Zonal Nursing at the Ayr Clinic
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Transcript of Zonal Nursing at the Ayr Clinic
Zonal Nursing at the Ayr Clinic
Hugh Hill & James DalrympleMovember 2012
Introduction
• Meaningful involvement• Effective and evidence based practice• Embedding and delivering a recovery model• Busy, active and engaging wards• Person centred care• Getting the balance right between safety and
freedoms
The Impact of Enhanced Observations
• Up to 6 patients 1:1 or 2:1• Increased stress levels• Motivation levels reduced• General lack of hope• Similar experiences of mental health settings they had
been in before
The Teams Mission?
• To explore viable alternatives to traditional observation methods
• To examine related research and good practice articles and visited other hospitals that were operating alternative engagement strategies
• To develop a proposal and project plan • To consult and develop a new system• To work with patient and the MDT to find a better
way for patients and staff.
What is Zonal Nursing?
• Staff are allocated to specified zoned areas in the ward rather being assigned to an individual patient
• Via an established ‘Zoning’ system patients are allocated an individual risk assessment
• Patients can move between areas and be monitored discretely
• A security nurse and floor walker manage and monitor the zones
Changing Culture
• Improving communication at every level on the ward• Testing trust and confidence in each other and teams• Ownership and commitment to the process• Putting patients front and centre• Flexibility in roles and approaches• Getting the patients to work with us• Supervision and support
After 10 months?
• The environment is less restrictive• It is conducive with delivering better therapeutic
intervention• Activity has increased allowing staff to develop
protected time and introduce structured programmes for people in the ward
• Culture of positive risk taking • Supporting recovery
Specialing
Less is more?
• Staffing numbers• Supervision• Morale• Meaningful week – 25 hours minimum• Therapeutic environment• Greater freedoms, responsibility and options• Incidents• Fun
What next?
• RCN and MWC Nominations• Presenting the work – articles, workshops, posters• Full evaluation – February 2013• Extend across the hospital• Share practice – (Thanks to Dykebar and Leverndale)
Conclusion
• Drivers for change• Evidence base• Ownership at team level• Involving patients• Substantial improvements in ward experience• Substantial improvements in nursing opportunities• A positive step for change.
References: • STEEL, M., 2012. Breaking with tradition. Activate, 6(10), pp. 5
• CARR, P., 2012. Using Zonal Nursing to Engage Women in a Medium Secure
Setting. Mental Health Practice, 15(7), pp. 14-20
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Movember – changing the face of men’s health