Collaboration, Lamination & Adaptation
It had been a busy few weeks just finding my way around the hospital, visiting the wards, infiltrating various forums, when I suddenly had a thought… Where is our AKI care bundle? I had a vague recollection of seeing one when I first met Dr Karl Bonnici (Acute Medicine Consultant) at my pre-interview visit to Stockport. When I asked him the next day, the conversation went something like this:
Me: Oh… so that’s an AKI care bundle from another hospital?
KB: Yeah, that one’s from Wigan, I’ve got this one from Manchester Royal Infirmary and this one’s from…
In fact, Dr Bonnici had several examples and I wondered… What is the collective noun for AKI care bundles?
Me: So, we don’t actually have one for Stockport?
KB: Ermm, well no, but these have given me some really great ideas!
Me: Okaaay… so we need to develop our own?
KB: That’s right!
Collaboration Not a collective noun but a great noun and what a wonderful word it is – working with others to produce or create something. Expressed differently: giving us professional permission to pilfer the ideas of others! I have been genuinely amazed and grateful for the willingness of others to share their experience, wisdom and resources. You only need look around the ‘Think Kidneys’ website to see real collaboration in action.
We wanted to develop our care bundle as a single document that not only ensured all the basics were covered, whatever the severity of AKI, but also provided guidance for staff when additional investigations were required and a clear process for escalation. Now, if you’ve read my first blog, you will know that I do not possess the greatest IT skills. Let me tell you, the formatting of that A4 document on my laptop was extremely painful. Working at the kitchen table was perhaps not the best place, all things Health & Safety considered, however, it was conveniently close to refreshments. Countless versions later, it was finally finished, Stockport had a brilliant AKI care bundle (it’s my prerogative to be biased) and I had tennis elbow, which is no joke!
While the care bundle went off to be printed, I made my own training copies for the ward AKI champions. You’ve never truly been involved in quality improvement work until you have mastered the art of lamination – ask any nurse! Armed with my expertly laminated care bundles, I met with the ward managers, all enthusiastic and excited about introducing something so fantastic which would really make a difference to patient safety. Maybe it was the crazed look in their eyes, the fixed smile or the slump of the shoulders – you know the look, it’s the one we display when working flat out and someone comes along and asks you to do even more!
It’s not that the ward managers were reluctant to engage with quality improvement, far from it – their main concern was about releasing staff for training. I quickly realised that I needed a much more flexible approach and the original plan to deliver group training went out of the window. I agreed to deliver training in each ward at a time that would suit them rather than me.
It was essential that each ward had AKI champions trained to use the care bundle but this way was going to take forever. Would I get all areas trained prior to the implementation date set for 16th May, 2016…? Find out in the next gripping instalment…
Wendy Oakes
Wendy Oakes, joined Stockport NHS Foundation Trust as AKI specialist nurse at the end of March 2016. Brand-new to the Trust, a brand-new role for the hospital and a brand-new role for her. With a background in critical care nursing, she has a PGCE in adult education which was useful when developing a competency based training programme for nurses providing continuous renal replacement therapy in ICU. She has experience of working at a senior level in critical care to drive quality improvements in patient care and safety.