#WeNurses - Thursday 13th September 2018 8pm (GMT Standard Time) In the name of safety?

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This chat is guest hosted by @DrGillianJanes

In the name of safety? – identifying and letting go of low value safety practices


There is a tendency in the NHS to add more initiatives, protocols and interventions in an attempt to make care safer. Not only does this require more of already time-pressured staff but such processes and practices are not always evidence based or proven to actually enhance safety despite becoming embedded within the team and organisational culture.

Work is underway to actively discourage the use of ineffective or harmful clinical treatments and practices. However we need to do likewise with non-clinical safety practices, rules and procedures that do not necessarily improve safety or no longer add value if we are to build a safer healthcare system, improve the process of care and reduce costs.

With no common language for this approach of stopping low value safety practice, over 40 terms have been used to describe it, including: de-implementation, disinvestment, de-commissioning and mindful forgetting approach (Coiera, 2017). However, developing and embedding the principles of this approach in organisations could help create the space and time needed for frontline staff to deliver safer, patient-centred care. Research indicates that a conscious decision-making process is needed for individuals to let go of low-value safety practices and therefore concerted effort may be required to achieve this in practice.

We are researchers from @YH_PSTRC seeking to facilitate and investigate the impact of stopping low value safety practices in the NHS as a means of enhancing patient safety. We are keen to discuss some of the following areas with NHS clinicians and other staff during this session:


  1. What is it about this topic that made you want to join the TweetChat? 
  2. What’s good/not so good about terms like: low-value, de-implementation, disinvestment, de-commissioning, mindful forgetting etc used to describe this topic?
  3. How might we engage other staff to submit ideas and get involved?
  4. Themes emerging from some of our early responses eg. Duplication, ‘one size fits all’ KPIs, and approach to risk assessments


More background information / wider reading on this topic can be found at: http://yhpstrc.org/2018/03/02/in-the-name-of-safety/      



Reference

Coiera E (2017)The forgetting health system Learn Health Sys. 2017;1:e10023.p1-6 https://doi.org/10.1002/lrh2.10023


About our guest host

Gillian Janes is a Senior Research Fellow in the recently established NIHR Yorkshire & Humber Patient Safety Translational Research Centre (http://www.yhpstrc.org), working primarily on the workforce engagement and wellbeing theme. She is a Registered General Nurse with over 35 years’ experience as a clinician, service manager, healthcare educator and researcher encompassing acute and renal medicine, General Practice, Public Health and Higher Education. She has provided quality improvement and Higher Education consultancy for the NHS Institute for Innovation and Improvement, private, social enterprise, Higher Education and NHS organisations and was a member of the National Reference Group for Service Improvement. She has developed applied quality, safety and governance leadership programmes, including a nationally recognised Postgraduate Certificate in Human Factors in Health and Social Care. Gillian is a Senior Fellow of the Higher Education Academy, past Fellow of the Centre for Excellence in Teaching and Learning in the Health Professions (CETL4HealthNE) and member of the NHS England/Health Foundation Q Founding Cohort. She has strategic change experience as a member of Primary Care Trust, University and Academic Health Sciences Network/Patient Safety Collaborative/Q/HealthEducation England North East executive steering groups. Her PhD explored the Silences inherent in patient recovery experiences and role of social and professional norms in this. 





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QUESTION 3 (QUESTION 2 WAS MISSED!)


QUESTION 4


QUESTION 5


QUESTION 6 - the final question was a poll tweet, here are the results:





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 #WeNurses transcript

 
@WeNurses
13 September 2018 20:00
Hello and good evening and welcome to #WeNurses Please send us a tweet to say "HI" if you are joining us for the… https://twitter.com/i/web/status/1040314212130713601
@YH_PSTRC
13 September 2018 20:00
RT @WeNurses: Hello and good evening and welcome to #WeNurses Please send us a tweet to say "HI" if you are joining us for the next hour…
@LawtonRebecca
13 September 2018 20:00
#wenurses looking forward to hearing your thoughts this evening @YH_PSTRC
@Lau_Proc
13 September 2018 20:01
Hello I'm joining #WeNurses
@Gemma_Louch
13 September 2018 20:01
@WeNurses HI #WeNurses
@JFr4ser
13 September 2018 20:01
@WeNurses Hello #wenurses
@averil_adams
13 September 2018 20:01
@WeNurses Hello, Averil here from Mansfield #WeNurses ??
@janekohara
13 September 2018 20:01
@WeNurses #wenurses Hello! I am here tonight ??
@WeNurses
13 September 2018 20:02
Tonights #WeNurses is: In the name of safety ? And is being led by @DrGillianJanes ... Welcome Gillian and over to you :D
@AgencyNurse
13 September 2018 20:02
Hello Teresa here - ready to talk safety #WeNurses
@Gemma_Louch
13 September 2018 20:02
@WeNurses Hello Gemma here from @YH_PSTRC and @yqsrdotorg #wenurses :)
@DrGillianJanes
13 September 2018 20:02
Hello everyone. Thanks to #WeNurses & @YH_PSTRC team tonight @LawtonRebecca @janekohara @abialbutt @CarolineReyno15… https://twitter.com/i/web/status/1040314920196337664
@DrGillianJanes
13 September 2018 20:03
Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses… https://twitter.com/i/web/status/1040315015826423809
@WeNurses
13 September 2018 20:03
Hello and welcome - and thanks for the useful link #WeNurses
@yqsrdotorg
13 September 2018 20:03
RT @WeNurses: Tonights #WeNurses is: In the name of safety ? And is being led by @DrGillianJanes ... Welcome Gillian and over to you :D
@Pollybird1
13 September 2018 20:03
Hi ??#WeNurses
@YH_PSTRC
13 September 2018 20:03
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@miss_ellen_m
13 September 2018 20:04
@WeNurses Hi also joining tonight #wenurses
@WeNurses
13 September 2018 20:04
QUESTION 1 is here ... great question #WeNurses
@AgencyNurse
13 September 2018 20:04
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@JaclynC_7
13 September 2018 20:04
RT @WeNurses: **Staring in 1/2 an hour** In the name of safety? #WeNurses Background read here > https://t.co/Z5HXxH4DCr Join in fro…
@faebeth
13 September 2018 20:04
@CarolineReyno15 @YH_PSTRC Hi #WeNurses
@yqsrdotorg
13 September 2018 20:04
RT @WeNurses: QUESTION 1 is here ... great question #WeNurses https://t.co/WgNgGFTdbU
@steve_grimbleby
13 September 2018 20:04
@WeNurses Steve from Reading. ?? #WENURSES
@yqsrdotorg
13 September 2018 20:04
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@yqsrdotorg
13 September 2018 20:04
RT @DrGillianJanes: Hello everyone. Thanks to #WeNurses & @YH_PSTRC team tonight @LawtonRebecca @janekohara @abialbutt @CarolineReyno15 @La…
@WeDistrictNurse
13 September 2018 20:04
RT @WeNurses: QUESTION 1 is here ... great question #WeNurses https://t.co/WgNgGFTdbU
@WeCYPnurses
13 September 2018 20:05
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@janekohara
13 September 2018 20:05
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@averil_adams
13 September 2018 20:05
@DrGillianJanes Important to differentiate between patient safety & tick boxes #WeNurses
@AgencyNurse
13 September 2018 20:05
RT @WeNurses: QUESTION 1 is here ... great question #WeNurses https://t.co/WgNgGFTdbU
@Gemma_Louch
13 September 2018 20:06
RT @WeNurses: QUESTION 1 is here ... great question #WeNurses https://t.co/WgNgGFTdbU
@WeNurses
13 September 2018 20:06
Excellent point ... so what is the difference ?? What should we look out for ?? #WeNurses
@averil_adams
13 September 2018 20:06
@WeNurses Also important to allow patients to take risks #WeNurses
@yqsrdotorg
13 September 2018 20:07
RT @WeNurses: Excellent point ... so what is the difference ?? What should we look out for ?? #WeNurses https://twitter.com/averil_adams/status/1040315607948906497
@Pollybird1
13 September 2018 20:08
@DrGillianJanes Depends what the ‘extra’ is? Patient/resident care first #prioritising #delegation #WeNurses
@WeNurses
13 September 2018 20:08
#WeNurses
@WeNurses
13 September 2018 20:08
Excellent point #WeNurses
@NRCUK
13 September 2018 20:08
@averil_adams @DrGillianJanes any top tips on that? #wenurses
@receivingconsnt
13 September 2018 20:09
@WeNurses Oh gosh I’ve done it again ??#forgotthehashtag #wenurses
@LawtonRebecca
13 September 2018 20:09
#WeNurses interesting point @averil_adams what kind of risks do you think we stop patients from taking?
@faebeth
13 September 2018 20:09
@WeNurses Anything you do should be evidence based and for a reason #WeNurses
@JFr4ser
13 September 2018 20:10
@averil_adams @WeNurses Is that a thing? Documenting a negative. As a just in case? #wenurses
@sarah_janemad
13 September 2018 20:10
@rachh343 @LisaABarbier @Handover_Nurse @jogroves_nhs @jennyh1811 - #WeNurses chat tonight !!!! ????
@sarah_janemad
13 September 2018 20:10
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@sarah_janemad
13 September 2018 20:10
RT @WeNurses: **Staring in 1/2 an hour** In the name of safety? #WeNurses Background read here > https://buff.ly/2PkEMe7 Join in fro…
@averil_adams
13 September 2018 20:10
@JFr4ser @WeNurses Seems to be where I'm working now...... #WeNurses
@WeNurses
13 September 2018 20:10
@BGlickstein WELCOME Barbara! If click on #Wenurses and add #wenurses to your tweets everybody will see and enjoy your contribution :)
@janekohara
13 September 2018 20:10
@JFr4ser @DrGillianJanes Is this just about values? Or knowledge too? #wenurses
@AgencyNurse
13 September 2018 20:11
I like this point #WeNurses
@averil_adams
13 September 2018 20:11
@JFr4ser @WeNurses But I can't bring myself to do it #wasteoftime #WeNurses
@sarah_janemad
13 September 2018 20:11
@WeNurses Hi #WeNurses - In background - apologies if being a bit late ?? great toooc for a chat btw https://t.co/bjGIO0SJpT
@WeNurses
13 September 2018 20:11
RT @JFr4ser: @averil_adams @WeNurses Is that a thing? Documenting a negative. As a just in case? #wenurses
@SusanMcgavock
13 September 2018 20:11
@WeNurses Hi #wenurses
@WeNurses
13 September 2018 20:11
RT @faebeth: @WeNurses Anything you do should be evidence based and for a reason #WeNurses
@CIMARebecca
13 September 2018 20:11
@WeNurses Just passing by and noticed your beautiful blue bird! Gorgeous! #wenurses
@averil_adams
13 September 2018 20:11
@LawtonRebecca Deterring them from going home if high risk of falls #WeNurses
@WeNurses
13 September 2018 20:12
#WeNurses
@JFr4ser
13 September 2018 20:12
@janekohara @DrGillianJanes I’d hope they influence each other #wenurses
@AgencyNurse
13 September 2018 20:12
Arrrgggghh yes !! #WeNurses
@WeNurses
13 September 2018 20:12
#Wenurses
@WeNurses
13 September 2018 20:12
@sarah_janemad thanks for saying hi :) enjoy lurking or participating, both add value :) #wenurses
@AgencyNurse
13 September 2018 20:13
@averil_adams @JFr4ser @WeNurses I have seen it too .... it's very frustrating to have to document things that DON'T happen !! #WeNurses
@WeNurses
13 September 2018 20:13
What do others think ?? #WeNurses
@JFr4ser
13 September 2018 20:13
@averil_adams @WeNurses I’d be the same ??? #wenurses
@AgencyNurse
13 September 2018 20:14
Great question - and one we should continually ask ourselves #WeNurses
@SusanMcgavock
13 September 2018 20:15
@DrGillianJanes Stop to think is it really necessary- prioritise safe practice - too much to do is in itself unsafe #wenurses
@WeMidwives
13 September 2018 20:15
Midwives - what do you think ?? #WeNurses
@yqsrdotorg
13 September 2018 20:15
RT @WeNurses: What do others think ?? #WeNurses https://twitter.com/JFr4ser/status/1040317080275509251
@WeAHPs
13 September 2018 20:15
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@WeMHNurses
13 September 2018 20:15
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@WeNurses
13 September 2018 20:15
Just tuning in to tonight's #wenurses ? HI :) Don't forget to add #wenurses to your tweets And to see the chat, si… https://twitter.com/i/web/status/1040318164125528064
@averil_adams
13 September 2018 20:16
@AgencyNurse Such as cleaning the skin before IM injection #WeNurses
@WeNurses
13 September 2018 20:16
@WeMidwives hello lovely Midwives :) do come and join in to #wenurses where everybody adds value!
@RuthMBaxter
13 September 2018 20:17
@AgencyNurse @averil_adams @JFr4ser @WeNurses #WeNurses i can well imagine!!! Is it just falls or are there other n… https://twitter.com/i/web/status/1040318590262620161
@janekohara
13 September 2018 20:17
@DrGillianJanes Did I miss a question! Goes so fast! #wenurses
@LawtonRebecca
13 September 2018 20:17
#WeNurses deadoption is another term used
@RuthMBaxter
13 September 2018 20:17
RT @WeNurses: What do others think ?? #WeNurses https://twitter.com/JFr4ser/status/1040317080275509251
@AgencyNurse
13 September 2018 20:19
@RuthMBaxter @averil_adams @JFr4ser @WeNurses I have mostly seen it with falls #Wenurses
@nursemaiden
13 September 2018 20:19
Hello Sally here from Bristol late to conversation sorry! #WeNurses
@CarolineReyno15
13 September 2018 20:19
@Lau_Proc @WeNurses I think a lot of staff would agree with you #WeNurses
@averil_adams
13 September 2018 20:19
@RuthMBaxter @AgencyNurse @JFr4ser @WeNurses I don't think so...... #WeNurses but as you say why stop at no falls?
@Lau_Proc
13 September 2018 20:19
I like the term de-cluttering as it implies there's too much of something and a need to get rid. #wenurses
@janekohara
13 September 2018 20:20
@JFr4ser @DrGillianJanes Indeed - I can imagine. In terms then of stopping things, would this work the other way around? #wenurses
@JFr4ser
13 September 2018 20:20
@receivingconsnt And yet staff staffing to do it well seems not to be held to the same standard? #wenurses
@WeNurses
13 September 2018 20:20
@nursemaiden Hello Sally, anybody on time in Bristol must have a helicopter these days :) thanks for joining #wenurses
@jamesfm55
13 September 2018 20:20
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@SusanMcgavock
13 September 2018 20:21
@DrGillianJanes #wenurses great terms are relevant, accurate and safe
@DrGillianJanes
13 September 2018 20:21
@averil_adams Piece by @EnricoCoiera really struck me - ‘the forgetting health system’ - will put up link when I can #WeNurses
@fechter_k
13 September 2018 20:21
RT @DrGillianJanes: Looking forward to lively discussion about stopping low value, non clinical safety practices #WeNurses…
@BrooksCarole
13 September 2018 20:21
@DrGillianJanes #wenurses I like the simple term of de-cluttering and #tidyfriday which is my favorite :)
@averil_adams
13 September 2018 20:22
@DrGillianJanes @EnricoCoiera Sounds fascinating #WeNurses
@SusanMcgavock
13 September 2018 20:22
@DrGillianJanes Decscribing what we do want rather than what we don’t #wenurses
@WeNurses
13 September 2018 20:23
Really interesting question for QUESTION 4 #Wenurses
@AgencyNurse
13 September 2018 20:24
Here here !!! #WeNurses https://t.co/GaaX62yblJ
@AgencyNurse
13 September 2018 20:24
THIS #WeNurses
@JFr4ser
13 September 2018 20:24
RT @Lau_Proc: I like the term de-cluttering as it implies there's too much of something and a need to get rid. #wenurses
@averil_adams
13 September 2018 20:24
@JFr4ser @AgencyNurse @WeNurses Often see nurses writing meaningless statements but not referring to the 1 thing that matters! #WeNurses
@LawtonRebecca
13 September 2018 20:24
#WeNurses I like the following from a paper on stopping doing things - we mourn losses more than we celebrate gains… https://twitter.com/i/web/status/1040320421437087751
@NRCUK
13 September 2018 20:25
RT @AgencyNurse: THIS #WeNurses https://twitter.com/averil_adams/status/1040320169992757248
@DrGillianJanes
13 September 2018 20:25
@AgencyNurse Agreed - some argue more difficult than spreading innovation whixh is difficult enough #WeNurses
@AgencyNurse
13 September 2018 20:25
@faebeth yes indeed - it takes a courageous practitioner to question if it's needed and to stop #WeNurses
@CarolineReyno15
13 September 2018 20:25
@AgencyNurse Agree, I think there is a worry about the consequences of stopping something even if it doesn't add value #WeNurses
@sarah_janemad
13 September 2018 20:25
RT @LawtonRebecca: #WeNurses I like the following from a paper on stopping doing things - we mourn losses more than we celebrate gains. If…
@janekohara
13 September 2018 20:25
RT @LawtonRebecca: #WeNurses I like the following from a paper on stopping doing things - we mourn losses more than we celebrate gains. If…
@averil_adams
13 September 2018 20:26
@nursemaiden Absolutely. That's when you need relevant and concise information rather than statements about what hasn't happened #WeNurses
@YH_PSTRC
13 September 2018 20:26
RT @LawtonRebecca: #WeNurses I like the following from a paper on stopping doing things - we mourn losses more than we celebrate gains. If…
@NRCUK
13 September 2018 20:26
@LawtonRebecca this is the tweet that just keeps on giving, 3 1/2 years old now :) #WeNurses https://t.co/k8mBd7vUzj
@averil_adams
13 September 2018 20:26
@DrGillianJanes An illustration of how much nursing time has been freed up would be good #WeNurses
@AgencyNurse
13 September 2018 20:28
@DrGillianJanes eek !! #WeNurses
@JFr4ser
13 September 2018 20:28
@DrGillianJanes Hierarchical support #wenurses
@sarah_janemad
13 September 2018 20:28
RT @NRCUK: @LawtonRebecca this is the tweet that just keeps on giving, 3 1/2 years old now :) #WeNurses https://t.co/k8mBd7vUzj
@Lau_Proc
13 September 2018 20:28
https://t.co/l6spybFTd9 Also worth checking out this video on achieving behaviour change #wenurses
@WeNurses
13 September 2018 20:28
Fab thanks for sharing #WeNurses https://t.co/j1tRFYUnBB
@WeNurses
13 September 2018 20:29
Another great link #WeNurses https://t.co/n2jxcGgKyi
@yqsrdotorg
13 September 2018 20:29
RT @Lau_Proc: https://t.co/l6spybFTd9 Also worth checking out this video on achieving behaviour change #wenurses
@AgencyNurse
13 September 2018 20:29
Bingo !!! Yep agree ... the support has to be there #WeNurses
@AgencyNurse
13 September 2018 20:30
That makes sense - #Wenurses
@YH_PSTRC
13 September 2018 20:30
RT @Lau_Proc: https://youtu.be/4OEK6pxDOPc Also worth checking out this video on achieving behaviour change #wenurses
@JFr4ser
13 September 2018 20:30
@CarolineReyno15 @AgencyNurse Plus often little consensus. People can feel like they are mavericks rather than safe clinicians #wenurses
@LawtonRebecca
13 September 2018 20:30
A few people in our survey have suggested care plans should go #wenurses https://t.co/PtxCd2iZ79
@AgencyNurse
13 September 2018 20:31
Yes it's hard to be that lone voice #WeNurses https://t.co/FNyjazcRCB
@RuthMBaxter
13 September 2018 20:31
RT @NRCUK: @LawtonRebecca this is the tweet that just keeps on giving, 3 1/2 years old now :) #WeNurses https://twitter.com/NRCUK/status/566144736462139392
@WeNurses
13 September 2018 20:31
ooooohhhh ... thoughts ?? #WeNurses
@yqsrdotorg
13 September 2018 20:31
RT @LawtonRebecca: A few people in our survey have suggested care plans should go #wenurses https://twitter.com/JFr4ser/status/1040321200784912385
@WeNurses
13 September 2018 20:31
@LawtonRebecca To be replaced with? #wenurses
@AgencyNurse
13 September 2018 20:31
@LawtonRebecca wow that sounds like a tweetchat all on it's own ! What's their rationale ?? #Wenurses
@WeNurses
13 September 2018 20:32
RT @AgencyNurse: @LawtonRebecca wow that sounds like a tweetchat all on it's own ! What's their rationale ?? #Wenurses
@WeNurses
13 September 2018 20:32
QUESTION 5 #WeNurses
@faebeth
13 September 2018 20:32
@LawtonRebecca Maybe these care plans need to be updated? #WeNurses
@janekohara
13 September 2018 20:32
@NRCUK @averil_adams @DrGillianJanes Now that would be the holy grail @NRCUK! #wenurses
@sarah_janemad
13 September 2018 20:33
@Gemma_Louch Awesome ! Bookmarked did later ???? #WeNurses
@WeNurses
13 September 2018 20:34
Interesting question here #WeNurses
@JFr4ser
13 September 2018 20:34
@nursemaiden I think statement was meant in a what was document at the time, no? #wenurses
@sarah_janemad
13 September 2018 20:35
@Gemma_Louch @averil_adams @DrGillianJanes @EnricoCoiera Awesome ! Bookmarked for later ???? #WeNurses
@AgencyNurse
13 September 2018 20:35
very true - careplans are useless if they are not used #WeNurses
@RuthMBaxter
13 September 2018 20:36
@JFr4ser @nursemaiden #wenurses I’m interested in your thoughts on care plans! What do you find frustrating about t… https://twitter.com/i/web/status/1040323300587724802
@janekohara
13 September 2018 20:36
@JFr4ser @DrGillianJanes Yes, indeed. This often happens after being involved in adverse events too I guess? #wenurses
@Lau_Proc
13 September 2018 20:37
Do people have forums in the workplace to discuss the removal of these low value practices or does it happen "off record"? #wenurses
@nursemaiden
13 September 2018 20:37
RT @RuthMBaxter: @JFr4ser @nursemaiden #wenurses I’m interested in your thoughts on care plans! What do you find frustrating about them? (I…
@averil_adams
13 September 2018 20:38
@faebeth @DrGillianJanes @LawtonRebecca It's policy in many places now because research showed it actually led to less errors #WeNurses
@WeNurses
13 September 2018 20:38
Fab link thanks Gillian #WeNurses
@WeMidwives
13 September 2018 20:39
RT @WeNurses: Fab link thanks Gillian #WeNurses https://t.co/gUOgJWpNsh
@WeMidwives
13 September 2018 20:39
Great question #WeNurses
@RuthMBaxter
13 September 2018 20:39
RT @WeNurses: Interesting question here #WeNurses https://twitter.com/CarolineReyno15/status/1040322588923387905
@faebeth
13 September 2018 20:40
@averil_adams @DrGillianJanes @LawtonRebecca Interesting, I was lead to believe the opposite. A good point for discussion. #WeNurses
@DrGillianJanes
13 September 2018 20:40
@faebeth @averil_adams @LawtonRebecca Agree difficult issues but some evidence single helping medications can also be safer #WeNurses
@AgencyNurse
13 September 2018 20:40
Nice idea #WeNurses
@receivingconsnt
13 September 2018 20:41
@Lau_Proc @janekohara Hmm not sure good question... ?? #wenurses
@JFr4ser
13 September 2018 20:41
@WeNurses Yes, travelling against the tide is not easy #wenurses
@yqsrdotorg
13 September 2018 20:41
RT @AgencyNurse: Nice idea #WeNurses https://t.co/i11TneduGl
@Lau_Proc
13 September 2018 20:41
I think not being listened to or expectations of not being listened to help low value practices to thrive #wenurses
@JFr4ser
13 September 2018 20:41
@NRCUK @janekohara @averil_adams @DrGillianJanes Ah you know what they say about common sense.... #wenurses
@DrGillianJanes
13 September 2018 20:42
How might some of the barriers to stopping be overcome? what might help I wonder....#WeNurses
@JFr4ser
13 September 2018 20:42
This. A million times this! #wenurses
@LawtonRebecca
13 September 2018 20:42
#WeNurses some interesting discussion about double checking. Evidence of benefit not strong and some studies have f… https://twitter.com/i/web/status/1040324852199157760
@averil_adams
13 September 2018 20:42
@AgencyNurse @faebeth @DrGillianJanes @LawtonRebecca Good point! #WeNurses
@yqsrdotorg
13 September 2018 20:42
RT @DrGillianJanes: How might some of the barriers to stopping be overcome? what might help I wonder....#WeNurses
@NRCUK
13 September 2018 20:42
@JFr4ser @janekohara @averil_adams @DrGillianJanes They, have a lot to answer for :) #wenurses
@WeNurses
13 September 2018 20:43
RT @LawtonRebecca: #WeNurses some interesting discussion about double checking. Evidence of benefit not strong and some studies have found…
@WeNurses
13 September 2018 20:43
Interesting stuff #WeNurses
@Gemma_Louch
13 September 2018 20:44
RT @DrGillianJanes: How might some of the barriers to stopping be overcome? what might help I wonder....#WeNurses
@yqsrdotorg
13 September 2018 20:44
RT @WeNurses: Interesting stuff #WeNurses https://twitter.com/LawtonRebecca/status/1040324852199157760
@WeNurses
13 September 2018 20:44
What does everyone think ? #WeNurses
@WeMidwives
13 September 2018 20:44
RT @DrGillianJanes: How might some of the barriers to stopping be overcome? what might help I wonder....#WeNurses
@WeAHPs
13 September 2018 20:44
RT @DrGillianJanes: How might some of the barriers to stopping be overcome? what might help I wonder....#WeNurses
@Jo3_NHS
13 September 2018 20:44
@Lau_Proc @WeNurses Where quality improvement initiatives are effectively implemented this should be part of it. #WeNurses
@janekohara
13 September 2018 20:45
RT @LawtonRebecca: #WeNurses some interesting discussion about double checking. Evidence of benefit not strong and some studies have found…
@sarah_janemad
13 September 2018 20:45
RT @LawtonRebecca: #WeNurses some interesting discussion about double checking. Evidence of benefit not strong and some studies have found…
@JFr4ser
13 September 2018 20:45
RT @Lau_Proc: I think not being listened to or expectations of not being listened to help low value practices to thrive #wenurses
@RuthMBaxter
13 September 2018 20:45
RT @Lau_Proc: I think not being listened to or expectations of not being listened to help low value practices to thrive #wenurses
@averil_adams
13 September 2018 20:46
@DrGillianJanes Yes! How many times has a patient said 'That's not my usual dose' #WeNurses
@DrCarolPercy
13 September 2018 20:46
RT @WeNurses: Fab link thanks Gillian #WeNurses https://twitter.com/DrGillianJanes/status/1040323544775909376
@WeNurses
13 September 2018 20:46
This sounds like an action for tomorrow #Wenurses
@sarah_janemad
13 September 2018 20:46
@JFr4ser @faebeth @averil_adams @DrGillianJanes @LawtonRebecca https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063127/ #WeNurses
@LawtonRebecca
13 September 2018 20:47
@DrGillianJanes #WeNurses Definitely need to overcome worry and feelings of anticipated regret - if I stop doing i… https://twitter.com/i/web/status/1040326076604579841
@averil_adams
13 September 2018 20:47
@sarah_janemad @JFr4ser @faebeth @DrGillianJanes @LawtonRebecca Great thanks ?? #WeNurses
@janekohara
13 September 2018 20:47
RT @sarah_janemad: @JFr4ser @faebeth @averil_adams @DrGillianJanes @LawtonRebecca https://t.co/aEC3unFniF #WeNurses
@DrGillianJanes
13 September 2018 20:48
Great thanks for sharing ?? #WeNurses https://t.co/pB5MSXOP3j
@AgencyNurse
13 September 2018 20:48
I think it's all about people - support, encouragement, listening ... having a forum for discussion #WeNurses
@faebeth
13 September 2018 20:48
@sarah_janemad @JFr4ser @averil_adams @DrGillianJanes @LawtonRebecca I will have a look at this #WeNurses
@WeNurses
13 September 2018 20:48
RT @DrGillianJanes: Great thanks for sharing ?? #WeNurses https://twitter.com/sarah_janemad/status/1040325978629844992
@janekohara
13 September 2018 20:48
@Lau_Proc Like your style, @Lau_Proc ?? #wenurses
@averil_adams
13 September 2018 20:48
RT @sarah_janemad: @JFr4ser @faebeth @averil_adams @DrGillianJanes @LawtonRebecca https://t.co/aEC3unFniF #WeNurses
@WeNurses
13 September 2018 20:49
Good point #Wenurses https://t.co/rArG7lHTsL
@Lau_Proc
13 September 2018 20:49
@janekohara Thank you :) #wenurses
@WeNurses
13 September 2018 20:49
Lots of great links being shared this evening - ere's another #WeNurses
@LawtonRebecca
13 September 2018 20:49
#WeNurses could patients help us to stop doing things that don't make care safer?
@WeNurses
13 September 2018 20:49
RT @DrGillianJanes: Agreed but also need right team-org culture to support/drive such change in attitude - give confidence to try #WeNurses…
@JFr4ser
13 September 2018 20:50
@WeNurses Awwww @wenurses always build people up with little rewards! It’s like a virtual pat on the back ?? #wenurses
@WeNurses
13 September 2018 20:50
What do we think folks ? #WeNurses
@RuthMBaxter
13 September 2018 20:50
RT @LawtonRebecca: #WeNurses could patients help us to stop doing things that don't make care safer?
@David_ukan
13 September 2018 20:51
RT @averil_adams: @DrGillianJanes Important to differentiate between patient safety & tick boxes #WeNurses
@averil_adams
13 September 2018 20:51
@mary_titchener @AgencyNurse I often write care plans but rarely read them #WeNurses
@Gemma_Louch
13 September 2018 20:51
RT @WeNurses: What do we think folks ? #WeNurses https://twitter.com/LawtonRebecca/status/1040326705917960193
@sarah_janemad
13 September 2018 20:51
@AgencyNurse @janekohara @LawtonRebecca @RuthMBaxter @NatashaHardicre Only in the NHS ?? #WeNurses. This sort of thi… https://twitter.com/i/web/status/1040327228045897734
@YH_PSTRC
13 September 2018 20:52
RT @sarah_janemad: @JFr4ser @faebeth @averil_adams @DrGillianJanes @LawtonRebecca https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063127/ #WeNurses
@janekohara
13 September 2018 20:52
Now that is my kind of question....! ?? #wenurses @jamesfm55 any thoughts?
@WeNurses
13 September 2018 20:53
RT @janekohara: Now that is my kind of question....! ?? #wenurses @jamesfm55 any thoughts? https://twitter.com/LawtonRebecca/status/1040326705917960193
@faebeth
13 September 2018 20:54
@WeNurses Good idea #WeNurses
@sarah_janemad
13 September 2018 20:54
RT @WeNurses: What do we think folks ? #WeNurses https://twitter.com/LawtonRebecca/status/1040326705917960193
@averil_adams
13 September 2018 20:54
@janekohara @jamesfm55 They could, but onus shouldn't be on them. You're so vulnerable as a patient #WeNurses
@JFr4ser
13 September 2018 20:54
@LawtonRebecca Feedback from patients and caters can help here. Personal experience recently of this. Listening organisation and care habit stopped #wenurses
@WeNurses
13 September 2018 20:54
Just 7 minutes left of tonights #WeNurses Perhaps a good time to share what you will do as a result of this tweetchat ? https://t.co/cMFhEJfBu1
@mary_titchener
13 September 2018 20:54
@averil_adams @AgencyNurse Definitely something that I hear, also “I write care plans but no one else reads them!” #wenurses
@Lau_Proc
13 September 2018 20:55
We'd definitely get an honest answer #wenurses https://twitter.com/janekohara/status/1040327392164753408
@yqsrdotorg
13 September 2018 20:55
RT @WeNurses: Just 7 minutes left of tonights #WeNurses Perhaps a good time to share what you will do as a result of this tweetchat ? htt…
@WeDistrictNurse
13 September 2018 20:55
RT @WeNurses: Just 7 minutes left of tonights #WeNurses Perhaps a good time to share what you will do as a result of this tweetchat ? htt…
@And0142
13 September 2018 20:55
RT @WeNurses: Lots of great links being shared this evening - ere's another #WeNurses https://twitter.com/abialbutt/status/1040326483682754562
@LawtonRebecca
13 September 2018 20:55
great to get your views on this #WeNurses https://twitter.com/YH_PSTRC/status/1040326848989851649
@averil_adams
13 September 2018 20:56
@janekohara @RuthMBaxter @AgencyNurse @LawtonRebecca @NatashaHardicre When we started auditing them maybe? Used a a measure of quality and performance (but never audited to see link between CPs and patient outcomes #WeNurses
@janekohara
13 September 2018 20:56
RT @averil_adams: @mary_titchener @AgencyNurse I often write care plans but rarely read them #WeNurses
@AgencyNurse
13 September 2018 20:56
I'm going to look at when we can slot in #Wenurses discussions on care plans and double checking https://twitter.com/WeNurses/status/1040327956781047808
@JFr4ser
13 September 2018 20:56
@RuthMBaxter @AgencyNurse @janekohara @LawtonRebecca @NatashaHardicre Ours are preprinted and are ticked off depending on patient need. Most of the time it’s a once size fits all ie 4hrly obs. None of which actually ensured 4hrly obs are done much less accurate response to the finding #wenurses
@sarah_janemad
13 September 2018 20:57
RT @WeNurses: Just 7 minutes left of tonights #WeNurses Perhaps a good time to share what you will do as a result of this tweetchat ? htt…
@faebeth
13 September 2018 20:57
@WeNurses I will read the article on double checking and discuss this issue with some colleagues. But after having double checking drummed into me it makes me a little uncomfortable #WeNurses
@Pollybird1
13 September 2018 20:57
We are using electronic care plans @ErskineP2C to capture person centred care delivery. Care staff are actively involved to record live #capturethemoment the RN can then focus on #recording #essentials #wenurses
@janekohara
13 September 2018 20:57
@averil_adams @RuthMBaxter @AgencyNurse @LawtonRebecca @NatashaHardicre Ah - so maybe there the assumed link to quality and safety? Then get seen as a 'proxy' for good care, when they might actually get in the way of it? #wenurses
@AgencyNurse
13 September 2018 20:58
@RuthMBaxter @janekohara @LawtonRebecca @NatashaHardicre no access, they are developed at a desk and not with the person, no one reads them, they are not working documents .. often a tick box exercise #wenurses
@averil_adams
13 September 2018 20:58
@janekohara @RuthMBaxter @AgencyNurse @LawtonRebecca @NatashaHardicre Exactly! #WeNurses
@hshanawaniMD
13 September 2018 20:58
RT @LawtonRebecca: #WeNurses some interesting discussion about double checking. Evidence of benefit not strong and some studies have found…
@AgencyNurse
13 September 2018 20:58
Some wise words here #WeNurses https://twitter.com/janekohara/status/1040328693212688385
@Lau_Proc
13 September 2018 20:58
I would encourage everyone to continue these discussions, taking them into your workplace, raising the issue at meetings or simply over lunch, Don't be afraid to challenge culture #wenurses
@JFr4ser
13 September 2018 20:58
@LawtonRebecca Carers! Doh, autocorrect #wenurses
@WeNurses
13 September 2018 20:59
Something to do tomorrow ... let us know how it goes #Wenurses https://twitter.com/Lau_Proc/status/1040328976718331906
@janekohara
13 September 2018 20:59
@AgencyNurse Good to know I can be 'wise' at 9pm at night...! #wenurses
@Lau_Proc
13 September 2018 20:59
Now I can identify with that! I used to write out exercise care plans for an audience of one! #wenurses https://twitter.com/mary_titchener/status/1040328005019729920
@AgencyNurse
13 September 2018 21:00
@janekohara yep - in fact very wise ! #WeNurses
@JFr4ser
13 September 2018 21:00
@faebeth @WeNurses Embrace the liberty of professional autonomy... if only for that one wee task ?? #wenurses
@DrGillianJanes
13 September 2018 21:00
RT @LawtonRebecca: great to get your views on this #WeNurses https://twitter.com/YH_PSTRC/status/1040326848989851649
@EdSmyth85
13 September 2018 21:01
RT @LawtonRebecca: great to get your views on this #WeNurses https://twitter.com/YH_PSTRC/status/1040326848989851649
@WeNurses
13 September 2018 21:01
Wow what a tweetchat ... so many other things to now discuss !! Thank you so very much @DrGillianJanes and team - brilliant discussion #Wenurses https://t.co/rB8Mw0GNlJ
@averil_adams
13 September 2018 21:01
@JFr4ser @faebeth @WeNurses Yes good one! Me too ?? #WeNurses
@DrGillianJanes
13 September 2018 21:01
Can't believe that was an hour! Thanks for fab discussion and ideas. Do contribute your own ideas on which low value safety practices to stop here: https://www.surveymonkey.co.uk/r/7BWHW5H & encourage your colleagues too - closes Oct & we'll share updates at http://yhpstrc.org/ #WeNurses
@LawtonRebecca
13 September 2018 21:01
and keep in touch with us @YH_PSTRC about what you are doing 'In the name of safety' #WeNurses @Lau_Proc
@JFr4ser
13 September 2018 21:02
@Lau_Proc The organisation likes a care plan - let’s them believe that care was delivered even when all other evidence/recollection/documentation says otherwise #wenurses
@Jo3_NHS
13 September 2018 21:02
I always aim to minimise non value adding activity, increasing the amount of time available for focussing on safe and effective direct care, hopefully minimising avoidable harm. I'll persevere ?? #WeNurses https://twitter.com/WeNurses/status/1040327956781047808
@averil_adams
13 September 2018 21:02
@WeNurses @DrGillianJanes Great discussion thanks all ?? #WeNurses
@janekohara
13 September 2018 21:02
@RuthMBaxter @JFr4ser @AgencyNurse @LawtonRebecca @NatashaHardicre Oooh - bringing out the big guns there @RuthMBaxter ?? #wenurses
@WeNurses
13 September 2018 21:02
Tonights #WeNurses would be a fab one to reflect on for your CPD folks ... here is the link to MyWe for you > http://www.wecommunities.org/MyWe https://t.co/xcGmHwJUma
@Lau_Proc
13 September 2018 21:03
Thank you #wenurses
@WeNurses
13 September 2018 21:03
IMPORTANT LINK - please do contribute #WeNurses https://twitter.com/DrGillianJanes/status/1040329759597764608
@sarah_janemad
13 September 2018 21:03
@WeNurses @DrGillianJanes Brilliant !!!! One of the best #WeNurses chats yet ?????? thank you all !!!
@Lau_Proc
13 September 2018 21:03
RT @WeNurses: Tonights #WeNurses would be a fab one to reflect on for your CPD folks ... here is the link to MyWe for you > https://t.co/b6…
@janekohara
13 September 2018 21:03
#WeNurses Thanks for a great chat everyone. Really interesting! I am off to say goodnight to my daughter, and eat some tea...
@Pollybird1
13 September 2018 21:03
The detail in care plans should be like a prescription - if it is my care plan I would like #involved give me the care i need and respect my wishes #wenurses regardless of setting or age we all deserve to be #listened to
@yqsrdotorg
13 September 2018 21:03
RT @WeNurses: IMPORTANT LINK - please do contribute #WeNurses https://twitter.com/DrGillianJanes/status/1040329759597764608
@WeNurses
13 September 2018 21:04
@sarah_janemad @DrGillianJanes thanks for joining us #WeNurses
@yqsrdotorg
13 September 2018 21:04
RT @sarah_janemad: @WeNurses @DrGillianJanes Brilliant !!!! One of the best #WeNurses chats yet ?????? thank you all !!!
@DrGillianJanes
13 September 2018 21:04
RT @WeNurses: IMPORTANT LINK - please do contribute #WeNurses https://twitter.com/DrGillianJanes/status/1040329759597764608
@WeNurses
13 September 2018 21:04
@janekohara thanks for joining Jane and enjoy your tea #Wenurses
@WeAHPs
13 September 2018 21:04
RT @WeNurses: IMPORTANT LINK - please do contribute #WeNurses https://twitter.com/DrGillianJanes/status/1040329759597764608
@WeMidwives
13 September 2018 21:04
RT @WeNurses: IMPORTANT LINK - please do contribute #WeNurses https://twitter.com/DrGillianJanes/status/1040329759597764608
@JFr4ser
13 September 2018 21:04
Great chat. Went so quickly, could go on and on and on #wenurses
@WeLDnurses
13 September 2018 21:04
RT @WeNurses: IMPORTANT LINK - please do contribute #WeNurses https://twitter.com/DrGillianJanes/status/1040329759597764608
@WeGPNs
13 September 2018 21:04
RT @WeNurses: IMPORTANT LINK - please do contribute #WeNurses https://twitter.com/DrGillianJanes/status/1040329759597764608
@WeNurses
13 September 2018 21:05
@JFr4ser Thank you so much for taking part #Wenurses
@DrGillianJanes
13 September 2018 21:05
Oh wow thanks Sarah - great support from @AgencyNurse & this great community #WeNurses https://twitter.com/sarah_janemad/status/1040330190382092289
@RuthMBaxter
13 September 2018 21:05
Great idea! #WeNurses https://twitter.com/sarah_janemad/status/1040327645383348225
@averil_adams
13 September 2018 21:05
@Pollybird1 Yes! A meaningful care plan should be the nurses prescription, spot on #WeNurses
@Lau_Proc
13 September 2018 21:06
RT @DrGillianJanes: Oh wow thanks Sarah - great support from @AgencyNurse & this great community #WeNurses https://twitter.com/sarah_janemad/status/1040330190382092289
@RuthMBaxter
13 September 2018 21:06
RT @sarah_janemad: @WeNurses @DrGillianJanes Brilliant !!!! One of the best #WeNurses chats yet ?????? thank you all !!!
@AgencyNurse
13 September 2018 21:06
I like this #WeNurses https://twitter.com/averil_adams/status/1040330768281686016
@punc17kerrym
13 September 2018 21:08
RT @faebeth: @WeNurses Anything you do should be evidence based and for a reason #WeNurses
@Pollybird1
13 September 2018 21:22
Very quiet ?? tonight @dtbarron @weejenn38 @BeattieDougie was it the #sugar #overload ?? I’ve just spent a great hour with #WeNurses




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