CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
272
AFRICA
outstanding assessment skills and deep critical thinking. These skills
are not imbued in the nurse on completion of basic registration train-
ing. During a time of change, one of the matrons identified a need for
development of the knowledge and skills of practitioners and made
contact with the university.
Aim:
The matron working in collaboration with UNN helped develop
a simulation-based training module but ultimately wanted to know if
following this intervention would make the workforce fit for practice,
and whether the intervention made the nurses competent paediatric
HDU practitioners.
Methods:
The educational module uses theory and practice through
simulation and reflection on real practice, which is grounded in
real case studies, to allow staff to develop the requisite knowledge
and skills to recognise and provide emergency care for critically ill
children. A collaborative journey began between the matron and the
senior clinical academic from the University, which resulted in nurse
competence assurance in the recognition of the sick and critically ill
child for nurses working in cardiac care.
Results:
A research study carried out to assess the cardiac nurse’s
perception of the impact of the module concluded that this had
enhanced the underpinning of knowledge and improved clinical skills
in the recognition and safe care of critically ill children.
Conclusion:
This has allowed continuing partnership between
academic and practice organisations to ensure that provision of
educational modules meets identified local and wider workforce
development needs. Further research has taken place following on
from this initial study.
963: THE IMPORTANCE OF A STRUCTURED NURSING
ASSESSMENT OF A PAEDIATRIC CARDIOTHORACIC
PATIENT: THE POSITIVE RESPONSE TO CHANGE
Ashley Nadine Hurford, Claire Ranmal, Di Robertshaw
Great Ormond Street Children’s Hospital, UK
Background:
With the changing nursing role and the dependency
of their cardiothoracic patients, the importance of patient assessment
and excellent structured communication has been considered essen-
tial in maintaining patient safety.
Methods:
Great Ormond Street Children’s Hospital cardiothoracic
unit initiated a radical change in January–March 2011 to the way
their high- and low-dependency wards assessed their patients. The
new structure was devised to recognise the in-depth assessment that
is now required in the simple and complex cardiothoracic patient.
The implementation of the new structure was supported by senior
nurses experienced in the advanced assessment of patients. As part
of the development, the University affiliated with the Trust was also
consulted, to ensure that the tool met academic standards.
The nursing team concluded that to be succinct and effective,
known structures of assessment would need to be adapted to create a
new tool. The tools that were used in establishing the new structure
were the ABC approach to patient assessment previously established
by the Resuscitation Council UK and the ‘SBAR’ approach originally
devised by the naval military. The new tool was implemented over a
four-week period with small group training at the patient bedside.
Results:
Following implementation, our results showed 100%
compliance with the tool. At one year we still maintain an average
95% compliance with the tool. Our figures are only affected by the
employment of agency staff, which we are striving to train, to ensure
we will again achieve 100% compliance.
Conclusion:
We feel that we are achieving high compliance in the
use of our tool, as it has been designed by nurses for nurses, and the
simplicity of the tool is paramount to our successful implementation.
We would now like to share our experience internationally.
999: ‘THE IMPACT OF MODERNISING THE WAY WE
NURSE’: A NURSE’S EXPERIENCE IN MOVING THE
CARDIOTHORACIC WARD TO A NEWLY DESIGNED AND
BUILT ENVIRONMENT
Ashley Nadine Hurford, Di Robertshaw, Elizabeth Leonard
Great Ormond Street Children’s Hospital, NHS Foundation Trust, UK
Background:
The increase in patient numbers and the dependency
of patients means the cardiothoracic unit needs to evolve. The avail-
ability of a new building to expand into is one that needs precise
planning and communication.
Methods:
Great Ormond Street Children’s Hospital cardiothoracic
unit expanded into a new building, increasing capacity to eight high-
dependency beds, with 16 ward beds. The unit was designed to
provide maximum privacy and well-being for all patients. The nurs-
ing process required change as patients were to be nursed in single
cubicles not open bays. The facilities of the unit were also improved
for patients and visitors, with break-out rooms, play rooms and
adolescent facilities.
The change in nursing methods meant preparing the nursing staff
was vital to the move. A system of training days was established to
provide support in learning how to manoeuvre patients around the
ward, carry out emergency procedures, and become familiar with
modern technology that would be available to the patients, as well
as newly designed patient safety equipment and technology. Nursing
staff were given the opportunity to develop working strategies on
team days, which were facilitated by senior staff. All strategies were
implemented.
Results:
The patients were all moved safely and effectively within
two hours. All nursing staff completed a follow-up questionnaire to
identify lessons to be learned for a further move in four years’ time.
All staff stated they felt supported throughout their training and the
effective communication they had regarding the move gave them
confidence in caring for their patients.
Conclusions:
We believe that by sharing our experience of transition-
ing to a new unit we can demonstrate that the key to a happy, effec-
tive workforce and patient satisfaction is effective communication
and empowering nurses to become involved in the decision-making
processes of establishing new working practice.
1002: EVALUATION OF A NUTRITIONAL STATUS INTER-
VENTION IN CHILDREN WITH CONGENITAL HEART
DISEASE
Lijuan Fu, Tingting Zhang
Shanghai Children’s Medical Centre, China
Objective
: To investigate the feeding of children with catch-up
growth after nursing intervention.
Methods
: From October 2010 to January 2011, children younger
than six months with non-cyanotic congenital heart disease (CHD)
who had undergone surgery at the Shanghai Children’s Medical
Centre were selected by convenience sampling. Random allocation
was taken to divide them into two groups (
n
=
56 and
n
=
58). The
control group followed the current clinical feeding regime and educa-
tion, while the experimental group was given feeding guidance from
hospitalisation to post-discharge follow up. During hospitalisation,
feeding guidance, including primary feeding information, feeding
information especially for children with CHD, feeding behaviour
information, and high-calorie feeding principles were given to the
children’s parents. In addition, the handbook
Feeding Guidance for
Children with Congenital Heart Disease
was distributed to them at
discharge. The nurses followed them up for three months and contin-
ued to guide the parents on how to feed according to the handbook.
In this study, information was collected according to the
Baseline Questionnaire for Children with CHD, Feeding Knowledge
Questionnaire for Parents, Feeding Index Questionnaire, and State
Anxiety Inventory. The effect of the feeding guidance follow-up
plan, which aimed at improving parents’ feeding knowledge, regu-
lating feeding behaviour, and easing feeding anxiety was evaluated
by feeding knowledge scores, feeding index, and level of feeding
anxiety scores.
Results
: After following them up for three months, the feeding
knowledge of the caregivers improved (
p
<
0.05), the feeding index
