Feb 212019
 

David Murphy, Programme Advisor – Falls & Frailty, tells us about Falls Awareness Week 2019

Did you know that from Monday 18th February through to Friday 22nd February it is Falls Awareness Week in Wales, sponsored by Care & Repair Cymru, Age Cymru and Age Connects. At 1000 Lives Improvement, Public Health Wales the Falls and Frailty team are lending our support to the campaign and have been encouraged by the wide interest and support of colleagues from across NHS Wales and Welsh Government.

What is a Fall?
A fall is an unwanted event whereby an individual comes to rest inadvertently, either on the ground, or lower level with or without loss of consciousness. (NICE Clinical Guidance 2013)


Are Falls a Common Problem?

Yes. Falls place a significant demand on health and social care services, as well as the third sector in Wales. People aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. In Wales alone, an estimated 122,000 older people will fall more than once in their home with around 7,000 ending up in hospital. This creates additional demands on Ambulance Services and Hospital Staff.

The Cost of Falling

Most significantly, the human cost of falling includes distress, pain, injury, loss of confidence, loss of independence and mortality. Falling also affects the family members and carers of people who fall.

Falls have been estimated to cost the NHS alone more than £2.3 billion per year in the UK (NICE 2013). Using a simple population based estimated this could equate to around £110 million for NHS Wales. Therefore, falling has an impact on quality of life, health and healthcare costs as well as impacting on the wider community and economy.

A National Taskforce

That is why a National Falls Prevention Taskforce was established just over 2 years ago, supported by 1000 Lives Improvement in Public Health Wales. The Taskforce focuses on primary falls prevention and management with the ambition to reduce the number of falls experienced by older people in Wales. The national falls prevention campaign is entitled ‘Steady On, Stay Safe’. It incorporates interventions around the 3 Pillars of Strength and Balance Training, Capturing Falls History and Tackling Environmental Factors in order to prevent avoidable harm.

The Chartered Society of Physiotherapists (CSP) note that physical inactivity is a major public health problem and something that needs to be prioritised. For the CSP campaign check out #LoveActivityHateExercise

Launching Falls Awareness Week

Neil Williams of Care and Repair Cymru is the Taskforce Chairman. In a recent article in the Western Mail to launch Falls Awareness Week he noted that falls should not be seen as an inevitable part of growing old. This year’s campaign targets Welsh GP Practices providing leaflets and posters with common sense advice and signposting to relevant services. Some of the key messages to prevent falls include checking that footwear is appropriate and well fitting, ensuring medication is reviewed, testing eye sight, maintaining a healthy diet and stay hydrated. For further information you can follow the link to view the Falls Prevention Resource Hub: http://www.ageingwellinwales.com/en/resource-hub/fp-resources

Feb 212019
 

Mae David Murphy, Ymgynghorydd Rhaglen – Cwympo ac Eiddilwch, yn dweud wrthym am Wythnos Ymwybyddiaeth o Gwympo 2019

Oeddech chi’n gwybod ei bod hi’n Wythnos Ymwybyddiaeth o Gwympo yng Nghymru rhwng dydd Llun, 18 Chwefror a dydd Gwener, 22 Chwefror, a noddir gan Gofal a Thrwsio Cymru, Age Cymru ac Age Connects. Yn 1000 o Fywydau – Gwasanaeth Gwella, Iechyd Cyhoeddus Cymru, mae’r tîm Cwympo ac Eiddilwch yn rhoi ein cefnogaeth i’r ymgyrch, ac wedi cael eu hannog gan ddiddordeb a chefnogaeth ehangach cydweithwyr ar draws GIG Cymru a Llywodraeth Cymru.

Beth yw cwymp?
Mae cwymp yn ddigwyddiad dieisiau lle mae unigolyn yn dod yn ddisymud yn anfwriadol, naill ai ar y llawr, neu ar lefel is, wedi neu heb golli ymwybyddiaeth. (Arweiniad Clinigol NICE 2013)

A yw cwympo yn broblem gyffredin?

Ydy. Mae cwympo yn rhoi pwysau sylweddol ar wasanaethau iechyd a gofal cymdeithasol, yn ogystal â’r trydydd sector yng Nghymru. Pobl 65 oed a hŷn sydd â’r risg uchaf o gwympo, gyda 30% o bobl dros 65 oed, a 50% o bobl dros 80 oed, yn cwympo o leiaf unwaith y flwyddyn. Yng Nghymru yn unig, amcangyfrifir y bydd 122,000 o bobl hŷn yn cwympo mwy nag unwaith yn eu cartref, gydag oddeutu 7,000 ohonynt yn mynd i’r ysbyty. Mae hyn yn creu pwysau ychwanegol ar Wasanaethau Ambiwlans a staff ysbytai.

Cost cwympo

Yn fwyaf arwyddocaol, mae cost ddynol cwympo yn cynnwys trallod, poen, anafiadau, colli hyder, colli annibyniaeth a marwolaeth. Mae cwympo hefyd yn effeithio ar aelodau teulu a gofalwyr pobl sy’n cwympo.

Amcangyfrifir bod cwympiadau’n costio mwy na £2.3 biliwn y flwyddyn i’r GIG yn unig yn y DU (NICE 2013). Gan ddefnyddio amcangyfrif syml ar sail poblogaeth, gallai hyn fod yn hafal i oddeutu £110 miliwn i GIG Cymru. Felly, mae cwympo yn cael effaith ar ansawdd bywyd, iechyd a chostau gofal iechyd, yn ogystal â chael effaith ar y gymuned a’r economi ehangach.

Tasglu cenedlaethol

Dyna pam y sefydlwyd Tasglu Atal Cwympiadau Cenedlaethol ychydig dros ddwy flynedd yn ôl, gyda chefnogaeth 1000 o Fywydau – Gwasanaeth Gwella yn Iechyd Cyhoeddus Cymru.  Mae’r Tasglu’n canolbwyntio ar reoli ac atal cwympiadau sylfaenol, gydag uchelgais i leihau nifer y cwympiadau y mae pobl hŷn yng Nghymru yn eu cael. Enw’r ymgyrch atal cwympiadau cenedlaethol yw ‘Sadiwch i Gadw’n Saff’. Mae’n ymgorffori ymyriadau sy’n ymwneud â’r tri philer o hyfforddiant cryfder a chydbwysedd, nodi hanes cwympo, a mynd i’r afael â ffactorau amgylcheddol, er mwyn atal niwed osgoadwy.

Mae cyflawni gweithgareddau neu ymarfer corff priodol yn bwysig hefyd. Mae Cymdeithas Siartredig y Ffisiotherapyddion yn nodi bodi segurdod corfforol yn broblem iechyd cyhoeddus fawr ac yn rhywbeth sydd angen ei flaenoriaethu. I weld ymgyrch Cymdeithas Siartredig y Ffisiotherapyddion, gwiriwch #LoveActivityHateExercise

Lansio Wythnos Ymwybyddiaeth o Gwympo

Neil William o Gofal a Thrwsio Cymru yw Cadeirydd y Tasglu. Mewn erthygl ddiweddar yn y Western Mail i lansio Wythnos Ymwybyddiaeth o Gwympo, nododd na ddylid ystyried cwympo yn rhan anochel o fynd yn hŷn. Mae ymgyrch eleni yn targedu meddygfeydd Cymru trwy ddarparu taflenni a phosteri sy’n rhoi cyngor synnwyr cyffredin a chyfeirio gwasanaethau. Mae rhai o’r negeseuon allweddol i atal cwympo yn cynnwys gwirio bod esgidiau yn addas ac yn ffitio’n dda, sicrhau bod meddyginiaeth yn cael ei hoedlog, cael profion llygaid, cynnal diet iachus a bod yn hydradol. I gael mwy o wybodaeth, dilynwch y ddolen i weld y Ganolfan Adnoddau ynghylch Atal Cwympiadau: http://www.ageingwellinwales.com/en/resource-hub/fp-resources

Feb 192019
 

In this Blog, Richard Desir, Senior Workforce Transformation Nurse, Aneurin Bevan University Health Board and All Wales District Nursing Workforce Operational Lead shares the journey of the development of an evidence based workload and workforce tool and Interim Nurse Staffing Principles for District Nursing.

The All Wales District Nursing workforce and workload group is tasked to develop a District Nursing Workload and Workforce Tool that has been evidenced within the Welsh context, that would assist Health Boards in community nursing workforce planning. This important work will positively contribute to the delivery of care to patients in their own home and help shape the workforce by ensuring the safe and effective deployment of district nurses to meet the needs of the populations they serve.

A triangulated approach will be used when calculating the number and skill mix of nurses required within District Nursing Services, which takes into account:

  • Patient acuity and dependency
  • Quality audit
  • Professional judgement

The group has undertaken a staged approach to developing the learning and evidence base with each stage of the development of the Quality Audit tool and the Welsh Levels of Care, using service improvement methodology Improving Quality Together 1000 Lives (2014), each phase follows the Plan, Do, Study, Act (PDSA) cycle.

Under the leadership of Paul Labourne, Richard Desir and Katrina Rowlands the All Wales District Nursing workforce group have embarked on a remarkable and ambitious journey to journey to create the evidence to:

  • Determine what is quality and how this can be measured and articulated?
  • Develop and test an acuity and dependency tool to help assess workload.
  • Explore how professional judgement is used to inform decision making the associated factors

Throughout 2017/18 over 600 frontline District Nurses and management teams have engaged in workshops held across Wales to explore how the ‘Welsh Levels of Care’ could be used as an acuity tool within district nursing and sessions have been held to inform the further testing of the District Nursing Quality Audit.

The testing of the quality audit tool has resulted benefitted patients and district nursing teams by triggering:

  • Systematic roll out of National Early Warning scores within district nursing
  • Systematic roll out of “what Matters to me “ framework
  • Systematic improvement to equipment available to district nurses
  • Systematic capturing patient outcomes and experience to inform service improvement
  • The early digitalisation of capturing data and using that data digitally
  • Creating new evidence
  • Energising the district nursing workforce

The Chief Nursing Officer in Wales requested that an interim set of guiding nurse staffing principles for district nursing be developed and implemented to support the preparation for extension of the Act while the work to develop an evidence based workforce planning tool for District Nursing is undertaken. In September 2017 the District Nursing Staffing Principles were launched. These are monitored biannually and individual feedback provided to each organisation involved.

The implementation of the district nursing staffing principles has enabled a baseline assessment of services to understand where service development is required.  Enabling district nursing teams to be well defined, well led, and well supported.  They have highlighted areas where demand and capacity may be mismatched and further work is required.  It has introduced additional skill mix to district nursing such as administration support that has released time for patients.  The iterative assessment of the principles and the feedback given is supporting organisations with their development of the core universal nursing care at home service recognising the unique contribution district nurses play in the management of population health, improving public health and keeping the patient at the centre of care.

If you would like to find out more about the work undertaken by the District Nursing work stream  please email richard.desir@wales.nhs.uk or Katrina.Rowlands@wales.nhs.uk

Feb 192019
 

Yn y blog hwn, mae Richard Desir, Uwch-nyrs Trawsnewid y Gweithlu ym Mwrdd Iechyd Prifysgol Aneurin Bevan ac Arweinydd Gweithredol Gweithlu Nyrsio Ardal Cymru-gyfan, yn rhannu’r daith o ddatblygu offeryn gweithlu a llwyth gwaith ar sail tystiolaeth, ac Egwyddorion Staff Nyrsio Dros Dro ar gyfer Nyrsys Ardal.

Gwaith y grŵp gweithlu a llwyth gwaith Nyrsio Ardal Cymru-gyfan yw datblygu Offeryn Gweithlu a Llwyth Gwaith Nyrsio Ardal, sydd wedi cael ei amlygu yng nghyd-destun Cymru, a fyddai’n cynorthwyo Byrddau Iechyd o ran cynllunio’r gweithlu nyrsio cymunedol. Bydd y gwaith pwysig hwn yn cyfrannu’n gadarnhaol at gyflwyno gofal i gleifion yn eu cartrefi eu hunain, ac yn helpu ffurfio’r gweithlu trwy sicrhau y caiff nyrsys ardal eu lleoli’n ddiogel ac yn effeithiol i fodloni anghenion y poblogaethau y maent yn eu gwasanaethu.

Defnyddir ymagwedd drionglog wrth gyfrifo nifer a chymysgedd sgiliau’r nyrsys sydd eu hangen ar gyfer Gwasanaethau Nyrsio Ardal, sy’n ystyried:

  • Dibyniaeth a chraffter claf
  • Archwiliad ansawdd
  • Barn broffesiynol

Mae’r grŵp wedi defnyddio ymagwedd raddol at ddatblygu’r sail dystiolaeth a dysgu gyda phob cam o ddatblygu’r offeryn archwilio ansawdd a lefelau gofal Cymru, gan ddefnyddio methodoleg gwella gwasanaeth, Gwella Ansawdd Gyda’n Gilydd, 1000 o Fywydau (2014), ac mae pob cam yn dilyn y cylch  Cynllunio, Gwneud, Astudio, Gweithredu (PDSA).

O dan arweinyddiaeth Paul Labourne, mae Richard Desir a Katrina Rowlands, a’r grŵp gweithlu Nyrsio Ardal Cymru-gyfan, wedi dechrau ar daith ryfeddol ac uchelgeisiol i greu’r dystiolaeth i:

  • Bennu beth yw ansawdd, a sut gellir ei fesur a’i fynegi?
  • Datblygu a phrofi offeryn craffter a dibyniaeth i helpu asesu llwyth gwaith.
  • Archwilio sut defnyddir barn broffesiynol i lywio gwneud penderfyniadau a’r ffactorau cysylltiedig.

Yn ystod 2017/18, mae dros 600 o Nyrsys Ardal rheng flaen a thimau rheoli wedi cymryd rhan mewn gweithdai a gynhaliwyd ledled Cymru, i archwilio sut gellid defnyddio ‘Lefelau Gofal Cymru’ fel offeryn craffter ym maes nyrsio ardal, a chynhaliwyd sesiynau i lywio profi archwiliad ansawdd nyrsio ardal ymhellach.

Mae profi’r offeryn archwiliad ansawdd wedi bod o fudd i gleifion a thimau nyrsio ardal, trwy sbarduno:

  • Cyflwyno’n systematig sgorau rhybudd cynnar cenedlaethol ym maes nyrsio ardal
  • Cyflwyno’n systematig fframwaith “Beth sydd o bwys i mi”
  • Gwella’n systematig yr offer sydd ar gael i nyrsys ardal
  • Dal yn systematig ganlyniadau a phrofiadau cleifion i lywio gwella’r gwasanaeth
  • Digideiddio dal data yn gynnar a defnyddio’r data hwnnw’n ddigidol
  • Creu tystiolaeth newydd
  • Ysgogi’r gweithlu nyrsio ardal

Gofynnodd Prif Swyddog Nyrsio Cymru am i set dros dro o egwyddorion staff nyrsio arweiniol ar gyfer nyrsio ardal gael eu datblygu a’u gweithredu, i gynorthwyo paratoi ar gyfer ymestyn y Ddeddf, wrth i’r gwaith i ddatblygu offeryn cynllunio’r gweithlu ar sail tystiolaeth gael ei gyflawni. Ym mis Medi 2017, lansiwyd Egwyddorion Staff Nyrsio Ardal. Caiff y rhain eu monitro bob chwe mis, a rhoddir adborth unigol i bob sefydliad cysylltiedig.

Mae gweithredu’r egwyddorion staff nyrsio ardal wedi galluogi asesiad sylfaenol o wasanaethau i ddeall ble mae angen datblygu’r gwasanaeth. Bydd yn galluogi timau nyrsio ardal gael eu diffinio’n dda, eu harwain yn dda, a’u cefnogi’n dda. Maen nhw wedi amlygu meysydd lle efallai nad yw’r galw a’r gallu yn cydweddu ac mae angen mwy o waith. Mae wedi cyflwyno cymysgedd sgiliau ychwanegol at nyrsio ardal, fel cymorth gweinyddol, sydd wedi rhyddhau amser ar gyfer cleifion. Mae’r asesiad ailadroddol o’r egwyddorion a’r adborth a roddwyd, yn cefnogi sefydliadau i ddatblygu’r gwasanaeth gofal nyrsio yn y cartref cyffredinol craidd, gan gydnabod y cyfraniad unigryw y mae nyrsys ardal yn ei wneud o ran rheoli iechyd y boblogaeth, gwella iechyd cyhoeddus, a chadw cleifion yng nghanol gofal.

Os hoffech ddarganfod mwy am y gwaith a gyflawnir gan y ffrwd gwaith Nyrsio Ardal, anfonwch neges e-bost at richard.desir@wales.nhs.uk neu Katrina.Rowlands@wales.nhs.uk

Jan 172019
 

13 District General Hospitals in Wales are working collaboratively with the 1000 Lives Improvement service at Public Health Wales to improve the care they provide to patients undergoing emergency laparotomy surgery (emergency bowel surgery).

This work is part of an all wales quality improvement programme called Emergency Laparotomy Cymru (ELC) launched in July 2018.

ELC focusses on a patient’s care, from the time of the individual presenting to hospital, throughout their perioperative journey and during recovery.

Hospitals are using a 6-step evidence-based care bundle approach to deliver improvements.

A data collection system known as NELA (the National Emergency Laparotomy Audit) is used, to better understand individual standards of care and use data to make improvements.

Three clinical leads have been appointed to progress the work across local regions.  Over the next few months, they will be sharing their thoughts over why this programme is so important and will discuss how it’s developing.  Each lead will be working closely with other members of a multi-disciplinary team from each hospital within their region. This will consist of staff across emergency departments, radiology, theatre, critical care and surgical wards.

 In this first blog, we speak with Dr Babu Muthuswamy, South East clinical lead. Babu is a Consultant in Anaesthesia and Intensive Care and Clinical Director for Critical Care at Aneurin Bevan University Health Board.

 In your opinion, why is ELC so important?

In Wales, a number of hospitals have good clinical pathways to improve the care and outcomes of patients undergoing emergency laparotomy but there is still variation in processes and outcomes for patients having this high-risk surgery.

ELC has been launched to support NHS Wales in improving patient outcomes across Wales. We are striving to ensure that outcomes and satisfaction levels, for patients and their wider family members, rank as some of the best in the UK.

What made you want to get involved?

I have been part of the NELA audit since its roll out 2014 and have been the lead for the Royal Gwent Hospital throughout this period. There have been numerous challenges along the way in relation to improving the processes of care to emergency laparotomy patients. Being part of a national project like this helps to raise the profile of this work and to highlight the high-risk nature of this surgical procedure. It also helps to focus the minds of multi-disciplinary teams in each hospital to work towards one aim which is improving care and patient outcomes.

 What do you hope it will achieve?

Through ELC I am hopeful that we can improve patient outcomes from:

  • Having evidence-based practice guidelines as elements of the ELC bundle;
  • Providing a support network for the NELA leads in each of the hospitals involved;
  • Improving the scope of research to refine current practice; and
  • Disseminating successful clinical pathways that have been adopted in other hospitals (across the UK).

ELC is following a UK model that has been tried and tested, having achieved successful results.

For further information:

Email:  National ELC Programme Lead:  Margaret.Rennocks@wales.gov.uk

Website:  http://www.1000livesplus.wales.nhs.uk/elc-cymru

Follow the conversation on Twitter #EmergencyLaparotomyCymru

Jan 172019
 

Mae 13 o’r Ysbytai Cyffredinol Dosbarth yng Nghymru yn cydweithio â 1000 o Fywydau – Gwasanaeth Gwella, yn Iechyd Cyhoeddus Cymru, i wella’r gofal y maen nhw’n ei ddarparu i gleifion sy’n cael llawdriniaeth laparotomi brys (llawdriniaeth brys ar y coluddyn).

Mae’r gwaith hwn yn rhan o raglen gwella ansawdd Cymru gyfan, o’r enw Laparotomi Brys Cymru (ELC), a lansiwyd ym mis Gorffennaf 2018.

Mae ELC yn canolbwyntio ar ofal cleifion, o’r cyfnod y daw’r unigolyn i’r ysbyty, trwy gydol ei daith amdriniaethol, ac yn ystod ei gyfnod gwella.

Mae ysbytai’n defnyddio ymagwedd pecyn gofal ar sail tystiolaeth 6 cham i gyflwyno gwelliannau.

Defnyddir system casglu data o’r enw NELA (Archwiliad Cenedlaethol Laparotomi Brys) i ddeall safonau gofal unigol yn well, a defnyddio data i wneud gwelliannau.

Mae tri arweinydd clinigol wedi cael eu penodi i ddatblygu’r gwaith ar draws rhanbarthau lleol. Dros y misoedd nesaf, byddan nhw’n rhannu eu meddyliau ynghylch pam mae’r rhaglen hon mor bwysig, a byddant yn trafod sut mae’n datblygu. Bydd pob arweinydd yn gweithio’n agos ag aelodau eraill o dîm amlddisgyblaeth o bob ysbyty yn eu rhanbarth. Bydd yn cynnwys staff ar draws adrannau brys, radioleg, theatr, gofal critigol, a wardiau llawfeddygol.

Yn y blog cyntaf hwn, rydym ni’n siarad â Dr Babu Muthuswamy, arweinydd clinigol y de-ddwyrain. Mae Babu yn Ymgynghorydd Anaesthesia a Gofal Dwys, a Chyfarwyddwr Clinigol ar gyfer Gofal Critigol ym Mwrdd Iechyd Prifysgol Aneurin Bevan.

 Yn eich barn chi, pam mae ELC mor bwysig?

Yng Nghymru, mae gan nifer o ysbytai lwybrau clinigol da i wella gofal a chanlyniadau cleifion sy’n cael laparotomi brys, ond mae amrywiaeth o ran prosesau a chanlyniadau cleifion sy’n cael y llawdriniaeth risg uchel hon.

Lansiwyd ELC i gefnogi GIG Cymru i wella canlyniadau cleifion ledled Cymru. Rydym ni’n ymdrechu i sicrhau bod canlyniadau a lefelau bodlonrwydd cleifion a’u haelodau teulu ehangach ymhlith y gorau yn y DU.

Pam yr oeddech chi eisiau bod yn gysylltiedig?

Rwyf wedi bod yn rhan o archwiliad NELA ers ei gyflwyno yn 2014 ac mae wedi bod yn arweinydd ar gyfer Ysbyty Brenhinol Gwent trwy gydol y cyfnod hwn. Mae nifer o heriau wedi bod ar hyd y ffordd mewn perthynas â gwella prosesau gofal i gleifion laparotomi brys. Mae bod yn rhan o brosiect cenedlaethol fel hwn yn helpu i godi proffil y gwaith hwn, ac amlygu natur risg uchel y weithdrefn lawfeddygol hon. Mae hefyd yn helpu i ffocysu meddyliau timau amlddisgyblaeth ym mhob ysbyty i weithio tuag at un nod, sef gwella gofal a chanlyniadau cleifion.

 Beth rydych chi’n gobeithio y bydd yn ei gyflawni?

Trwy ELC, rwy’n gobeithio y gallwn ni wella canlyniadau cleifion yn sgil:

  • Cael canllawiau ymarfer ar sail tystiolaeth fel elfennau o’r pecyn ELC;
  • Darparu rhwydwaith cymorth ar gyfer arweinwyr NELA ym mhob un o’r ysbytai cysylltiedig;
  • Gwella cwmpas ymchwil i fireinio ymarfer presennol; a
  • Lledaenu llwybrau clinigol llwyddiannus sydd wedi cael eu mabwysiadu mewn ysbytai eraill (ledled y DU).

Mae ELC yn dilyn model y DU sydd wedi cael ei brofi, ar ôl cyflawni canlyniadau llwyddiannus.

I gael mwy o wybodaeth:

E-bost:  Arweinydd Cenedlaethol Rhaglen ELC:  Margaret.Rennocks@wales.gov.uk

Gwefan:  http://www.1000livesplus.wales.nhs.uk/elc-cymru

Dilynwch y sgwrs ar Twitter #EmergencyLaparotomyCymru

Dec 072018
 

Dr John Boulton, Interim Director of NHS Quality Improvement and Patient Safety, 1000 Lives Improvement

It’s been a busy few months since I joined Public Health Wales in the summer – although I’m not complaining! When I first arrived, I was also part time in my role as Executive Director of Continuous Improvement in the Aneurin Bevan University Health Board and so was effectively wearing two hats. Now, a few months in to the full time role, I continue to be astounded by the volume of work going on and commitment of the team within 1000 Lives Improvement.

The last several months really has been a journey of discovery and information gathering and I have met many stakeholder groups in order  to gain an in depth understanding of an organisation that’s already in its tenth year – I’m hearing some really great things.

In going through that journey, however, there is a clear recognition that the 1000 Lives team need to evolve the way that they support Quality Improvement within Wales. I think 2019 is going to be an exciting time for 1000 Lives Improvement. We are looking at what we do and how we do it to enable us to support NHS Wales and Social Care to improve services and achieve the vision set out in Welsh Government’s A Healthier Wales: our Plan for Health and Social Care (2018).

Responding to The Parliamentary Review of Health and Social Care in Wales (2018), the plan sets out a long-term future vision of a ‘whole system approach to health and social care’, which is focussed on health and wellbeing, and on preventing illness. It calls for transformation to an integrated system, with new models of seamless local health and social care and we’re developing plans around how we can support you to deliver this transformation. The 1000 Lives team is well placed to support this.

To inform our thinking, we’d like to hear from all staff and services about your service improvement experience and what you’d like help with moving forwards. Please share your thoughts with us via our online survey.

We’ll be feeding back in the New Year about what we learn and how we can support you moving forwards – keep an eye on our website, newsletter and social media for the most recent updates.

Dec 072018
 

Dr John Boulton, Cyfarwyddwr Dros Dro Gwella Ansawdd a Diogelwch Cleifion y GIG, Gwasanaeth Gwella 1000 o Fywydau

Mae’r misoedd diwethaf wedi bod yn brysur ers i fi ymuno ag Iechyd Cyhoeddus Cymru dros yr haf – ond nid cwyno ydw i! Pan gyrhaeddais i am y tro cyntaf, roeddwn i hefyd yn gweithio’n rhan-amser yn fy swydd fel Cyfarwyddwr Gweithredol Gwella Parhaus ym Mwrdd Iechyd Prifysgol Aneurin Bevan, ac felly roeddwn i’n gwisgo dwy het mewn gwirionedd. Bellach, ychydig fisoedd ar ôl dechrau’r rôl amser llawn, rwy’n parhau i gael fy synnu gan faint o waith sy’n cael ei wneud ac ymroddiad tîm Gwasanaeth Gwella 1000 o Fywydau.

Mae’r misoedd diwethaf wedi bod yn daith o ddarganfod a chasglu gwybodaeth, ac rwyf wedi cwrdd â nifer o grwpiau rhanddeiliaid er mwyn cael dealltwriaeth ddofn o sefydliad sydd eisoes yn ei ddegfed flwyddyn – rwyf wedi clywed pethau da iawn.

Yn ystod y daith honno, fodd bynnag, cafwyd cydnabyddiaeth gref bod angen i’r tîm 1000 o Fywydau ddatblygu’r ffordd y maen nhw’n cefnogi Gwella Ansawdd yng Nghymru. Rwy’n credu y bydd 2019 yn gyfnod cyffrous i Wasanaeth Gwella 1000 o Fywydau. Rydym ni’n ystyried ein gwaith ar hyn o bryd a sut rydym ni’n ei wneud er mwyn ein galluogi ni i helpu GIG Cymru a Gofal Cymdeithasol i wella gwasanaethau a chyflawni’r weledigaeth a roddir yng nghynllun Llywodraeth Cymru Cymru Iachach: ein Cynllun Iechyd a Gofal Cymdeithasol (2018).

Mae’r cynllun yn ymateb i’r Adolygiad Seneddol o Iechyd a Gofal Cymdeithasol yng Nghymru (2018), ac mae’n nodi gweledigaeth tymor hir ar gyfer y dyfodol, sef ‘iechyd a gofal cymdeithasol yn cael eu darparu drwy un system gyfan ddi-dor’, sy’n canolbwyntio ar iechyd a lles, ac ar atal salwch. Mae’n galw am drawsnewid yn system integredig, gyda modelau newydd o iechyd a gofal cymdeithasol lleol di-dor, ac rydym yn datblygu cynlluniau o gwmpas sut gallwn ni eich cefnogi i gyflenwi’r trawsnewidiad hwn. Mae tîm 1000 o Fywydau mewn lle da i gynorthwyo hyn.

Er mwyn llywio ein ffordd o feddwl, hoffem glywed oddi wrth yr holl staff a gwasanaethau am eich profiad o wella gwasanaethau, a sut hoffech chi helpu gan edrych at y dyfodol. Rhannwch eich barn gyda ni trwy ein harolwg ar-lein.

Byddwn yn rhoi adborth yn y flwyddyn newydd ynghylch beth a ddysgwyd a sut gallwn ni eich cefnogi chi wrth symud ymlaen – cadwch lygad ar ein gwefan, cylchlythyr a’r cyfryngau cymdeithasol i weld y newyddion diweddaraf.

 

 

 

 

Aug 082018
 

Dawn Parry, Paediatric Project Lead

As I walked to a meeting in the Children’s Hospital for Wales recently, I found myself reflecting on how much has happened since I came into post in January, when prior to my current role, I was based at that very hospital.

My nursing career commenced  in 1984 when I started my RGN training in Bangor, North Wales, close to my home town on Anglesey. Upon qualifying, I started as a Staff Nurse on the paediatric unit before obtaining my RSCN in Great Ormond Street in 1989. I then moved to Cardiff where my career has progressed to the present day. I feel I have been fortunate to have insight into paediatric nursing in both rural and urban settings, in tertiary and district general hospitals. This insight has proved invaluable to me in connecting with new colleagues from hospitals across Wales and to understand some of the pressures they experience and the challenges they seek to overcome.

Not all the changes I have seen during my career have been positive, but the introduction of the Nurse Staffing Levels (Wales) Act, 2016 I believe will be one of the most important changes I have witnessed. I consider it to be a positive step for health boards, nursing staff and most importantly, for our children, young people and their families.

The  All Wales Nurse Staffing Programme supports NHS Wales in meeting the requirements of the Nurse Staffing Levels (Wales) Act, which places a legal duty upon health boards and trusts to ensure that they are providing sufficient nurses to allow nurses time to care for patients sensitively.

The role of the paediatric work stream is to devise an evidence based approach to determine appropriate staffing levels within identified paediatric inpatient wards. The approach must be evidenced in the Welsh context and follow a common model of triangulation, which centres on three critical sources of knowledge: patient acuity, quality indicators and professional judgement. To date, 18 inpatient paediatric wards over the five health boards have been involved in capturing the acuity data for the audits on a twice daily basis.

In June this year, we hosted a successful paediatric event where paediatric nurses came together from across Wales to share their knowledge and expertise in reviewing and revising the new draft paediatric Welsh levels of care in preparation for testing on the wards.

My enthusiasm for this project has intensified during this time, due to fantastic reception I have received from colleagues across the whole of Wales and the sense that something very significant can be achieved through collaborative working, forming partnerships and support systems that could potentially transcend the aims of the current project.

Aug 082018
 

Dawn Parry

Wrth i fi gerdded i gyfarfod yn Ysbyty Plant Cymru yn ddiweddar, dechreuais fyfyrio ar faint sydd wedi digwydd ers i fi ddechrau yn y swydd ym mis Ionawr, oherwydd cyn fy swydd bresennol roeddwn yn gweithio yn yr union ysbyty hwnnw.

Dechreuodd fy ngyrfa nyrsio ym 1984, pan ddechreuais fy hyfforddiant RGN ym Mangor, Gogledd Cymru, ger fy nhref enedigol ar Ynys Môn. Ar ôl cymhwyso, dechreuais fel Nyrs Staff ar yr uned bediatrig cyn ennill fy RSCN yn Great Ormond Street ym 1989. Yna, symudais i Gaerdydd lle mae fy ngyrfa wedi mynd o nerth i nerth hyd heddiw. Rwyf wedi bod yn lwcus i gael mewnwelediad i faes nyrsio pediatrig mewn lleoliadau gwledig a threfol, mewn gofal trydyddol ac ysbytai cyffredinol rhanbarthol. Mae’r mewnwelediad hwn wedi bod yn amhrisiadwy i fi wrth gysylltu â chydweithwyr newydd mewn ysbytai ledled Cymru ac i ddeall rhywfaint o’r pwysau sydd arnynt, a’r heriau maen nhw’n ceisio eu goresgyn.

Nid yw’r holl newidiadau yr wyf wedi’u gweld yn ystod fy ngyrfa wedi bod yn rhai cadarnhaol, ond yn fy marn i, bydd cyflwyno Deddf Lefelau Staff Nyrsio (Cymru) 2016 yn un o’r newidiadau pwysicaf yr wyf wedi’u gweld. Rwy’n ystyried hwn yn gam cadarnhaol i fyrddau iechyd, staff nyrsio ac, yn bwysicaf oll, i’n plant, pobl ifanc a’u teuluoedd.

Mae Rhaglen Staff Nyrsio Cymru Gyfan yn cynorthwyo GIG Cymru i fodloni gofynion Deddf Lefelau Staff Nyrsio (Cymru), sy’n gosod dyletswydd gyfreithiol ar fyrddau iechyd ac ymddiriedolaethau i sicrhau eu bod yn darparu digon o nyrsys i roi amser i nyrsys ofalu am gleifion mewn ffordd sensitif.

Rôl y llif gwaith pediatrig yw dyfeisio dull ar sail tystiolaeth er mwyn pennu lefelau staff priodol o fewn wardiau cleifion mewnol pediatrig a amlygwyd. Rhaid rhoi tystiolaeth mewn cyd-destun Cymreig i’r dull, a dylai ddilyn model cyffredin o driongli, sy’n canolbwyntio ar dair ffynhonnell hanfodol o wybodaeth: aciwtedd cleifion, dangosyddion ansawdd, a barn broffesiynol. Hyd yma, mae 18 o wardiau pediatrig cleifion mewnol dros y pum bwrdd iechyd wedi cymryd rhan mewn cofnodi data am aciwtedd ar gyfer yr archwiliadau ddwy waith y dydd.

Ym mis Mehefin eleni, cynhaliom ddigwyddiad pediatrig llwyddiannus lle daeth nyrsys pediatrig ynghyd o bob cwr o Gymru i rannu eu gwybodaeth a’u harbenigedd am adolygu a diwygio fersiwn ddrafft lefelau gofal pediatrig newydd Cymru i baratoi ar gyfer profi ar y wardiau.

Mae fy mrwdfrydedd am y prosiect hwn wedi tyfu yn ystod y cyfnod hwn, yn sgil adborth gwych yr wyf wedi’i dderbyn gan gydweithwyr ledled Cymru, a’r teimlad y gellir cyflawni pethau arwyddocaol trwy weithio gyda’n gilydd, creu partneriaethau a systemau cymorth a all fynd y tu hwnt i nodau’r prosiect presennol.