Shropshire Community Healthcare NHS Trust
Kate Perkins Shropshire Children’s Community Nursing Team
Children’s Entral Feeding and Blood Pressure monitoring – Children’s Community Nursing Team
“Flo has enabled some of our patients to become more autonomous in their own care, with some teenagers even taking the lead in managing their conditions and interventions”
Kate Perkins from Shropshire Community Healthcare Trust ‘s Community Children’s Nurse Team has been discussing how the team have utilised Flo in supporting the management of their caseload maximising the integration of her unique techniques and methods to support children under their care.
Across paediatric cohorts there are certain patients and conditions that require face-to-face contact. Flo has enabled the Children’s Community Nursing Team to manage part of their caseload remotely and had created an effective alternative for families.
Entral Feeding Weaning Pathway
The aim of this pathway is to reduce and eventually discontinue the patients requirement for entral feed. To do this the team work closely with professionals and the patient, gradually reducing their feed. Children need their weight recored fortnightly and changes are made depending on the records. Flo has saved the need for face-to-face visits as it allowed the patients to send in their weight and enabled the Community Children’s nurse to manage to the extra caseload.
Kate highlighted “If Flo were to stop tomorrow, we would need to find extra capacity to allocate to these patients, therefore increasing their dependency and potentially delaying their progress.”
Blood Pressure Monitoring
For children that require blood pressure monitoring, which could be twice a week, Flo enabled the team to reduce the number of visits to these patients without compromising clinical effectiveness. Flo has given patients the opportunity to take their blood pressure readings from home and send them in through a text message. The team have almost instant access to the readings and are able to liaise with clinicians and patients accordingly. This has saved valuable time for the Community Children’s Nurse and the patient.
With valued time being released from these visits, it has allowed more time for higher dependancy patients and other roles such as staff management / completing documentation / admin.
Case Study 1
Child Y requires weight measurements every 2 weeks since referral to the team back in September 2012 as a result of being enlisted on the entral feeding weaning pathway.
Upon being offered the opportunity to support their child via Flo, the family were happy to interact remotely, confident that the team could access their child’s weight reading and intervene when necessary. The family now weighs their child at a convenient time for them as prompted by Flo, and sends their child’s weight reading for the team to review.
This has allowed the family to be able to weigh their child as part of their family routine and avoided the reliance, scheduling and intervention of a nurse visit every other week. Child Y now sees Flo as part of her routine and on a Sunday after her bath and hair wash, she understands that is when she is weighed and Mum sends her weight to Flo.
For Child Y alone, this has made family life much easier and avoided 2 hours 20 minutes of travel time and associated mileage cost for the team every fortnight equating to over 450 hours of clinical time released with no negative impact on clinical outcomes.
Case Study 2
A pragmatic secondary benefit arose from the capture of patient data sent to Flo that enabled quick and efficient clinical decision making between the Children’s Community Nursing Team and Acute Paediatric Team at Shrewsbury and Telford Hospitals when upon assessment of the child’s blood pressure readings further clinical input was deemed to be required.
Upon Shropshire Community Children’s Nursing Team identifying deterioration in a patient’s blood pressure, readings were able to be downloaded from Flo into a sharable excel file and emailed securely to the Acute Paediatric Team. This provided sufficient evidence for the patient to be expedited and seen more quickly and medication changes to be initiated promptly.
The summary below demonstrates the non-value added clinical time released the use of Flo across both pathways described above. With only 7 patients, a total of valuable 795 clinical hours have been saved, releasing the same capacity as an extra 1.0wte nurse working for over 21 weeks. More importantly this has enabled the team to work even more efficiently prioritising their time for higher dependent patients, or those who clinically need face-to-face care.
Using clinical time effectively and efficiently is increasingly important given the increasing caseloads and complexity of the patients managed by the Shropshire Community Children’s Nursing Team. Combined with the importance of ensuring that families remain engaged with their child’s condition and ensuring that the child can lead as normal a life as possible not dictated by their illness, Flo has provided a convenient alternative for both families and the team alike.
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Children’s Community Nursing Team- Entral and BP Monitoring
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