Dec 2021 - Foresight Newsletter

Dec 2021 - Foresight Newsletter

DECEMBER 2 0 2 1

ED I T I ON 1 1

As a district, we have faced many challenges due to the COVID-19 pandemic. This year’s NSLHD Safety and Quality Account (2020-2021 Report and 2021-2022 Future Priorities) captures the dedication and commitment of NSLHD staff in continuing to provide high-quality care during difficult times. Produced annually, the NSLHD Safety and Quality Account showcases our district’s achievements and safety and quality priority initiatives. The account demonstrates our district’s ongoing commitment to clinical excellence, evidence-based quality improvement, and continued engagement with our consumers. The account also provides our patients and consumers with open and transparent information about our performance against safety and quality indicators for the 2020-2021 financial year. The safety and quality improvement activities outlined in the account align with the priorities set out in the NSLHD Strategic Plan and are underpinned by the National Safety and Quality Healthcare Standards. We acknowledge the outstanding contribution from teams in our hospitals and services across the district, including important and valuable input of our consumer advisors in the co-design of this year’s NSLHD Safety and Quality Account. NSLHD Safety and Quality Account 2020-2021 Report, 2021-2022 Future Priorities SAFETY AND QUALITY ACCOUNT

IN THIS EDITION:

NSLHD Safety and Quality Account Communicating with our Patients in the Era of Facemasks Consumer Advisor Toolkit Rhinoswab self testing

What is Situational Awareness? COVID-19 IPAC Manual Update ims+ training offerings 2022 What did you think of this issue? Give us your feedback.

Clinical Governance Standard

Click image to download in full

DECEMBER 2 0 2 1

ED I T I ON 1 1

Communicating for Safety Standard Partnering with Consumers Standard COMMUNICATING WITH OUR PATIENTS IN THE ERA OF FACEMASKS The use of facemasks in NSW health care settings has now become part of our ‘new normal’ and will continue to be so in the months to come. This important public health strategy can slow the spread of the COVID-19 virus but has bought with it the need for a conversation focused on communication in the era of facemasks. When we consider health care communication, it is common for us to rely on the spoken word to convey a message. However nonverbal communication is even more important than the words we use. By covering the lower half of our face, it will become more difficult to put the spoken word into context which can lead to uncertainty or misunderstanding. The struggle to communicate is intensified for vulnerable communities including for the older person, people living with cognitive impairment, people from CALD backgrounds and for the deaf community.

Some thoughts to consider before entering a patient’s room Take a pause and a moment to think about what your body language might convey when the receiver can’t see your mouth for visual cues Pay attention to your body posture, the tone and pitch of your voice Simplify your language and use more words than you usually would Maintain eye contact as this enables connection and understanding* Ask questions to check in that you’ve correctly interpreted the patient’s emotions and responses. Summarise what you have heard back to the patient to clarify and share understanding Use your hands and gestures such as thumbs up, wave and head nods Adjust for patients who have hearing loss, use images, the written word or where possible, speech to text apps 1. 2. 3. 4. 5. 6. 7. 8. * Remain sensitive to the needs of patients and carers whose cultural practice is to avoid eye contact or to drop their gaze as a sign of respect. Source: CEC Academy Alumni Newsletter 27.10.21

The Safety Fundamentals for Person Centred Communication (PCC) - CEC Activities such as Teach Back support staff build relationships and partner with patients and their families and carers. They reflect the emphasis on improving communication, PCC and safety, and the relationship between these elements. RESOURCES

CONSUMER ADVISOR TOOLKIT The Consumer and Patient Experience (CAPE) team is pleased to release the NSLHD Consumer Advisor Toolkit , a resource for consumers and staff that provides information on how to join and partner with NSLHD to strengthen the way we evaluate, plan, monitor and deliver our health service.

Partnering with Consumers Standard

Thankyou to our dedicated consumer advisors and the many collaborators who co-designed the toolkit.

The toolkit will be distributed to consumer participation committees across our sites and services and is available for download from the NSLHD Consumer and Community Partnership Intranet site.

Click image to access the toolkit

DECEMBER 2 0 2 1

ED I T I ON 1 1

Preventing and Controlling Healthcare-Associated Infection Standard

RHINOSWAB SELF-TESTING

NSLHD is the third district in NSW to commence rhinoswab self-testing. This initiative is also in place at SLHD and SWSLHD The success has been a collaborative effort between the areas, sites, support from the NSLHD Executive, Ministry of Health, NSW Health Pathology, local pathology department managers and NSLHD Central stores. A willingness to succeed meant that our first batch of self-testing specimens was sent off and analysed on Tuesday 7 December 2021.

Convenience - staff do not have to wait to be seen at the testing clinic. They can perform the test at a time convenient to them before, during or after a shift Improved experience Results are available to staff members within 24 hours WHAT IS SITUATIONAL AWARENESS? During periods of high stress, the mind becomes fatigued and situational awareness is comprised which can lead to patient and personal harm through poor decision-making. Situational awareness is critically important, especially at this time, because it drives decision-making. Kiosks have been set up in emergency departments and intensive care units at HKH, RNSH and Ryde Hospital for staff working in these departments who have completed an online training module. Using their own mobile phone, staff scan the QR code on the kiosk to register and proceed to self-test. The samples are analysed using polymerase chain reaction (PCR) testing. A new system has been introduced across NSLHD that involves staff undertaking surveillance self-testing for COVID-19. Double vaccinated staff are less likely to be symptomatic and this system works as an early detection strategy in the event that staff may contract COVID-19 from the community. The benefits for staff include: Situational Awareness is about being aware of all the elements in your immediate environment and how they relate to patient and personal safety. It is the careful observation of what’s around us (perception), understanding its significance (reflection) and predicting how it might influence what we are doing (forecast). Practising situational awareness is to pick up cues that may interfere with, or influence, how we may treat patients and proactively stay ahead of the situation. The term originated in the aviation sector. It is a feature of high reliability and is one of the most important non- technical skills defined in human factors.

Fig 2. Rhinoswab

Fig 1. Kiosk and label printer

Clinical Governance Standard

Safety Fundamentals for Teams: Safe care for patients during COVID-19 – fact sheet Using Safety Huddles during COVID 19 – Information for clinicians fact sheet Be a voice for safety - Information for Managers and Team Leaders RESOURCES teamwork and communication, such as safety huddles. These activities fall under the Clinical Excellence Commission's Safety Fundamental for Teams. These resources are designed to support individuals and teams to respond to the pace of change, to step up to lead and speak up for safety Situation awareness may be lost because of fatigue, distractions, stressful situations, high workload, vigilance failures, poorly presented information, forgetting key information and poor mental models. The result of losing situation awareness (or having an inadequate awareness) may be poor decision making, risk-taking and other unsafe behaviours. The use of mindfulness techniques can strengthen mental agility and boost situational awareness. COVID-19 has brought rapid changes to our workplaces and work teams. A team approach to mindful awareness involves activities that enhance

Some signs of a loss of situational awareness include: 1.

Fixation on one thing to the exclusion of everything else i.e. missed diagnosis Poor communications, such as vague or incomplete statements Not following established procedures Not having the ‘time to think’.

2.

3. 4.

DECEMBER 2 0 2 1

ED I T I ON 1 1

COVID-19 IPAC MANUAL UPDATE The COVID-19 Infection Prevention and Control Manual provides guidance on infection prevention and control requirements for the management of patients or clients with suspected, probable or confirmed COVID-19, the use of personal protective equipment (PPE), and transmission prevention strategies in acute and non- acute healthcare settings. The updated version includes minor amendments; additional detail for visiting and a new section - Occupational Exposure FAQs for CFHN – home visit.

IMS+ TRAINING OFFERINGS Training offerings in the use of ims+ for incidents and consumer feedback is available at any time in the form of eLearning modules, user guides and quick reference guides and videos. Managing and Reviewing (45min) ims+ Reporting (comprehensive) - from searching to designing reports (4hr) Advanced - for Clinical Governance (WHS and Patient Safety Senior Staff) (4hr) Virtual classroom (webinar) offerings for 2022 are now available for the following:

COVID-19 Infection Prevention and Control Manual

Version 1.8 (18 Nov 2021)

Further resources

COVID -19 PPE Advice – NSLHD Infection Prevention and Control - NSLHD Preventing and controlling healthcare-associated infections standard - National and statewide resources supporting NSQHS St 3 - CEC

See ims+ training schedule for 2022

For more information visit the ims+ training page

Clinical Governance Standard

Preventing and Controlling Healthcare-Associated Infection Standard

POLICIES, PROCEDURES AND GUIDELINES New, updated and recent ly publ ished distr ict wide PPGs The fol lowing l inks to documents from the PROMPT document system.

Clinical Governance Standard

Site Containment Standard Operating Covid-19 Procedure Blood and Blood Products Governance - NSLHD Policy Non-invasive Respiratory Support for Adults with COVID-19 Guideline Bladder Care - Postnatal – NSLHD Guideline Clinical Nurse Specialist / Clinical Midwifery Specialist Grade 1 Grading and Revalidation – NSLHD Procedure Operating Theatre Bone Bank - NSLHD Procedure Antenatal Testing and Management of Thyroid Disease_Guideline Inpatient assessment and management of pregnant women with COVID-19 (SARS-CoV-2) Guideline Intravascular Devices: Peripheral Intravenous Cannula (PIVC) - Insertion, Management and Removal in Neonates - NSLHD Procedure Stroke Pathway Guideline

SAFETY ALERTS New , u p d a t e d a n d r e c e n t l y p u b l i s h e d

Clinical Governance Standard

​SN:024/21 - Ensuring the safe and appropriate use of casirivimab and imdevimab - ​Issued 7 Dec ​SI:010/21 - ​Electronic Fetal Monitoring (EFM) during water immersion - ​Issued ​30 Nov SI:009/21 - R​ ecirculating air filtration device use in NSW hospitals - ​Issued ​26 Nov SN:022/21 - Preparation of Pfizer COVID-19 vaccines - ​Issued ​17 Sep SN:021/21​- ​Safety risks due to new labelling on the outer carton packaging of intravenous potassiumchloride ampoules - Issued ​10 Sep

Medication Safety Updates Medication Safety Updates including medication shortages are available on the CEC website.

Safety Alert (SA) - Requires immediate attention and action Safety Notice (SN) - Requires risk assessment at the district level Safety Information (SI) - Ensuring that lessons learned from state-wide, national or international sources are shared actively across NSW health system

For more information, contact: [email protected]