Nottingham’s e-nurses an example for other Trusts to follow


The use of technology and mobile devices to monitor patients’ symptoms and status across Nottingham University Hospitals NHS Trust (NUH) is being heralded by a national NHS organisation as an example to follow for other Trusts.

NHS Digital, the arm of the NHS that works to improve care by making better use of technology, data and information, has launched its first ever ‘e-nursing’ weeklong campaign, and has singled out Nottingham as a shining example.

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Over 6,000 clinical staff at NUH have mobile devices, in which they input data about patients – replacing paper charts on the ends of beds. This means staff across NUH can use a range of information to make informed decisions quickly. Last year, over 3million patient observations were done on these mobile devices by clinical staff.

Bed managers can use the system as a nerve centre for the entire hospital – seeing in real time who is in every bed, what their symptoms are, which specialists they are waiting to see, what patients are waiting for next in their treatment (to reduce delays) and ensuring they are put in the most appropriate ward for their needs.

The mobile devices are proving to be a cost-effective investment, speeding up the process of freeing up beds at the discharge end, and having a positive impact on reducing numbers of patients waiting on trolleys at the other end of the patient flow process.

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It is proving extremely beneficial for handovers too – both internally between people coming on and off shifts, and in linking up with community healthcare providers who have all the information they need about patients who may enter their care after being discharged.

Susan Clarke, senior nurse in ICT at NUH, said: “Using this system has transformed the way we work.

“We can see what processes are standing in the way of completing a patients transfer from hospital, and speed that process up, which obviously has a positive impact on patient experience, improves our efficiency and reduces delays for patients who require admission to our hospital.

“We have introduced a red/green system – green shows us there is nothing delaying the process; red alerts us to the fact there is an issue that needs rectifying.”

She added that scepticism from some nurses when the technology was introduced was quickly overcome by ensuring the development of the technology was clinically led, kept as simple and intuitive as possible and one-to-one support given to those who needed it:

“Some of our staff were initially nervous at such a step change in our way of working.

“But through spending dedicated one-to-one time with those who needed it, staff have overwhelmingly bought into the changes, and the vast majority would now never wish to go back to paper.

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And she was keen to stress that the technology is an aid, not a replacement to, high quality compassionate nursing care:

“Nurses and midwives will always need to give hands-on care but digital technology and data are creating new opportunities to change the way we deliver care in almost every setting.

“It remains crucial that nurses engage patients in conversations about their care – in fact more so now than ever because the information is being kept on mobile devices rather than on charts left by the bedside.

“I’m passionate that harnessing new technology must never be about dehumanising nursing, and it’s crucial that new nurses being trained have the knowledge and skills not to have to rely purely on technology.”

Caron Swinscoe, Clinical Lead for Nursing at NHS Digital, said: “Bedside technology gives clinical staff crucial information about patients in the palm of their hand which is accurate, up-to-date and shared by the whole team. Used effectively, it can ensure that changes in patients’ conditions are noted in real time and help to ensure early recognition and quick action, vital in the care of sick patients.

“Nottingham are showing that it is possible to go a step further – using the tools at their disposal that they’re already using for e-observations of patient symptoms to map patient flows across their hospitals.”