2 results
Increasing Early Cardiac Screening in an Inpatient Psychiatric Setting Using the KardiaMobile 6 Lead Device
- Tomasz Pierscionek, Gavin Urban, Ignatius Loubser
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S106
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- Article
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Aims
The Royal College of Psychiatrists' core standards include a comprehensive physical health review as a vital part of an inpatient admission.
To determine whether using the KardiaMobile 6 lead (KM6L) device on an inpatient psychiatric ward would increase:
a. the percentage of patients who receive an ECG during an inpatient stay
b. the percentage of patients who receive an ECG within 24 hours of admission
MethodsThe KM6L device provides a 6 lead ECG recording within 30 seconds. It enables ECGs to be performed more efficiently and less intrusively than a 12 lead ECG machine.
The study aimed to offer all patients (101) admitted to an acute inpatient ward (July 2022 – Jan 2023) an ECG using the KM6L device, unless reporting chest pain, having significant cardiac history, or doctor otherwise concerned – in that event a 12L ECG would be done instead.
The percentage of patients receiving an ECG during an inpatient stay and the percentage who received an ECG within 24 hours of admission were compared on the same ward when using:
a. the KM6L device between July 2022 and Jan 2023; and
b. a 12L ECG between July 2021 and July 2022
QT intervals were calculated manually as the automatic feature is still in development
ResultsBetween July 2021 – July 2022, using a 12L ECG:
• 217 patients admitted
• 142 (65.4%) had a 12L ECG during their inpatient stay. Of these, 83 were done within 24 hours of admission (58.5%). Overall, 83/217 (38.2%) of patients had an ECG within 24 hours of admission.
Between July 2022 – Jan 2023, when KM6L device available on ward:
• 101 patients admitted
• 66* (65.3%) had an ECG during their inpatient stay. Of these, 46 were done within 24 hours of admission (69.7%). Overall, 46/101 (45.6%) of patients had an ECG within 24 hours of admission
*Note: 15/66 patients had a 12L ECG as available clinician did not know how to operate KM6L device
ConclusionKM6L, despite being easier to use and less intrusive, did not increase the percentage of patients who received an ECG during an inpatient stay. However, there was a notable increase in the percentage of ECGs performed within 24 hours of admission. KM6L offers a cost and time saving alternative for obtaining ECGs; earlier cardiac screening may also reduce risk.
Future work will consider further training of healthcare professionals in how to use the KM6L device and expand its use across healthcare settings.
Introducing an MDT Morning Huddle on an Adult Inpatient Unit During the COVID-19 Pandemic
- Sita Parmar, Tomasz Pierscionek, Helen Souchon, Naomi Thompson, Amina Shahzad, Rithika Koshy, Nokuthula Marks, Victor Doku, Saraspadee Veeramah
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S107
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- Article
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- You have access Access
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Aims
This quality improvement project aimed to introduce a staff communication tool, ‘the morning huddle’, to Goddington ward (Green Parks House, Oxleas NHS Foundation Trust). The huddle's purpose was to share key information between members of the ward's multidisciplinary team (MDT) regarding patient risk, diagnosis, mental state and treatment progress.
MethodsThe project team worked with the Oxleas Quality Improvement (QI) team to create a structured huddle with agreed goals that commenced at 9am each morning. The team sought views from ward staff on the existing communication process before implementing the huddle via a series of weekly questionnaires. The morning huddle was introduced on 26th May 2020 and all members of the team were invited (including the ward consultant, junior doctors, ward manager, nursing staff, healthcare assistants, psychologists, occupational therapist, and ward administrator).
Following multiple PDSA (Plan, Do, Study, Act) cycles, the team further refined the morning huddle into a meeting with a set template that included COVID-19 test results, psychiatric risk concerns, medication adherence, and barriers to discharge. The project team also timed the huddle, aiming for it to last a maximum of 30 minutes. A questionnaire was distributed to ward staff weekly after the huddle was implemented to ascertain their views on the process. Data collection for the project ended on 2nd August 2020.
ResultsThe project's main outcomes were based on two questions from the weekly staff questionnaire:
1. “How effective did staff members find the morning huddle in addressing their concerns about patients and promoting safety of patients and staff?”
This improved over the course of the project, starting with 20% of staff finding the huddle “good” or “very good” in its effectiveness to 77% finding it “good” or “very good” in the final questionnaire.
2. “How effectively do staff feel that their concerns about patients are addressed by the rest of the team?”
This also improved, starting with 40% of staff selecting “well” or “very well” to 100% in the final questionnaire.
ConclusionGoddington ward introduced a huddle that was valued by the entire MDT. The huddle improved how well staff felt their concerns about patients were addressed and a noticeable improvement in team morale was observed. While the project succeeded in implementing a huddle that staff appreciated, patient outcomes also need to be considered in future