Monthly archives: October 2021

Heartbeat: Staying safe with skin dosimetry

Our imaging team lead the way when it comes to providing a patient-focused service. They offer a full diagnostic service using X-ray, Ultrasound, MRI, DEXA and CT scanning machines, nuclear medicine and radiopharmacy. To ensure our services remain as safe as possible, we continually take steps to stay compliant with the latest safety regulations.

Anyone working with radiation needs to meet the Health and Safety Executive (HSE) criteria of competence and have the necessary experience and expertise to allow the safe use of ionising radiation.

Dr Bill Thomson recently retired Head of Physics and Nuclear Medicine, presented a paper at the National Radiation Protection Advisers meeting. This allowed for discussion on radiation protection topics of interest and regulators, HSE attended.

Speaking to Heartbeat, Bill remarked: “My topic for this meeting was new modelling of skin dosimetry from accidents in nuclear medicine. This dosimetry forms the basis for required HSE radiation risk assessments. Fortunately, accidents are quite rare, but if any radiopharmaceutical lands on the skin or hands in an accident, skin doses can be very highs. Having accurate models of skin contamination becomes important.

“I have supported with dosimetry calculations where the annual skin dose was exceeded, requiring HSE input. I have also been developing models of droplets landing on skin or gloves in an accident, and also modelling the retention on direct skin contamination. Needle stick injury with a radioactive tracer is another area I have modelled.

“Normal skin doses tend to relate to handling and dispensing procedures, particularly in radiopharmacy. We monitor colleagues with finger doses at their fingertips. We can then ensure that all fingertip skin doses are well below the annual limits.

“I have been using and promoting the use of a dedicated software program developed by the U.S. Nuclear Regulatory Commission. This involves developing models of droplets on the skin and gloves. Any accident can involve radioactive droplets, e.g. from a syringe during dispensing. I have been presenting this work to promote staff awareness of the high skin doses that can result from droplets on skin, and help with wider data of the doses involved.”

Dr Thomson added: “We have also enhanced our PPE to ensure all bare skin is covered during dispensing and injection procedures. Other departments are now doing the same – being ‘bare below the elbow’ cannot apply for those processes.”

Heartbeat: A guide to Dysphagia – new e-learning module now available

In 2019, the International Dysphagia Diet Standardisation Initiative was rolled out across our Trust alongside a new gum based thickening agent, Nutilis Clear. This brought about a much needed standardisation of the language used to describe food and fluid safety modifications and necessitated wide scale ward based training regarding new terminologies and methods for accurate mixing of drinks.

As part of the inpatient speech and language therapy department recovery phase following COVID-19, the speech and language therapy team have launched a reinvigorated strategy to regain structured swallowing awareness, training for our hospital wards and to support staff development needs with dysphagia management.

To support colleagues across the Trust to gain a better understanding of dysphagia, the team are encouraging colleagues to complete the online dysphagia e-learning module developed by Nutricia.

Launching the new training programme Highly Specialist Speech and Language Therapist, Briony Storey said: “Dysphagia is an often misunderstood condition but one that can be managed with care. It’s important that colleagues across the Trust take the time to learn the signs, symptoms and management skills to keep patients safe.

“The pandemic has taught many of us how to access virtual training sessions and this module can be accessed online through ESR, ‘Course 381: A Guide to Dysphagia’, making access to learning even easier than ever before.”

The new training resource is aimed at supporting any healthcare professionals caring for those with dysphagia and will help to increase awareness, understanding and management skills of those looking after patients experiencing swallowing difficulties. The virtual package presents a new training opportunity or would be appropriate as a concise recap for those who have had some level of prior swallowing awareness training during the rollout of the International Dysphagia Diet Standardisation Initiative.

The course is split into four modules, each taking approximately 15 minutes to complete. Each subset can be saved throughout and returned to at a convenient time therefore completion does not need to be in its entirety. The modules cover:

• What is dysphagia?
• Signs, symptoms and consequences
• Management of dysphagia
• Using a thickener

It is hoped that with the rollout of this training package, colleague confidence and knowledge will increase for recognising a patient with dysphagia and understanding the concurrent signs, symptoms and management options available. The training package forms part of a range of exciting Trust quality improvement initiatives focused around the importance of nutrition and hydration.

For more information, please email briony.storey@nhs.net.

Heartbeat: Creating a patient first culture with CQC assessments

The Care Quality Commission (CQC) regulates health and social care services in England. The commission ensures the quality and safety of care in hospitals, dentists, ambulances, care homes, and the care given in people’s own homes. Ongoing assessments provide us with an opportunity to learn from the highlights of each inspection.

Our overall CQC rating is “requires improvement” and they rated our services as “outstanding” in the caring domain. We are working collectively to improve our rating and ensure that we deliver a consistent standard of care across all areas.

We caught up with the team in Lyndon 2 to find out how they have been working to enhance the care provided in their area. Amber Markham, Interim Group Director of Nursing, told us: “We held a mock internal inspection of Lyndon 2 so that we could understand how we are performing. A small team of colleagues volunteered to be part of a mock inspection team. The team observed practices on the ward and spoke to co-workers and patients about staff attitudes and behaviours, standards, their knowledge of policies and procedures, and leadership visibility.

“This was done as part of our weAssure programme led by Ruth Spencer. Teams are inspecting areas using a mock CQC inspection, highlighting areas for improvement and areas of good practice.

“Lyndon 2 received a “good” rating, with a couple of things to improve upon to be rated as outstanding. One area to improve on was the ability of some colleagues to articulate quality improvement work. Safety huddles and the mechanisms used to feedback information from incidents and complaints was praised.”

So what was the biggest takeaway from this process we asked? Amber explained: “Not being fearful of the process. It’s there to help your team identify areas for improvement and to celebrate excellence.”

Barbara Boparai, Senior Sister added that Lyndon 2 received praise for its safety huddles and sustainability during the mock inspections. She explained: “We recognise the importance of safety and the provision of safe, effective patient care.

“Our goal is to ensure that each patient is cared for in a respectful and dignified manner and to reduce their length of stay and get them back to health. We are patient advocates and, looking after our patients is our number one priority.”

Barbara added: “One of the ways we meet our standards of care is by holding frequent safety huddles. It allows patient safety issues to be communicated within our multidisciplinary team, allowing us to identify and address any concerns. Working in this way means that we can share experience and reach the most patient focused resolutions.

“Safety huddles are an essential part of what we do in Lyndon 2 – it’s a dynamic clinical environment that looks after patients admitted for surgical interventions such as general surgery, ENT and urology. For us to perform to a high standard, we need to ensure that colleagues have the knowledge and skills to perform in an ever changing NHS and a way to escalate and resolve any issues that impact patient care.”

Chief Executive’s Message – Friday 22 October

This week colleagues, I am going to be very brief and to the point in my Friday Message. I want to convey three things:

• Please get your COVID booster jabs done ASAP
• Please get your flu jab done ASAP
• Please complete your staff survey return ASAP

The first two are part of my core expectations of all our staff and should be a default action of any professional in our service. The third is essential as, without a strong response rate, we can’t be held to account by you all on making improvements and changes to staff engagement and lived experience.

I’ll leave all three actions in your hands!

Thank you in anticipation

Richard

Note: You can see all our Star Awards winners by clicking here.

COVID-19 Bulletin: Friday 22 October

1. New: Roll up, roll up, get your boosters – winter is coming

Did you know we are operating walk-in clinics for the COVID booster jab and flu vaccination at various sites across the Trust?

Now more than ever, it’s really important that we are all protected not least because we are expecting the next few months to be particularly challenging.

There’s the potential for a severe flu season, combined with increased COVID-19 transmission, long COVID and the usual winter illnesses circulating that we avoided last year due to lockdown restrictions.

There are also those patients whose treatment plans were regrettably disrupted due to COVID-19 who may need more care.

So with all these factors in mind, we’ve made it as simple as possible for you to protect yourselves and everyone around you as winter approaches.

Dr David Carruthers (pictured above), Medical Director, had his booster recently by taking advantage of the walk-in clinic at City Hospital’s vaccination hub.

He said: “I’ve had my booster jab and my flu vaccination. I’m sure you’ll all want to join me in protecting yourselves, patients and colleagues over the winter.

“It’s very easy to either book in or walk in at our hubs, so I would encourage you all to get protected.”

You can also book an appointment at the clinics, which are listed below with opening times.

Both vaccinations are perfectly safe to have together. Should you not wish to do this, you can split your jabs by booking two separate appointments or just make it clear when you attend a walk-in clinic.

COVID-19 boosters will be Pfizer and those eligible include those who have had their second dose (including Pfizer or Astra Zeneca) and have no contraindications to the Pfizer vaccination.

There must be at least six months (180 days) between your second dose of your COVID-19 jab and your booster.

Please be aware that the Sandwell vaccination hub is closed on 25 and 28 October but will remain open on all other days next week. It will close permanently after October 31, but pop up clinics will be held throughout November on site.

The City vaccination hub will remain open seven days a week where colleagues will be able to receive their flu jab and COVID booster. A pop-up clinic will operate on Monday at Rowley Regis Hospital, where no appointment is needed.

See below table for opening times.

Prefer to book an appointment? Using our easy self-booking system you can arrange an appointment to have your vaccinations at a time and date to suit you. You need your NHS number which you can find on the NHS app or you can book via the following links:

• Sandwell and West Birmingham NHS Trust
• NHS website

Receiving your COVID booster/flu jab elsewhere?

If you receive your COVID booster and/or flu vaccination elsewhere please ensure that your place of work is recorded as Sandwell and West Birmingham NHS Trust on the system. This will help to keep your occupational health records updated so that you do not receive further correspondence about the vaccinations.

If you have any other questions regarding the vaccine please contact occupational health on 0121 507 3306.

Watch Dr Carruthers talk about being vaccinated:

Colleagues should also be aware that we are now offering walk-in and booked appointments for 12-17 year-olds at the City hub.

 Boost your immunity this winter – get your flu jab and COVID-19 booster.

2. New: Wolverhampton COVID lab suspension not linked to Black Country Pathology Services

You may have seen in the media recently that a lab in Wolverhampton has been suspended from testing due to inaccurate results for COVID-19 PCR tests.

Please be assured that this is in no way associated with Black Country Pathology Services. Any results that you may have received for your patients, or your own LAMP test, will be accurate.

If you have any questions, please contact rwh-tr.communicationsdept@nhs.net.

3. Updated: New swabbing pathway for elective surgery

An updated swabbing pathway has been issued for patients undergoing elective surgery.

The new guidance covers the process around what to do if a patient arrives without their PCR test result or if a member of their household tests positive for COVID-19.

You can read the full guidance here.

4. Reminder: Join the saliva testing programme to protect your patients and loved ones

Did you know saliva testing (known as LAMP – Loop Mediated Isothermal Amplification) is a speedy and less invasive way of detecting COVID-19?

You can book a kit collection slot for the weekly test, which requires you to spit into a tube in the morning before you brush your teeth or an hour after you have eaten.

When you arrive at work, you can deposit your sample into a red collection box. Many of these are positioned around our acute and community sites.

You can find drop off points and more information by clicking here.

If you are still unsure how to complete your LAMP test, be sure to check out the step-by-step guide in the video below.

Even if you are vaccinated it is vital that you register and carry out the weekly tests as they will help identify if you’re asymptomatic. Your saliva sample is ONLY used to test for COVID and is disposed of after testing.

The weekly saliva test is an easy way to help us all ensure we are remaining safe and playing our part in the battle against COVID-19.

Uptake of the weekly saliva test is monitored to ensure we are doing everything we can to protect our patients, the public and each other.

The latest data by group is below:

5. Reminder: Do you need a disposable FFP3 masks?

If you require disposable FFP3 mask please call ext. 4938 (City) or ext. 2824 (Sandwell).

If you are in charge of a clinical area, please ensure you have an ample supply of these masks.

Note: We must remind colleagues they should not be reliant on their silicone mask only.

If you have not been fit tested for a disposable masks please book an appointment via ESR. If you have issues booking through ESR, please call ext. 5195.

6. Reminder: Have you thought about taking advantage of time out with your team?

Taking time out is important for both mental and physical health and wellbeing, particularly after the difficulties many of us have experienced during the pandemic. Many team leaders have expressed a wish to arrange some time for teams to step away from the work environment and jointly reflect on experiences. These away days can take a range of formats, but in order to help managers, the Trust is happy to consider centrally funding reasonable costs associated with these experiences.

This could include:

• Hire of an external venue
• Facilitator/external speaker costs
• Transport to external venue
• Refreshment costs (no alcohol)
• External team building activities
• Backfill costs

If an away day or something similar is of interest to you and you team, please visit Connect for further details. These activities should be carried out in line with our Trust infection prevention and control guidance.

Restart a heart and save a life this October

In the UK, there are approximately 66,000 out of hospital cardiac arrests each year and cardiac arrests haven’t stopped during the COVID-19 pandemic. In fact, early data shows they have increased, meaning learning CPR is more important than ever.

Around 1 in 10 of these patients survive and about three quarters of these cardiac arrests happen at home. If someone you are with has a cardiac arrest, would you know what to do?

Every October, hundreds of thousands of people across the UK, and many more worldwide, learn CPR as part of the national ‘Restart a Heart’ campaign spearheaded by the Resuscitation council and this year is no different.

Across our Trust, resuscitation forms part of the basic life support training that all clinical colleagues undertake and are assessed on. This includes a mix of theory as well as much needed hands on experience that forms part of the assessment.

Sharing her thoughts on the ‘Restart a heart day’ Senior Sister in the deteriorating patients and resuscitation team Dawn Martin said, “It’s incredibly important for colleagues in both clinical and non clinical roles to understand the basic life support and resuscitation techniques. We have a really robust means to roll out training to our clinical teams through our ‘Basic Life Support Assessors’ who support us to roll out training to every corner of our Trust, but the statistics are clear – most cardiac arrests will occur in the most unexpected circumstances, so it’s important for colleagues to ensure they are fully trained.

“We have over 200 BLS assessors who support colleagues across our Trust to brush up on their BLS training, complete their assessment and to provide support in understanding changes to the clinical guidelines.

“COVID-19 proved to be quite challenging, when it came to resuscitation, with contradicting advice flowing from unreliable sources making it difficult for people to understand what their roles in resuscitation is, it’s important that colleagues take the time to complete their training, understand what is being asked of them, what their role is and most importantly discuss any questions, queries or concerns they have.

“But to be clear, even with COVID, chest compression only CPR and early defibrillation can still be carried out, and in hospital level 3 PPE is required, when dealing with additional aerosol generating procedures when managing airways.”

For more information on completing basic life support training or to get involved with Restart a Heart Day, please contact swbh.resuscitationtraining@nhs.net.

3-way temporary traffic signals on the junction of Western Road and Dudley Road: 25 – 29 October

From Monday 25 October – Friday 29 October, there will be 3-way temporary traffic signals on the junction of Western Road and Dudley Road. The signals are required to enable utility providers to bring their service ducting across the existing road safely.

We ask that colleagues please be mindful and remain vigilant when accessing City Hospital and the surrounding areas on foot and by car and plan for delays when travelling to and from the hospital site.

ChemoCare now available

Following on from the ChemoCare system upgrade yesterday, ChemoCare V6 is now live and available via Connect under Clinical Systems.

The training videos will remain on Connect under the same link for refresher training.

Please call ext. 3579 if you require additional support or further information.

Dermatology cake sale: 28 October, 11am – 2pm

Our dermatology department will be hosting a cake sale on Thursday 28 October, 11am – 2pm on the ground floor of Sheldon block.

All funds raised from the cake sale will go towards Macmillan cancer support.

Note: Please ensure you follow social distancing, hand washing and PPE guidelines at the cake sale.

For more information please call 07870 544811 or email natalie.whitton1@nhs.net.

Congratulations to all our winners at this year’s Star Awards!

Last Friday we held our 2021 Star Awards where a total of 20 awards were handed out to both clinical and non-clinical colleagues across SWB.

Our awards ceremony, which was held at Aston Villa Football Club, aims to recognise the hard work and dedication of our colleagues and volunteers, both on the frontlines and our supporting services.

Throughout this week, we will be celebrating all our award winners from the annual awards.

Today we feature:

• Employee of the Year – Julie Booth
• Clinical Team of the Year (adults) – COVID Intensive Care Team 
• Clinical Team of the Year (children) – Children’s Speech and Language Therapy Team
• Non-Clinical Team of the Year – Bereavement Care Team

Be sure to also check out the video below featuring some of our very own NHS Heroes after they were crowned winners at the Star Awards 2021.