted to set up a service, so we did this together, with one of the main focuses being on anterior resection syndrome. Fast forward to 2020, and the service has won a number of accolades. It comprises of three extra nursing team members and two more colorectal consultants. In 2019 it had 500 referrals, compared to just 170 in its first year. “We hold clinics every day and patients from all over the country visit us,” Kelly added. One such patient is Lara Simms. The 21-yearold student started suffering from terrible constipation two years ago and was only able to pass a stool once every three weeks. Lara’s story was featured on the Radio 4 programme. She told the presenter: “It transpired that I had ‘slow bowel’ and it had come on all of a sudden. I found myself suffering from terrible stomach pain and I was constantly in and out of the hospital in Brighton where I'm a student. Doctors were baffled as to what was wrong with me.” Eventually, she received a diagnosis but medics unfamiliar with the condition were unable to treat the problem effectively. “I was SURGICAL SERVICES on 15 to 20 laxatives a day and looked so bloated. I couldn’t go out because I knew I would need to use the toilet so much,” she said. Lara visited her family home frequently and on one occasion she was admitted to Sandwell Hospital and referred to the FINCH team. Kelly discussed Lara's condition with her colleagues at the multi-disciplinary team meeting. She was told about the antegrade continence enema (ACE) procedure – an operation designed to help with emptying the bowel. It allows the patient to self-administer enemas into the large bowel after a hole is made in the appendix. Lara became the first patient at our Trust to have this procedure, performed by Mr Raj Peravali. Lara added: “Since having this operation my life has changed drastically for the better. I am able to carry on with my studies, go out and see my friends, go shopping without having to worry about where the nearest toilet it. I have the FINCH team to thank for this.” To contact the FINCH team email swb-tr.SWBH-GM-FINCH@nhs.net. To listen to the full interview on Radio 4 go to https://www.bbc. co.uk/programmes/m000gbft Trust Me I’m a Doctor presenter Dr Saleyha Ahsan (far right) with Raj Peravali, Colorectal Consultant Surgeon, and nurses from the FINCH team Liz Clarson (second left) and Kelly Stackhouse (third left). The team were interviewed for the Radio 4 programme Inside Health which was aired on 10 March. 23
Page 1 and 2: March 2020 Sandwell and West Birmin
Page 3 and 4: Our Trust’s plan to manage the pa
Page 5 and 6: Managing your health and wellbeing
Page 7 and 8: It’s not all about hospitals: Rea
Page 9 and 10: Supporting colleagues - swabbing fo
Page 11 and 12: Celebrating our stars of the week S
Page 13 and 14: GEMS - our valuable pieces of learn
Page 15 and 16: Milestone merger becomes reality as
Page 17 and 18: Mental health act administrator joi
Page 19 and 20: Year of the Nurse and Midwife Each
Page 21: Conference shares methods to improv
Page 25 and 26: Inside the mortuary - taking care o
Page 27 and 28: Safer Sleep Week to help prevent un
Page 29 and 30: This month we say hello to Liam Ken
Page 31 and 32: Toby writes about… management by

Heartbeat March 2020

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