Technology to modernise nursing

In October 2012 the Prime Minister announced the establishment of a £100m Nursing Technology Fund to support nurses, midwives and health visitors to make better use of digital technology in all care settings, in order to deliver safer, more effective and more efficient care.
   
The funding is for technologies such as digital pens, tablets and clinical software to support nurses and midwives to develop modern practices and to do their jobs more easily. Trusts applying for the funding had to demonstrate how their technology projects would deliver real improvements to patient care and safety.
   
Beverley Bryant, Director of Strategic Systems and Technology at NHS England, said: “This is about using modern technology to support and facilitate staff in providing compassionate and personalised nursing care.
   
“It is about making life easier for staff – for example a digital pen can improve record keeping and reduce paperwork, a tablet or iPad can mean a community nurse can work on the go without needing to make as many trips back to the office, which means more time spent with patients. Also, mobile IT devices that can be used at the bedside puts valuable information at a nurses’ fingertips. This is ultimately about enabling nurses and midwives to improve the care they provide for patients.”

A POSITIVE RESPONSE
The response to the fund was huge, with over 220 applications from 140 health Trusts around the country bidding for part of the fund.
   
Jane Cummings, Chief Nursing Officer for England, said: “We received an amazing response to application process and the decisions on choosing the successful projects have been difficult. It has always come back to one key question – how will this project deliver real, practical benefits for nurses, midwives and care staff and their patients.”
   
In the first round, 74 Trusts were awarded funding totalling almost £30m for 85 projects.

THE PROJECTS
Buckinghamshire Healthcare NHS Trust won the largest amount of funding, £1 million, for community mobile working. This will allow the trust to buy mobile devices and a supporting software solution to integrate directly to the EPR for community nurses and community midwives to enable more efficient ways of working. As an integrated Trust, community staff will be able to access records that support both acute and community care.
   
East Cheshire NHS Trust received £725,030 for a bedside e-observation system, which works as an electronic vital signs data capture solution to improve the accuracy of data and timeliness of escalation. It will utilise hand‑held technology to collect observations, and identify high risk and deteriorating patients, automatically sending an alert to the appropriate clinician. Specialist teams will then be enabled to proactively intervene.

DIGITAL PENS
A digital pen is an device which converts handwritten analogue information created using into digital data, enabling the data to be utilised in various applications.
   
Lincolnshire Partnership NHS Foundation Trust was awarded £107,000 for the use of digital pens in the community. The pens will be used by community nursing, consultant psychiatrist outpatient clinics and hospital in-reach services. The platform will allow in house design and management of forms for use with digital pens or tablets. The information captured can be integrated into back office patient systems and the original can be left with the ward, patient or carer.
   
Guy’s and St Thomas’ NHS Foundation Trust was also awarded funding (£210,000) for the deployment of digital pens to community and district nurses and community midwives. The captured data will interface with the eNtoing community access and new midwifery systems.
   
Northern Lincolnshire and Goole Hospitals NHS Foundation Trust received £36,550 for the extension of a digital pen solution within the maternity service to include antenatal maternity consultations and postnatal recording. This will improve electronic recording and enable the further integration of digital maternity records within the EPR system.
   
What’s more, West Suffolk NHS Foundation Trust was awarded £246,097 to enable its midwifery service to go digital. The deployment of a digital pen and patient feedback solution will transform the way midwives are working, enabling patients to become involved in the collection of their own clinical information, while midwives provide live data to the hospital systems to create a complete patient record of all treatment and care.

MOBILE DEVICES
Lancashire Care NHS Foundation Trust received £358,000 for agile working within the adult mental health service. The trust is striving to enable clinical staff in the community to become more flexible, more mobile, and reduce administration and travel burdens. As such, the funding will allow the rollout of 3G/4G enabled mobile devices and docking stations, which replace laptops and desktops PCs, to allow clinical work to be completed anytime, anywhere.
   
Portsmouth Hospitals NHS Trust received £167,000 for a Hospital@Night System. Nurse Coordinators and practitioners provide nursing leadership and clinical skills to all wards and patients at night, helping to reduce junior doctors working hours. They currently rely on pager and landline communications in receiving and managing up to 200 calls a night. The project will provide a dedicated Hospital@Night task management system, supported by tablets and smartphones, freeing up time for the coordinators/practitioners to be clinically available to patients, educate ward teams and ensure requests are prioritised in a timely manner.

VOICE RECOGNITION TECHNOLOGY
Alder Hey Children’s NHS Foundation Trust was awarded £164,500 for the implementation of voice recognition technology in the Paediatric Intensive Care Unit, integrated with the electronic patient record. This will free up time to care, and ensure that the broader narrative of the patient’s treatment is captured to supplement core structured data.
   
Black Country Partnership NHS Foundation Trust received £89,300 for a VITAL Metrics Tool solution. This will involve the implementation of the hardware and software to understand the competency levels of nurses across the organisation to identify gaps in practice, informed by results of service user feedback, concerns, complaints and the friends and Family Test. The software will develop e-forms to support the collection of information for audits such as Infection Prevention Control. All data will be captured through tablets and digital pens.
   
Bradford Teaching Hospitals NHS Foundation Trust was awarded 346,000 for a paperless midwife project. The project will provide the technology to allow Community Midwives to access and add to the maternity electronic medical record whilst visiting women in the community. The project will also provide the technology to access and add to this medical record within the Bradford Maternity Unit and throughout BTHFT – for example A&E.

ELECTRONIC OBSERVATION
Calderdale and Huddersfield NHS Foundation Trust received £810,000 for the deployment of an electronic observation system that enables nurses and clinicians to record clinical data at the bedside on electronic devices in real time. Doctors and others are able to receive alerts and review the information on a personal device from anywhere with access to the hospital network and respond accordingly.
   
Cambridge University Hospitals NHS Foundation Trust was awarded £630,000 for an eHospital nursing workflow system. Nurses in the ward environment will be enabled to be truly mobile using hand-held technology to record and review the crucial parts of the EPR at the bedside. The iOS app and iPod Touch devices incorporating barcode scanning will enable access to tools for clinical review, patient list management, medication administration, specimen collection, vital signs observation and fluid balance.
   
Luton and Dunstable University Hospital NHS Trust received £260,113 for a range of fixed computers and screens to increase accessibility and visibility of the existing electronic observation system. Additionally, the Wardware open source e-Obs solution will be further developed in line with the business continuity plan to ensure continuous monitoring should an outage occur, and to improve usability.
   
Homerton University Hospital NHS Foundation Trust received £677,000 for devices that can monitor vital signs. The deployment of vital signs and cardiac monitoring devices and software to record data from fixed and mobile monitors, supporting the capture of real time data directly into patients’ charts, removing the need for manual entry of all but respiratory rate and conscious level. Project aims will be delivered through empowered clinical decision making, increased efficiency, and the innovative use of technology.

BETTER COMMUNICATION
Devon Partnership NHS Trust received £103,215 for its learning disability nurses to be equipped with iPads and a range of LD apps. This will help them improve accessibility and help with communication  so that those with a learning disability are more fully involved in creating their own care plans, risk assessments, wellness recovery action plans and service evaluations. Pilot work has shown this leads to both clinical and operational benefits.
   
Devon Partnership NHS Trust also received £295,000 for its mental health nurses. The money will buy tablet/laptop hybrids for mental health nurses working in both inpatient and community settings. This will allow nurses to move from person to person without needing to return to the office, thereby spending more time with people who use the service.

TRACK AND TRIGGER       
Southport and Ormskirk Hospital NHS Trust was awarded £986,361 for the implementation of an electronic track and trigger system throughout the organisation in all adult inpatient areas. Nursing and other clinical teams will be issued with mobile hand held technology to provide electronic capture of nursing observations and other critical metrics. This will facilitate the immediate escalation of deteriorating patients to clinical teams with auditable response times, and automated further escalation.
   
Southend University Hospital NHS Foundation Trust was awarded £88,000 Electronic Pre-assessment System. The project aim is to implement a single pre‑operative assessment IT system that will ensure the appropriate risk assessment is completed digitally by pre-assessment nurses using tablets, and readily accessible to all clinical staff involved. Some self‑assessment is also supported. Patients that are unsafe to be anaesthetised are identified so that appropriate steps can be taken.
   
A full list of the 74 winning NHS Trusts can be found at www.england.nhs.uk.

TRANSFORMING NURSING
Jane Cummings, Chief Nursing Officer for England, said: “Equipment like this simply wasn’t available as little as 20 years ago and using this kind of modern technology is part of the innovative and new ways of working we need to embrace in tackling modern health challenges.”
   
Secretary of State for Health, Jeremy Hunt said: “Innovative new technologies such as digital pens, tablets and clinical software mean that staff can spend more time with patients, not paperwork, and offer safer care.
   
“This fund will allow nurses and midwives to develop new, more modern ways of working that will benefit staff and patients.”
   
A further prospectus for the second round of funding will be published shortly. £70 million will be available, to be spent in FY14/15.

FURTHER INFORMATION
www.england.nhs.uk