NURSE STAFFING REPORT

Transcription

1 NURSE STAFFING REPORT INTRODUCTION This paper fulfills the nationally mandated, post Francis II requirement for monthly Board Reports detailing achievement against required nurse staffing levels. This paper provides compliance report against modified minimum staffing levels (as reported at September Public Board). Compliance against revised staffing requirements will commence following discussion of full nursing establishment review at October Board. ACTUAL Vs. PLANNED NURSE STAFFING LEVELS COMPLIANCE The table below gives aggregate figures for compliance of actual vs planned staffing levels. Urgent Care Planned Care Women & Children s Trust Overall % % 98.4% 93.18% % Appendix 1 demonstrates ward-level compliance data for actual vs planned staffing, alongside quality indicators. The report covers the period June 1 st 30th ANALYSIS OF NURSE STAFFING RELATED KPIs (Appendix 1) including highlighted areas of concern Three community and one acute area fell below the threshold set for red RAG rating (<90% compliance) during this review period. When ward areas fall below the threshold of 90%, this prompts a more in-depth analysis of the quality and safety of care provided on those wards and triangulates the data against a set of key performance indicators which aim to demonstrate whether the reduced availability of nursing staff has impacted on patient care. This can be seen the table below: * Safe staffing levels RAG rated: Green - safely staffed with no immediate patient safety concerns Amber safely staffed but close watch due to concerns Red not safely staffed

2 Ward Area % Compliance Commentary Safely Staffed* Stroke Unit 88.14% The occupancy is reduced as a result of protecting empty beds; yes ensuring beds are available for any stroke patient, complying with the 4 hour window for admission. Due to this, the ward has been able to support other areas that have shortfalls in staffing. There is no corresponding increase in incidents, falls, infection or complaints. District Nursing Teams Southport & Formby & West Lancashire DN Team % Compliance Churchtown Formby Hillside 79.51% 89.66% 89.55% Commentary has seen an overall improvement this month in staffing levels moving from red to amber. Both Formby and Hillside are just below the 90% target. Sickness remains an issue for the three areas identified. As in previous months, both long and short term sickness is proactively monitored. Safely Staffed* yes The number of vacancies across the community has reduced and this is reflected in this month s report with the overall number of areas in red reducing. RISKS ASSOCIATED WITH NURSE STAFFING ISSUES Staffing compliance has improved in month however; the Trust continues to rely heavily on bank and agency fill to achieve this. Clinical posts continue to be released with a rolling generic advert through NHS Jobs; however local recruitment reflects the National picture. International recruitment remains as an agenda item to board. Nurses who were successfully interviewed in the Philippines continue to face delays in the recruitment process. The nurses that failed the OSCE Examinations last month are due to re-sit in August. They have had a tailored educational plan in place to give them the best possible chance of success.

3 We continue to work closely with our HEI colleagues in both recruitment and new ways of working. We will be working with Edge Hill to recruit and train associate nurses later this year. Conclusion and Recommendations teams continue to experience high demand, with significant pressures on staffing levels however, this has improved in month. This is demonstrated by a number of areas achieving the 90% threshold. The three areas that do not meet this are closely monitored. All wards have been reviewed not only on compliance against staffing levels, but also against a number of key performance indicators for safe care. There is no apparent link between staffing levels and performance indicator results for safe care this month. The Board can be assured that in order to mitigate the key risks to safe staff that: Staffing levels are discussed at the escalation meetings three times per day and actions taken to ensure staffing levels remain at safe levels across the organisation. Proactive recruitment to nurse vacancies continues. Simon Featherstone Director of Nursing, Quality & Risk

4 ANALYSIS OF NURSE STAFFING RELATED INDICATORS Appendix 1. June 2016 *Acute Trust based on following wards: 11B, 14A, 14B, 15A, 15B,7A, 7B, 9A,E Ward, EAU, FESS, G Ward, H Ward, Obs, PIU, SSU, Spinal.

5 Realtime Staffing % Temp Staffing of Nursing in post - Registered % Temp Staffing of nursing in post - Non Registered Staffing related Incidents Bed Occupancy Falls Pressure Sores C-Diff Cases MRSA Total Relating to clinical treatment Relating to attitude FFT - % recommended Sickness - Registered Sickness - Non Registered Vacancies Unplanned Admissions to ITU % of Obs that were late Agency usage Harms Infection Complaints FFT Sickness Jun-16 Trust % 10.10% 21.49% % % 5.40% 7.55% 154 N/A 16.4% Urgent Care % 17.37% 35.74% % % 5.31% 8.85% 82 N/A 17.5% 7A 90.91% 50.37% 68.00% % % 14.21% 6.73% 9 N/A 22.8% 7B % 38.98% % % % 8.36% 11.82% 10 N/A 14.0% Stroke Unit 88.14% 27.57% 50.21% % % 13.68% 29.49% 9 N/A 9.3% FESS % 68.55% 33.99% % % 1.71% 14.38% 11 N/A 9.8% EAU 98.36% 12.40% 37.31% % % 3.91% 3.61% 3 N/A 39.6% SSU 99.96% 33.15% 37.33% % % 7.53% 12.22% 9 N/A 23.1% 11B 99.69% 19.80% 39.08% % % 5.47% 6.26% 7 N/A 6.3% 14B % 30.14% 24.68% % % 6.74% 6.45% 5 N/A 8.8% A&E % 25.94% 13.26% 0 N/A % 4.22% 0.86% 5 N/A N/A Obs % 19.02% 20.34% % % 12.66% 0.00% 1 N/A 38.9% Rehab % 12.06% 49.42% % NTR 3.16% 10.37% 5 N/A 2.1% Critical Care 92.95% 4.19% 14.33% % N/A 2.89% 13.37% 8 N/A N/A Women & Childrens 98.40% 3.08% 4.68% % % 2.48% 5.34% -2 N/A 19.1% E Ward % 13.68% 0.00% % % 0.00% 0.00% 1 N/A 19.1% Maternity 94.68% 3.90% 13.33% % % 3.43% 6.28% -1 N/A N/A NNU % 2.25% 0.00% % N/A 0.24% 0.00% 1 N/A N/A Childrens Ward 98.61% 1.95% 0.00% % % 4.61% 9.24% -3 N/A N/A Childrens A&E % 0.00% 0.00% 1 N/A % 0.00% 0.36% -4 N/A N/A PAB % 0.00% 0.00% % N/A 0.00% N/A 2 N/A N/A Planned Care % 16.37% 17.91% % % 6.51% 6.30% 56 N/A 13.2% PIU 94.09% 42.21% 68.00% % % 8.87% 0.00% 0 N/A 10.2% 14A 94.98% 26.14% 23.56% % % 6.08% 3.54% 7 N/A 10.6% 15A % 36.60% 82.51% % % 0.51% 12.44% 4 N/A 14.5% 15B % 80.10% 30.69% % % 0.00% 12.65% 7 N/A 14.6% Spinal Unit 94.69% 14.61% 8.66% % % 7.42% 6.10% 12 N/A 15.4% G Ward % 12.39% 12.13% % % 3.06% 5.99% 3 N/A 13.7% Treatment Centre N/A 0.00% 0.86% 0 N/A % 8.32% 9.24% 2 N/A N/A Theatre N/A 19.43% 0.00% 3 N/A N/A 7.35% N/A 11 N/A N/A Radiology N/A 0.00% 0.00% 0 N/A N/A 0.00% N/A 0 N/A N/A & Continued Care 93.18% N/A N/A 1 N/A 3 27 N/A N/A % 6.56% 10.39% 25 N/A N/A Burscough D/Ns % N/A N/A 0 N/A 0 1 N/A N/A N/A 16.67% 0.00% 2 N/A N/A Hillside D/Ns 89.55% N/A N/A 0 N/A 0 0 N/A N/A N/A 6.72% 0.00% 1 N/A N/A Hants Lane D/Ns 98.93% N/A N/A 0 N/A 0 2 N/A N/A N/A 6.68% 60.91% 0 N/A N/A Sandy Lane D/Ns 98.82% N/A N/A 0 N/A 0 5 N/A N/A N/A 3.67% 28.04% 0 N/A N/A Tarleton D/Ns 90.26% N/A N/A 0 N/A 0 0 N/A N/A N/A 7.59% 0.00% 0 N/A N/A Ainsdale D/Ns % N/A N/A 0 N/A 0 5 N/A N/A N/A 2.40% 0.00% 1 N/A N/A Churchtown D/Ns 79.51% N/A N/A 0 N/A 0 5 N/A N/A N/A 8.80% 25.00% 1 N/A N/A Curzon Road D/Ns 95.61% N/A N/A 0 N/A 0 5 N/A N/A N/A 17.17% 0.00% 1 N/A N/A Formby D/Ns 89.66% N/A N/A 0 N/A 0 1 N/A N/A N/A 12.24% 0.00% -1 N/A N/A Red <90% 15%> 15%> N/A 93%> N/A N/A N/A N/A N/A <80% 7%> 7%> N/A 1 15%> Amber 90-95% 10-15% 10-15% N/A 85-93% N/A N/A - - N/A N/A N/A 80-94% 4-7% 4-7% N/A % Green 95%> <10% <10% N/A <85% N/A N/A 0 0 N/A N/A N/A 94%> <4% <4% N/A 0 <10%

6 Locations not above: Staffing Related Incidents Staffing Related Incidents Urgent Care 3 x Skelmersdale WIC 2 x CERT Women & Childrens 1 x Physiotherapy 1 x Gynae Planned Care Pressure Sores 1 x ENT 3 x awaiting location confirmation 1 x CERT Complaints Urgent Care 1 x GPAU 1 x Skelmersdale WIC Women & Childrens 2 x Access & Booking Planned Care 3 x Access & Booking 2 x General Outpatients 1 x Dermatology 1 x Eye Clinic 1 x MFU 1 x Orthopaedic OPD 3 x Podiatry 3 x Pain Management 2 x Continence 2 x MCAS 2 x awaiting location confirmation 1 x Psychology

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