Aim The aim of this 18 month service review was to reflect on the number of calls/contacts to the night co-coordinator triaging service were processing, to review on the number of emergency visits, their purpose, and if there was an increased usage of the medical on call support.
Background Since 11 January 2016, the emergency St Christopher’s community team out of hours service has been supported by the inpatient nursing service. This is managed by the night co-ordinator triaging out of hours calls and if an emergency visit is required, (after 10 pm to approximately 6.30–7 am), then a Band 6 night co-ordinator or Band 5 ward-based RN and HCA from the night team will visit the patient, using a wait and return cab service. There remains the on call support from the medical team. The St Christopher’s community service supports 5 CCGs and, over night, four of the CCGs fund a community over- night district nursing service.
Methods For the first six months there was a small working group, (Medical Consultant, CNS Nurse Manager and In-patient Matron), undertook an initial review of the service, with a focus of evaluating support from the medical team. This has continued with a three-monthly review by the Matron of the in-patient service. Each telephone contact from the patient or family member was recorded and any nurse visits by the inpatient nursing team. The out of hours visit was then reviewed retrospectively and themes analysed.
Findings and Conclusions On average per month there were 156 calls made to the night service triage service and eight nursing visits.
Of the 140 visits by the inpatient nursing team:
· 92 were primarily to administer medication for pain or end of life care
· 8 were for assistance with catheterisation issues
· 40 visits were for various other issues ranging from assessment of new symptoms, fixing O2 tubing, other hygiene issues and general nursing and repositioning issues.
All visits were assessed as appropriate use of this emergency support service, with the aim of supporting community patients at home and avoiding hospital admissions. The new service did not impact on medical on call support.
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