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Hywel Dda first in Wales to go live with digital nursing

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Nurses in South Pembrokeshire and Withybush hospitals are the first in Wales to go live with a new digital Welsh Nursing Care Record (WNCR) leading the way towards smarter, patient-centred ways of working.

This ground-breaking national project, which officially launched in Hywel Dda University Health Board on 19 April 2021, will transform nursing documentation and create a new digital way of working, using the latest tablet-based technology rather than paper forms.

In the first month of a phased implementation, over 15,000 nursing entries and more than 10,000 risk assessments have been made, reflecting the level of care and attention that each user is giving to the inpatients of Withybush and South Pembrokeshire hospitals.

Hywel Dda University Health Board and other NHS organisations across Wales are working with Digital Health and Care Wales to produce digital nursing documents that follow a patient through their healthcare journey, using the same standardised nursing language to reduce duplication and improve patient experience and care.

Mandy Rayani, Director of Nursing, Quality & Patient Experience said: “We are very excited to be involved in this collaborative project and to have the opportunity to influence the future of e-nursing for the benefit of nursing staff and patients.

“I’m proud of how nursing staff within Hywel Dda UHB have embraced this new way of working and we look forward to rolling it out to other hospital sites over the coming months.”

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Claire Bevan, Senior Responsible Owner for the WNCR project added: “I’m sincerely grateful for the incredible support given to the WNCR journey so far. and for the encouragement and support to make this possible within Hywel Dda, the first in Welsh nursing history to go digital.”

Angharad Murray, Staff Nurse at Withybush Hospital said: “The new system has changed how I work and I found it so easy to learn how to use it. It’s a very efficient process with nursing notes now all in one place and I don’t have to decipher different handwriting styles anymore!”

Fran Beadle, National Clinical Informatics Lead (Nursing), Digital Health and Care Wales said: “I had the pleasure to be present at the official launch of the Welsh Nursing Care Record in Hywel Dda; it was fantastic to see staff adapt so quickly to the new ways of working. A big thank you to everyone for embracing this change to make a difference in patient care across Wales.”

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Clinical representatives are leading the project to ensure it is fit for purpose, patient focused and aligns to nursing process. As a starting point, the teams have identified that the first set of documents to be standardised and developed digitally are the adult inpatient assessment and core risk assessments in relation to falls, pressure damage, pain, continence, nutrition, manual handling and discharge.

These have been chosen based on frequency of use, and those that have the biggest potential to improve patient assessment, inform care planning and enhance patient safety and outcomes. The current practice of recording and keeping paper records has become a burden and is taking front line staff away from care activities.

The experience, learning and feedback from the ward teams as they adopt the new digital process is helping to inform the future and ongoing development of digital patient care records.


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Swansea Bay NHS

Maggie’s making a big difference for adults with learning disabilities

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For over a decade, Maggie Higgins has made a big difference to the lives of people with learning difficulties and hearing loss – contributing to work which can help reduce the risk of them developing dementia.

Her support has even helped one adult hear birds singing clearly once again.

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For others, it helps fulfil their potential and maximise their independence despite any difficulties they may face.

Now her work has been recognised through a major NHS award.

Maggie’s responsibilities within the speech and language service, which is managed by Swansea Bay and hosted in Cardiff and Vale, involves supporting adults with a learning disability, particularly hearing loss.

She has helped improve services around successful assessment, diagnosis and ongoing support for hearing loss, while a key part of her role includes overseeing the Positive Approaches to Supporting the Senses (PASS) group, which she set up with clinical psychologist Dr Sara Rhys-Jones.

PASS works closely with audiology experts to support patients, many of whom have had no concerns highlighted about their hearing, or had not been assisted in attending hearing tests or follow up appointments.

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Significantly, Maggie’s work has led to a sustained sevenfold increase in referrals to audiology services for people with a learning disability – lowering the likelihood of undiagnosed or misdiagnosed hearing losses, which can decrease the risk of developing dementia.

Maggie has helped develop innovative new innovative learning disability and sensory impairment awareness training for professionals, families and carers. (Image: Swansea Bay NHS)

Maggie said: “This is particularly encouraging following a Lancet Commission report in 2020 which identified that ‘unsupported hearing loss is the single greatest preventable risk factor for developing dementia.’

“People with a learning disability are at far greater risk of having undiagnosed or unsupported hearing loss and are known to be three times more likely to develop dementia than the general public.

“I raise awareness and get people seen and supported appropriately to reduce the risk where possible.

“Sensory loss is particularly prevalent and frequently undiagnosed and unsupported amongst people with a learning disability. The responses that might indicate someone has a problem hearing are very often mistaken for characteristics of their learning disability.

“It is essential that we understand what someone can see and hear so that we provide the best possible support. We cannot accurately estimate the impact of a person’s learning disability unless we are aware of what they can see and hear.”

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Now in her 20th year with the speech and language service, Maggie has spent the last 12 years focusing on the impact of sensory loss on people with learning disabilities.

It is an area which she is particularly passionate about.

She said: “When I started this work, the link between unsupported hearing loss and dementia was not known but that was not the primary reason that I started to work on it.

“It was the fact that people weren’t recognising the signs of sensory loss and people were not accessing assessments. The work has become even more important now that we understand there is a link.

“You can’t underestimate the difference it can make to the lives of people with previously undiagnosed issues who go on to have hearing aids fitted.

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“One lady left her hearing aid fitting appointment and burst into tears because she could hear the birds singing.

“It is terribly frustrating for individuals who, given the right support, could be involved to a much greater degree.

“When hearing aids are fitted or communication is adapted appropriately, the difference in people’s ability to engage with others and their environment can be overwhelming to see, irrespective of whether or not they use verbal communication.”

Maggie also created My Hearing Action Plan to help people with learning disabilities and their carers understand their hearing loss and the methods they can implement.

Following diagnosis of hearing loss, Maggie and her team support individuals, carers and staff to understand the impact of that person’s particular hearing loss on their communication and daily living.

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Working with Occupational Therapist Maura Shanahan, she developed innovative learning disability and sensory impairment awareness training for professionals, families and carers, which enables them to experience particular levels of hearing loss.

It has led to an increase in the use of sensory-supportive approaches that help people with learning disabilities improve their health, well-being and quality of life.

Her efforts over the past decade have recently gained recognition in the form of being named the outright winner of The NHS Employers Award at the 2022 UK Advancing Healthcare Awards.

The award category identifies an outstanding achievement by an apprentice, support worker or non-registered technician in an allied health professional or healthcare science service.

She added: “I was totally amazed to be shortlisted, let alone win the award in my category.

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“I have thoroughly enjoyed working in the speech and language service for 20 years, so it was a really lovely way to celebrate that landmark.

“Working with adults with a learning disability is an absolute privilege.”

(Lead image: Swansea Bay NHS)

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Morriston

New regional centre at Morriston Hospital to treat lung conditions given go-ahead

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photo of doctor holding x ray result

Plans for a new multi-million pound Adult Thoracic Surgical Centre for South Wales can go ahead at pace following a major boost from Welsh Government.

The new centre, to be based at Morriston Hospital, Swansea, will treat lung cancer patients and others who need surgery for a range of chest conditions.

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It will be able to operate on an increased number of patients, potentially upwards of 20% more, and will be the third largest centre in the UK.

Following extensive public consultation in 2018, it was agreed that the new centre will provide a single service for South Wales for residents living in the Swansea Bay; Hywel Dda, Cwm Taf Morgannwg; Aneurin Bevan, Powys and Cardiff and Vale Health Board areas. The centre is expected to be open within the next three to five years.

Patients will be treated as much as possible within their local health board area, only having to travel to the Morriston centre for pre-admission assessment and the surgery itself.

The endorsement of the proposal by the Minister for Health and Social Services, Eluned Morgan will enable the next key stage – the development of detailed plans – to now get underway.

Siân Harrop-Griffiths, Swansea Bay University Health Board’s Director of Strategy and project lead, said: “Developing this scheme and getting the agreement of all the clinicians and organisations across South Wales has been time consuming and complex.

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“But we are delighted that this endorsement by the Minister means we can now take this work forward at pace to provide better thoracic surgical services for everyone across South Wales.”

Malgorzata Kornaszewska, Consultant Thoracic Surgeon at Cardiff and Vale University Health Board and Clinical Lead for the South Wales Adult Thoracic Surgical Services Programme said: “The new centre will be a centre of excellence with access to modern technology, and will be able to offer a comprehensive, modern, timely and high standard service to our patients.

“It will also create an excellent opportunity for teaching, training and research. This is an exciting time for the thoracic teams and Welsh thoracic patients.”

The South Wales Adult Thoracic Surgery Centre will standardise the delivery of these services across South Wales, improving the long-term sustainability of the service.

Having the specialist service in one dedicated centre will improve equity of access and patients’ experiences, and most importantly provide better health outcomes.

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The single site thoracic surgery centre will be designed in line with best practice and the recommendations of various reviews and consultation processes.

As a centre of excellence, it will provide dedicated thoracic surgery to meet national standards, enabling sub-specialisation of surgeons, which in turn will enable a higher standard of complex surgical procedures to be performed.

All health boards in South Wales, led by Swansea Bay UHB, have worked together alongside the Welsh Ambulances Services Trust and community health councils to develop and agree a plan to develop this new unit at Morriston Hospital.

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Morriston

Carpenter still at work after nearly slicing off his fingers says thanks to Morriston Hospital

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A retired carpenter who almost sliced off his fingers is still crafting away in his workshop thanks to the skill of Morriston Hospital staff.

Colin Taylor was working on turning a piece of wood into a teapot-shaped plant potholder when his wood cutter slipped and went into his hand.

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But despite slicing two fingers through to the bone, he is not just busy in his garden workshop but has also rediscovered his artistic skills as a way of thanking hospital staff.

The 73-year-old said: “I had put the wood in a vice and started shaping it with an electric cutter. I had a new blade which was able to cut everything including metal.

“It had gone well, when I had an itch on my nose and went to scratch it. I took my hand off the cutter and it cut across the timber and across my hand.

“There was blood spurting up in the air. I knocked the cutter off immediately, and my wife called my daughter who is a good first aider. She came up and my fingers were hanging off. I’d damaged them all, but particularly my middle and index finger, and had severed two tendons.

“My daughter took me to Prince Charles Hospital in Merthyr but they contacted Morriston Hospital who told me to come down straight away.

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“From the moment I went in it must have been the best treatment in my life. The people were so nice and courteous. I was seen to first by a young lady who cleaned me up, and then the doctor came and took a look at it and said I’d have to have an operation.

“They injected my finger and the operation didn’t take too long, and I went home and my left hand was in a plaster for in six weeks. The surgeon fixed the tendons.

“It is not 100%, but it is what it is. I have got to get on with it. It’s a bit stiff in the morning and I can’t bend my middle or index finger like I used to.”

The grandfather of three has since produced a couple of paintings which he has presented to staff at Morriston Hospital by way of thanks.

He added: “I did some painting a long time ago. I always enjoyed painting and carpentry, although I know I’m no Picasso.

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“But the people in hospital were so good to me I just wanted to do something to thank them.

“I’m not surprised the NHS has such a good reputation with people like that working there.”

Specialist hand physiotherapist Iona Davies added: “Following surgery and initial assessment at Morriston Hospital, Mr Taylor was able to access our specialist hand therapy services virtually, at a time when local therapy services were constrained due to Covid.

“This eliminated the need for him to travel from Tredegar, where he lives and cares for his disabled wife.

“He has been dedicated to his rehabilitation and exercises, and as a consequence has been able to achieve his treatment goals, returning to woodwork and painting. The outcome following such an injury is dependent as much on patient’s motivation and commitment as it is on surgical skill and therapy input.

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“We were delighted to receive his gift.”

Lead image: Colin and daughter Heather with the painting of Morriston Hospital (Image: Swansea Bay NHS)

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