Monthly archives: September 2019
Drug safety notice: Digoxin shortage
There is currently a UK supply issue with the licensed preparation of digoxin 250micrograms/1ml injection (2ml aps).
There is a supply issue with licensed digoxin 250micrograms/ml injection, with stock not expected until December. As an interim, the pharmacy team are sourcing an unlicensed preparation that is due in stock week commencing 30 September.
See the Digoxin memo for details on managing the drug supply shortage in the interim.
For more information please contact the pharmacy department on ext. 5259.
African-Caribbean health information conference: 18 October
The African-Caribbean health information conference will be hosted on Friday 18 October from 9.30am – 4pm at the Bethel Convention Centre.
The event will aim to focus on health concerns that affect a high number of African-Caribbean patients, and is designed to highlight, and address any educational and management difficulties health care professionals might find when engaging with this group of patients.
Note: Places are limited and must be pre-booked for catering purposes. If you are interested in this study day, please book your place at www.achicevents.org.uk.
Click here for more information.
Healthcare Futures UTC open day: 12 October
Heath Futures UTC, West Bromwich are hosting an open day for young people aged 14 – 19 who are interested in careers in health and social care on Saturday 12 October, 11am – 2pm.
To book your place visit the Eventbrite page link below.
https://www.eventbrite.co.uk/e/open-day-saturday-12th-october-2019-tickets-71649105403
For more information please call 0121 794 2888.
Common issues in Unity
today and tomorrow the support is focussed on coaching colleagues to carry out a number of tasks in Unity correctly. We want all users of the system to become comfortable and confident in how to complete the necessary tasks in the right order.
1. Recording of VTE assessments
VTE assessments are critical to providing safe patient care. All patients who require a VTE assessment must have this completed within six hours of the patient being admitted, in line with our Safety Plan. VTE assessments should be entered into Unity in real-time. Failure to process VTE assessments will result in a ‘hard stop’, effectively preventing a patient from progressing through to discharge home. Congratulations to AMU1 and AMU2 at City who so far today have completed all VTE assessments triggered.
2. Results endorsement
It is important that all colleagues are familiar with the process for endorsing results in Unity, both for laboratory and imaging reports. Today and tomorrow, this indicator is one that we all need to focus on in order to improve the safety of the care we provide. We currently have 20% of results that have been endorsed in Unity. The best department by far for endorsing results is our Emergency Department – well done.
The following QRGs on Connect can be referred to for help:
- MC03 – Endorsing results in message centre
- RT07 – Reviewing results
- RT08 – Viewing and forwarding results
- RT10 – Endorsing results
Results for tests such as radiology and pathology returned after 16 September are logged within Unity. However, if results for tests were returned before 16 September, you will find these in CDA/CSS.
3. Saving, signing and submitting clinical documents in Unity
Don’t forget to save your records if you are leaving your computer unattended. We have nearly 20,000 unsigned entries in Unity. Half of those comprise the impression and plan document, the physical exam document and the history of presenting illness document. Remember that your colleagues cannot see any unsigned documents within the patient record.
See the flowchart below to find out the correct pathway to follow when inputting documentation.
4. Discharging patients
It is essential that the suggested discharge care plan is commenced within six hours of admission. This enables the discussions to take place around discharge arrangements for your patients and in setting EDDs (Expected Dates of Discharge). Ensuring this is done will help us to safely manage our sites based on the capacity we have within the hospitals to admit our patients.
Trust weather update
Following on from this morning’s intense rainfall there has been a number of instances of flooding and associated disruption in the local area affecting roads and multiple public transport services across the region. Rolling updates can be found on the BirminghamLive website.
There is the possibility for delays in patients arriving for appointments, and staff should be aware to plan their journeys accordingly. We are aware currently that Grove Lane (between City and Sandwell Hospitals) is flooded and impassable. A yellow weather warning from the MET Office remains in effect over both Birmingham and Sandwell areas.
Additionally, there are some areas of City Hospital that have minor leaks, currently these are not impacting patient care. Staff are reminded to report any significant leaks to the Estates department.
Booking patient transport
Colleagues are reminded that to book patient transport they should call ext.5444.
Please do not press the ”transport” button in Unity as this is for use by porters only and will not secure transport for your patient.
All of our outpatient areas are now live on Unity
Thank you to everyone for your hard work today. Everywhere that went live with Unity on Saturday and Sunday remains live, and today all of our outpatient and ambulatory areas successfully came on line.
The structure in place to support you remains. Later tonight we will announce some adaptations in it to help you to more quickly get access issues solved via 4050 and to provide more support to help you to begin to use the system really well.
Top tips when using Unity in ED
We have put together some easy step-by-step tips for clinical colleagues to follow who are using our electronic patient record, Unity in our Emergency Departments at both City and Sandwell.
- Start of shift check-in: Go to top left tab, click on check-in, type your name, choose colour to match your uniform, press save, refresh.
- Chest pain bleep: Click on adhoc forms at the top of the screen, click on chest pain assessment, work through form, then triage as you would normally.
- Scanning documents: Search for the patient in CSS, select upload file, select ED scanned document. Please remember, you will need to scan the document you want as a PDF or image.
- Documenting clinician notes: Click on patient’s name, click on clnical note, click on 2nd tab “ED definitive assessment.” Note: All clinicians’ notes will be documented there.
- Giving medication and fluids: Go to drug chart, click on the box that matches the drug and correct date, fill in the details and press ok, then refresh.
Save and sign – clinical workflow documents
Don’t forget to save your records if you are leaving your computer unattended.
See the flowchart below to find out the correct pathway to follow when inputting documentation.
Trust-wide Unity implementation update – Issue 4 – Top Tips
All inpatient services in community facilities and hospitals are now live. We start outpatient go live at 6am on Monday. Thank you for your help to make the start of go live fortnight a success.
Top Five Tips
A few common issues have been picked up so far. Please take note of the following top tips:
- Don’t forget to save and sign your records
Sign and save your entries in Unity to ensure your colleagues can see your notes. Notes and additions to patient records in Unity must be signed and saved on the system for them to become visible against patient records. If you fail to save and sign before you tap out you run the risk of losing data. Today we have 3096 unsigned document entries which cannot be seen by other colleagues. Congratulations to M2, D7, Sandwell Critical Care and P5 for having less than 10 unsigned documents in a whole day.
- Completing VTE assessments in Unity
Currently we have 17 patients with missing VTE assessments. VTE assessments are critical to providing safe patient care. All patients who require a VTE assessment must have this completed within six hours of the patient being admitted, in line with our Safety Plan. VTE assessments should be entered into Unity in real-time. Failure to process VTE assessments will result in a ‘hard stop’, effectively preventing a patient from progressing through to discharge home.
- Administering medication: Ensure you scan the patient wristband
Today, at City Hospital, which went live yesterday, 161 medications have been administered without scanning the barcode on the patient’s wristband. Our best performers are City ED and D28 with just one such error. Colleagues are reminded that when carrying out medication administration, patient wristbands must be scanned. This is the long barcode next to the RXK number and not the square QR code in the centre of the wristband. This is different to the workflow you may have followed in the play domain.
Bypassing wristband barcode scanning poses a risk to positive patient identification.
- Results endorsement
It is important that all colleagues are familiar with the process for endorsing results in Unity, both for laboratory and imaging reports. Congratulations to City AMU1 who have endorsed correctly 25% of issued results which is the best current performance in the Trust. During next week this indicator is one that we all need to focus on in order to improve the safety of the care we provide.
The following QRGs on Connect can be referred to for help:
- MC03 – Endorsing results in message centre
- RT07 – Reviewing results
- RT08 – Viewing and forwarding results
- RT10 – Endorsing results
Results for tests such as radiology and pathology returned after 16 September are logged within Unity. However, if results for tests were returned before 16 September, you will find these in CDA/CSS.
- Documenting samples when collecting bloods in Unity
Remember when you are collecting bloods you must first print the label then take the blood sample and finally, mark the sample as collected within Unity. If you do not do this it is not possible to endorse the result when it is returned to the hospital from the laboratory. Over half of yesterday’s samples were collected with this omission.
For more information, please follow the attached QRG:
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