#WeDNs - Tuesday 25th February 2020 8pm (GMT Standard Time)
Documentation and District Nursing
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You would be forgiven in thinking that as a mobile community NHS service in 2020,District Nurses (DN) across the UK would have access to digital technology in patients’ homes. Clearly, live access to integrated health and care records would support the delivery of complex nursing care in the home. However, the Queen’s Nursing Institute (QNI, 2018) report, ‘Nursing in the Digital Age’ found that 29% of community nurses surveyed were still working largely with paper-based systems,despite 74% citing that IT systems provided a more reliable way of working compared to paper. The QNI (2018) also found 67, ‘differently named IT systems being used in community healthcare. Recent comments @WeDistrictNurses (2019)has similarly revealed frustration and concern amongst District and Community Nurses over a lack of e-documentation in DN practise and, where there is access to electronic systems, evidence of poor integration with multi-disciplinary team records, examples of repeat documentation and patchy connectivity.
What is your experience of DN documentation systems and how does this effect the care you can give your patients?
Chat questions:
1. Do you use electronic documentation, paper-based documentation or a mixed economy?
2. Do you have to double document i.e. transcribe/copy from paper-based notes inpatients’ home to office-based electronic system[s]?
3. Do you have remote access to patients’ DN and/or medical notes when in their home& what difference does this make to your care?
4. If so, what electronic systems are you using & what are the issues with them(e.g. connectivity, workable design)?
5. Are your documentation systems integrated or shared and if so, with whom – patient, multidisciplinary team, Primary Care Network (in England), GP?
6. Who makes decisions in your Trust/Board around documentation development – both design of care plans (software) and also choice of system (hardware)? i.e. Are DNs involved in these decisions?
References& Suggested Reading:
Akhu-Zaheya.L, Al-Maaitah.R & Hani.S.B (2018)‘Quality of nursing documentation: Paper-based health records versus electronic-based health records’ Journal of Clinical Nursing Vol 27, Issue 3 – 4, Pgs e578 – e589[Online] Available at https://onlinelibrary-wiley-com.libezproxy.open.ac.uk/doi/full/10.1111/jocn.14097(Accessed 29/01/2020)
Department of Health (2013) National mobile health worker project: final report. Department of Health, London [Online] Available at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213313/mhwp_final_report.pdf(Accessed 25.03.15)
Queen’s Nursing Institute (2013) Smart New World Revised edition [Online]Available at https://www.qni.org.uk/wpcontent/uploads/2016/09/smart_new_world_2014.pdf(Accessed 29/01/2020)
Queen’s Nursing Institute (2018) Nursing in the Digital Age [Online] Available at https://www.qni.org.uk/wp-content/uploads/2018/04/Nursing-in-the-Digital-Age-.pdf(Accessed 29/01/2020)
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#WeDNs transcript
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@WeCommNurses
25 February 2020 20:00
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Evening all #WeDNs and welcome to the chat, Documentation and District Nursing. |
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@WeCommNurses
25 February 2020 20:00
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First things first, please don't forget to use #WeDNs on your tweets. |
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@HeatherBain9
25 February 2020 20:01
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RT @WeDistrictNurse: Evening all #WeDNs and welcome to the chat, Documentation and District Nursing. |
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@WeCommNurses
25 February 2020 20:01
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#WeDNs!! https://twitter.com/WeDistrictNurse/status/1232395142818095107 |
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@Helenakelly73
25 February 2020 20:01
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Good evening from Edinburgh #wedns ?? |
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@HeatherBain9
25 February 2020 20:02
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And hello from Aberdeen #WeDNs |
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@WeNurses
25 February 2020 20:02
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Starting now over on #WeDNs >> https://twitter.com/WeDistrictNurse/status/1232394845861433352 |
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@MarielyonsBrown
25 February 2020 20:02
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Hello from Glasgow #wedns |
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@WeCommNurses
25 February 2020 20:02
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As everyone gathers, our first question tonight is 1. Do you use electronic documentation, paper-based documentation or a mixed economy? #WeDNs |
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@KayreenMcKenna
25 February 2020 20:03
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@WeDistrictNurse Good evening! Looking forward to joining in my first #WeDNs chat :) |
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@WeCommNurses
25 February 2020 20:03
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#WeDNs Have we anyone from south of the border ?? https://twitter.com/marielyonsbrown/status/1232395473387999232 |
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@WeCommNurses
25 February 2020 20:04
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@mjosiris Welcome ?? #WeDNs |
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@NatalieDoyle10
25 February 2020 20:04
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@WeDistrictNurse I used mixed #WeDns |
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@VickiJNurse
25 February 2020 20:04
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@WeDistrictNurse Paper based but we have Malinko coming soon #WeNurses #WeDNs |
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@HeatherBain9
25 February 2020 20:04
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Interested in this response as from what students report community nursing has not embraced technology in some areas #wedns @NRCUK @TheQNI @QNI_Scotland https://twitter.com/wedistrictnurse/status/1232395486604275712 |
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@emmaloufrain
25 February 2020 20:04
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@WeDistrictNurse TAMESIDE and Glossop ???? - we use paper notes in the house and record activity/outcomes/kpis/visit schedules on electronic system. Roll out of paper lite is coming soon! #weDNs |
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@WeCommNurses
25 February 2020 20:05
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@KayreenMcKenna Brilliant ?? you're very welcome #WeDNs |
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@WeCommNurses
25 February 2020 20:05
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@KayreenMcKenna #WeDNs welcome, where are you from |
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@KirstinRobins17
25 February 2020 20:05
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Evening #WeDns no pancakes for me ?? Northamptonshire based here ?? we use Dells and do very little paper notes other than with Ivs and medication we use paper in the house and document on system one as well. |
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@CareHome_Nurse
25 February 2020 20:06
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@WeDistrictNurse Evening! I'm in Grantown-on-spey! And no pancakes for me lol #WeDns |
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@KayreenMcKenna
25 February 2020 20:06
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@WeDistrictNurse I’m in barrhead Glasgow, but I work over in the east end of Glasgow. #WeDNs |
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@WeCommNurses
25 February 2020 20:06
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@VickiJNurse Thanks Vicki - what is Malinko? #WeDNs |
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@tiddleschick1
25 February 2020 20:06
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@WeDistrictNurse #weDNs mixed in midlothian lots of duplication |
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@WeCommNurses
25 February 2020 20:06
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RT @NatalieDoyle10: @WeDistrictNurse I used mixed #WeDns |
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@HeatherBain9
25 February 2020 20:06
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#wedns can you tell us more about Malinko https://twitter.com/vickijnurse/status/1232396021361192967 |
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@VickiJNurse
25 February 2020 20:07
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@WeDistrictNurse South Wales.. #WeDNs |
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@WeCommNurses
25 February 2020 20:07
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@Silverangel882 #WeDNs Another Scot ?? |
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@WeCommNurses
25 February 2020 20:07
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#wedns https://twitter.com/mjosiris/status/1232396447699603457 |
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@WeCommNurses
25 February 2020 20:07
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Already quite a variety of documentation methods #WeDNs Our second Q is already relevant then: 2. Do you have to double document i.e. transcribe/copy from paper-based notes in patients’ home to office-based electronic system[s]? |
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@KayreenMcKenna
25 February 2020 20:08
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@WeDistrictNurse We use an online system for documentation, however we do have a significant conversations sheet among other bits of documentation kept within the patient’s own home. #wedns |
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@WeCommNurses
25 February 2020 20:09
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#WeDNs https://twitter.com/JulieClennell/status/1232396679992750087 |
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@KirstinRobins17
25 February 2020 20:10
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#WeDNs we do use a paper obs chart in the home to track a visual change so that’s duplicated in notes and on system one. Also meds are duplicated but we don’t write any other notes in the house. |
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@WeCommNurses
25 February 2020 20:10
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Hi @Silverangel882 What is Morse? #WeDNs https://twitter.com/Silverangel882/status/1232396807411523590 |
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@VickiJNurse
25 February 2020 20:10
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Yes we do it three times in patients home in office notes and on comcare (records our visits and times) #WeDNs |
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@WeCommNurses
25 February 2020 20:10
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#WeDNs Sounds interesting @VickiJNurse Might it make a difference? https://twitter.com/VickiJNurse/status/1232397020909973509 |
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@tiddleschick1
25 February 2020 20:11
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@WeDistrictNurse Relevant info that's pertinent for sharing should be duplicated, but worries over missing something results in all being duplicated. Or worse case not recorded anywhere #weDNs |
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@WeCommNurses
25 February 2020 20:11
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#wedns https://twitter.com/amd_barra/status/1232397546498281473 |
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@HeatherBain9
25 February 2020 20:11
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#wedns who else is provide with laptops or tablets from their employer https://twitter.com/julieclennell/status/1232396679992750087 |
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@WeCommNurses
25 February 2020 20:11
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#wedns https://twitter.com/kayreenmckenna/status/1232397534884225027 |
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@VickiJNurse
25 February 2020 20:11
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@WeDistrictNurse It's been trialled in other teams and they love it ....eventually!! #WeDNs |
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@WeCommNurses
25 February 2020 20:11
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Just a reminder, please use #WeDNs on your chat tweets - to helps us to hear & collate your views. Thank you ?? |
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@KirstinRobins17
25 February 2020 20:12
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RT @WeDistrictNurse: Five minutes to go - are you ready with your cuppa to get chatting #weDNs https://t.co/scKLG7FjX0 |
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@Lisaannet_
25 February 2020 20:12
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@WeDistrictNurse Paper notes and caseload on spreadsheet #weDNs |
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@mjosiris
25 February 2020 20:12
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@WeDistrictNurse My electronic notes are not as comprehensive as notes in our home notes unless it’s a clinical change or something pertinent that others need to know but there are elements of duplication #WeDNs |
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@WeCommNurses
25 February 2020 20:12
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#WeDNs https://twitter.com/Silverangel882/status/1232397696910135297 |
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@WeCommNurses
25 February 2020 20:13
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RT @VickiJNurse: @WeDistrictNurse It's been trialled in other teams and they love it ....eventually!! #WeDNs |
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@HeatherBain9
25 February 2020 20:13
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@VickiJNurse #wedns is that not frustrating Vikki? What is the solution ? |
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@VickiJNurse
25 February 2020 20:13
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@HeatherBain9 We had laptops now updating to ipads for Malinko #WeDNs |
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@WeCommNurses
25 February 2020 20:13
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Remember to use #wedns with your tweets guys |
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@HeatherBain9
25 February 2020 20:14
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#wedns can you tell us more about Morse Annie and remember the #weDNs in your response https://twitter.com/wedistrictnurse/status/1232397730540146695 |
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@NatalieDoyle10
25 February 2020 20:14
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@HeatherBain9 We had tablets now been upgraded to laptops in GGC #WeDns |
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@WeCommNurses
25 February 2020 20:15
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Sounds like a lot of us are having to duplicate documentation... #WeDNs Not good on lots of levels (professional, efficiency, safety, etc, etc). |
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@VickiJNurse
25 February 2020 20:15
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@HeatherBain9 Hopefully the new Malinko which is being rolled out will help #WeDNs |
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@WeCommNurses
25 February 2020 20:16
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RT @HeatherBain9: @VickiJNurse #wedns is that not frustrating Vikki? What is the solution ? |
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@CareHome_Nurse
25 February 2020 20:17
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@HeatherBain9 We have iPads at NHS Highland #wedns |
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@KirstinRobins17
25 February 2020 20:17
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@WeDistrictNurse #WeDNs I feel that things for my area have got progressively better at moving towards paper light! But also I think staff are reluctant sometimes to not write a load in the house so duplicate anyway sometimes? |
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@WeCommNurses
25 February 2020 20:17
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Some of you have already answered part of the third question: http://3.Do you have remote access to patients’ DN and/or medical notes when in their home... SO what difference does this make to your practice? #WeDNs |
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@HeatherBain9
25 February 2020 20:18
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#wedns it appears there are a lot of new systems being implemented Malinko Morse etc is this the way forward. Do they all integrate with other record keeping systems |
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@KirstinRobins17
25 February 2020 20:19
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@WeDistrictNurse #WeDNs we all have VPN and it works fairly well so it’s rare I don’t have access when needed to system one. |
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@mjosiris
25 February 2020 20:19
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@WeDistrictNurse I wish - but I think we are trialling this software soon??? @tiddleschick1 #wedns |
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@WeCommNurses
25 February 2020 20:19
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Is this a common feeling - the need to write in the home as well as document electronically later #WeDNs? https://twitter.com/KirstinRobins17/status/1232399209120309248 |
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@AMD_barra
25 February 2020 20:20
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@Silverangel882 @WeDistrictNurse I’m looking forward to being able to access other Specialist Nurses’ notes and everything being in the one place. I’m just worried about the communication barrier an iPad may cause during a consultation at home #WeDns |
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@WeCommNurses
25 February 2020 20:20
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@KirstinRobins17 Could you tell us what VPN is? Thank you #WeDNs |
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@emmaloufrain
25 February 2020 20:21
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@WeDistrictNurse We have the nursing notes but no medical notes/access. Our electronic system will be using an offline function. Interested how services manage online with poor signal in rural areas etc? #weDNs |
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@mjosiris
25 February 2020 20:21
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@KirstinRobins17 @WeDistrictNurse I haven’t used mobile technology yet in practice but I get this! It’s drummed in to us ‘if it isn’t written down, it’s hasn’t been done/happened/ etc #wedns |
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@WeCommNurses
25 February 2020 20:21
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Any more views on whether documentation style hinders your communication? #WeDNs @AMD_barra https://twitter.com/AMD_barra/status/1232399931408777217 |
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@KirstinRobins17
25 February 2020 20:21
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@WeDistrictNurse #WeDns had to google it!! I have mobile internet but it’s via VPN so secure for data protection is my understanding. https://t.co/4NTVfIvAVF |
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@NatalieDoyle10
25 February 2020 20:22
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@WeDistrictNurse I can access EMIS and clinical portal. I find this very useful especially if the patient has just been recently discharged from hospital and having immediate discharge letters and updated mediations to hand makes my assessment more streamline and less repetitive #WeDns |
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@VickiJNurse
25 February 2020 20:22
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@WeDistrictNurse I feel we are under more pressure than ever to document we now have to attend scrutiny panels after pressure ulcer reporting where our documentation is scrutinised and discussed staff feel under even more pressure to ensure all paperwork in homes and office are completed. #WeDNs |
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@emmaloufrain
25 February 2020 20:23
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@VickiJNurse This must waste hours of clinical time ?? #weDNs |
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@HeatherBain9
25 February 2020 20:23
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#wedns does it have to be the nurse that uses the iPad , could it be the person you are providing care for or the carer? https://twitter.com/amd_barra/status/1232399931408777217 |
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@CareHome_Nurse
25 February 2020 20:23
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@AMD_barra @WeDistrictNurse Depending on the patient I sometimes write my notes in the car once I leave the house #WeDns |
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@Dreuittkelly
25 February 2020 20:23
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@WeDistrictNurse #WeDNs we write our electronic notes in the home using mobile connection or off line connection which uploads when we get connection. |
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@WeCommNurses
25 February 2020 20:23
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You're on to our next question already @emmaloufrain ?? #WeDNs Good question ?? https://twitter.com/emmaloufrain/status/1232400304718721025 |
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@VickiJNurse
25 February 2020 20:23
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@emmaloufrain it def does .... #WeDNs |
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@WeCommNurses
25 February 2020 20:24
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RT @KirstinRobins17: @WeDistrictNurse #WeDns had to google it!! I have mobile internet but it’s via VPN so secure for data protection is my… |
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@KayreenMcKenna
25 February 2020 20:24
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@WeDistrictNurse #wedns yes we do! We work agile in GG&C we have laptops and complete our documentation as we go round our visits. It significantly ^ patient face to face time and allows us to create a bespoke patient care environment as they can be involved in ordering equipment for example! |
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@WeCommNurses
25 February 2020 20:24
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@KirstinRobins17 Great, thank you ?? #WeDNs |
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@KirstinRobins17
25 February 2020 20:24
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@WeDistrictNurse @AMD_barra #WeDNs system one means I can see@all the other specialist teams entries and many of the GPS also I can send electronic letters and taste to the MDT including the GP. If the GP is on system one you can also seem meds and hospital letters etc. |
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@WeCommNurses
25 February 2020 20:24
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#wedns is this a familiar comment to others? How do we move beyond it? https://twitter.com/mjosiris/status/1232400313325359104 |
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@Dreuittkelly
25 February 2020 20:25
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@KirstinRobins17 @WeDistrictNurse #WeDNs we also use VPN. We can view third party records if consent set to shared. |
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@WeCommNurses
25 February 2020 20:25
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Is this common? #WeDNs Thanks for raising @VickiJNurse https://twitter.com/VickiJNurse/status/1232400570805293056 |
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@CareHome_Nurse
25 February 2020 20:25
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@HeatherBain9 As we have a full caseload on the ipad that could create confidentiality issues unless each record had a password #WeDns |
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@WeCommNurses
25 February 2020 20:25
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RT @Silverangel882: @AMD_barra @WeDistrictNurse Depending on the patient I sometimes write my notes in the car once I leave the house #WeDns |
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@mjosiris
25 February 2020 20:25
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@AMD_barra @WeDistrictNurse @Silverangel882 But sometimes even with paper notes you have to write when a person is still talking to you- no? I feel so rude but have developed being able to write and maintain a level of eye contact and chat. Hopefully be the same with digital #wedns |
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@WeCommNurses
25 February 2020 20:25
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Pop on #wedns Emma to keep tweet in chat https://twitter.com/emmaharan1/status/1232401032048762881 |
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@WeCommNurses
25 February 2020 20:25
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RT @Dreuittkelly: @WeDistrictNurse #WeDNs we write our electronic notes in the home using mobile connection or off line connection which up… |
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@KirstinRobins17
25 February 2020 20:25
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@mjosiris @WeDistrictNurse #WeDNs it is a big change so I totally get that sentiment. Initially it really made me feel like I’d missed a step now it’s just the norm! |
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@WeCommNurses
25 February 2020 20:26
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#WeDNs what do others think? https://twitter.com/heatherbain9/status/1232400671749570560 |
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@WeCommNurses
25 February 2020 20:26
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Fabulous! @KayreenMcKenna #WeDNs There is hope ?? https://twitter.com/KayreenMcKenna/status/1232400922850078721 |
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@WeCommNurses
25 February 2020 20:27
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RT @KirstinRobins17: @WeDistrictNurse @AMD_barra #WeDNs system one means I can see@all the other specialist teams entries and many of the G… |
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@WeCommNurses
25 February 2020 20:27
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Pop on #wedns to keep your tweets in the chat kate https://twitter.com/katelou1983/status/1232401508668329984 |
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@WeCommNurses
25 February 2020 20:27
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#WeDNs so how do we manage this? https://twitter.com/emmaloufrain/status/1232400304718721025 |
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@WeCommNurses
25 February 2020 20:27
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Absolutely #WeDNs @EmmaHaran1 https://twitter.com/EmmaHaran1/status/1232401032048762881 |
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@KirstinRobins17
25 February 2020 20:27
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@Katelou1983 @WeDistrictNurse #WeDNs it’s certainly got me out of a few binds when in a patients house and they not great at giving history ?? |
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@EmmaHaran1
25 February 2020 20:29
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#WeDNs vicki that’s a lot of time and duplication having to record patient contacts in 3 places. |
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@MISSALLYSONTHO1
25 February 2020 20:29
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@KirstinRobins17 @WeDistrictNurse #WeDNs We only sign for medication admin, catheter recording and similar in patient held record but it’s literally a signature and batch number etc. Then full notes written up electronically. Reduces risk of errors made in duplicating notes I think. (1/2) |
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@WeCommNurses
25 February 2020 20:29
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You're all racing away with these questions #WeDNs ???? So here's the next one, already partly answered: 4. What electronic systems are you using & what are the issues with them (e.g. connectivity, workable design)? |
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@KirstinRobins17
25 February 2020 20:29
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@mjosiris @WeDistrictNurse @AMD_barra @Silverangel882 #WeDns I don’t type in patients houses but a lot of my colleagues do! I tend to make notes and do it after each visit or at the end depending on the caseload. I struggle with my neck and can’t type sat in an awkward position etc. |
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@WeCommNurses
25 February 2020 20:30
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RT @MISSALLYSONTHO1: @KirstinRobins17 @WeDistrictNurse #WeDNs We only sign for medication admin, catheter recording and similar in patient… |
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@WeCommNurses
25 February 2020 20:30
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RT @KirstinRobins17: @mjosiris @WeDistrictNurse @AMD_barra @Silverangel882 #WeDns I don’t type in patients houses but a lot of my colleague… |
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@MISSALLYSONTHO1
25 February 2020 20:30
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@KirstinRobins17 @WeDistrictNurse #WeDNs But also helps staff when they can’t access notes (due to signal issues etc), OOH or bank staff to prevent any errors. Not perfect but seems to work ok ?????. (2/2) |
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@emmaloufrain
25 February 2020 20:30
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@StellaWelsh @KayreenMcKenna @WeDistrictNurse How does the patient feel about this? I would love to read my notes ?? #weDNs |
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@HeatherBain9
25 February 2020 20:31
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@KayreenMcKenna @WeDistrictNurse I think I need a wee trip to the west to observe #wedns on saying that I am concerned that approaches to record keeping are at regional level within community nursing @FionaCMcQueen @stevebaguley |
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@VickiJNurse
25 February 2020 20:31
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@MISSALLYSONTHO1 @WeDistrictNurse @KirstinRobins17 sounds good and makes sense!! #WeDNs |
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@EmmaHaran1
25 February 2020 20:31
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#WeDNs we use ecr as our records on our laptops. The only negative I have is reception in some areas of locality can be sometimes poor. Other than that our systems are very effective |
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@WeCommNurses
25 February 2020 20:31
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Couldn't agree more @Katelou1983 #WeDNs https://twitter.com/Katelou1983/status/1232401508668329984 |
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@KirstinRobins17
25 February 2020 20:31
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@WeDistrictNurse #WeDNs system one and it’s great my only bugbear is not all GPs use it and that can create some issues! But when you have a patient and everyone involved is using system one it’s like AMAZING ?? |
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@WeCommNurses
25 February 2020 20:32
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This sounds good @EmmaHaran1 (don't forget #WeDNs on your tweets so we can find them - thanks??) https://twitter.com/EmmaHaran1/status/1232401474052919298 |
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@WeCommNurses
25 February 2020 20:32
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RT @MISSALLYSONTHO1: @KirstinRobins17 @WeDistrictNurse #WeDNs But also helps staff when they can’t access notes (due to signal issues etc),… |
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@emmaloufrain
25 February 2020 20:32
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RT @KayreenMcKenna: @WeDistrictNurse #wedns yes we do! We work agile in GG&C we have laptops and complete our documentation as we go round… |
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@WeCommNurses
25 February 2020 20:33
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RT @emmaloufrain: @StellaWelsh @KayreenMcKenna @WeDistrictNurse How does the patient feel about this? I would love to read my notes ?? #weDNs |
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@MISSALLYSONTHO1
25 February 2020 20:33
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@EmmaHaran1 @WeDistrictNurse #WeDNs It makes such a difference having that additional access. Obviously it needs to be used appropriately and with care but I find it really useful! |
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@EmmaHaran1
25 February 2020 20:33
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Sorry #WeDNs I’ve never been on a tweet chat before |
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@KirstinRobins17
25 February 2020 20:33
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@MISSALLYSONTHO1 @WeDistrictNurse #WeDns our Bank and Agency all have Dells and mobile work so we are lucky there’s very few that don’t. |
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@WeCommNurses
25 February 2020 20:33
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RT @HeatherBain9: @KayreenMcKenna @WeDistrictNurse I think I need a wee trip to the west to observe #wedns on saying that I am concerned th… |
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@WeCommNurses
25 February 2020 20:34
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@KayreenMcKenna @StellaWelsh What is CNIS? #WeDNs |
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@WeCommNurses
25 February 2020 20:34
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RT @KirstinRobins17: @WeDistrictNurse #WeDNs system one and it’s great my only bugbear is not all GPs use it and that can create some issue… |
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@emmaloufrain
25 February 2020 20:34
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@VickiJNurse @WeDistrictNurse Is this negative pressure though? We must keep our documentation standards so high! #weDNs |
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@HeatherBain9
25 February 2020 20:35
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#wedns good point about reasonable adjustments but let’s be solution focussed and think how can we be smart in our working https://twitter.com/kirstinrobins17/status/1232402357188775936 |
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@KayreenMcKenna
25 February 2020 20:35
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@StellaWelsh @WeDistrictNurse #wedns @StellaWelsh misunderstanding me* (sorry! Typing too fast ????) |
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@CareHome_Nurse
25 February 2020 20:36
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@WeDistrictNurse As said before we use Morse, will be great for patients going to hospital as in Highlands they can access the records through Care Portal for continuity of care. #WeDns |
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@WeCommNurses
25 February 2020 20:36
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OK, so you're bringing us to this question as well now #WeDNs : 5.Are your documentation systems integrated or shared and if so, with whom – patient, multidisciplinary team, Primary Care Network (in England), GP? & what difference does it make to have this or not have it? |
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@WeCommNurses
25 February 2020 20:36
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RT @emmaloufrain: @VickiJNurse @WeDistrictNurse Is this negative pressure though? We must keep our documentation standards so high! #weDNs |
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@mjosiris
25 February 2020 20:36
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@HeatherBain9 @WeDistrictNurse @KayreenMcKenna @FionaCMcQueen @stevebaguley Yip the differences in documentation and record keeping are mind boggling ??in this day and age you’d think it’d be standardised nationally and definately digital!! #wedns |
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@KayreenMcKenna
25 February 2020 20:37
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@WeDistrictNurse @StellaWelsh #wedns CNIS Community Nursing Information System. It’s our online documentation system. Really easy to use and secure within the NHSGGC VPN |
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@WeCommNurses
25 February 2020 20:37
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@Silverangel882 Tell us more about Care Portal Shiona? #WeDNs |
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@WeCommNurses
25 February 2020 20:37
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@EmmaHaran1 #wedns Don’t worry we are all learning, more important to share practice |
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@CareHome_Nurse
25 February 2020 20:37
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@WeDistrictNurse Tbh I'm not sure if our GPs can access our notes, something I will ask when I'm back at work on Thursday #WeDns |
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@WeCommNurses
25 February 2020 20:37
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Good point from @mjosiris #WeDNs https://twitter.com/mjosiris/status/1232404091239833601 |
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@WeCommNurses
25 February 2020 20:38
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@KayreenMcKenna @StellaWelsh Thank you Kayreen #WeDNs |
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@HeatherBain9
25 February 2020 20:38
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RT @KirstinRobins17: @WeDistrictNurse #WeDNs system one and it’s great my only bugbear is not all GPs use it and that can create some issue… |
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@WeCommNurses
25 February 2020 20:38
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RT @KayreenMcKenna: @WeDistrictNurse @StellaWelsh #wedns CNIS Community Nursing Information System. It’s our online documentation system. R… |
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@margot_russell
25 February 2020 20:38
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RT @WeNurses: Starting now over on #WeDNs >> https://twitter.com/WeDistrictNurse/status/1232394845861433352 |
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@HeatherBain9
25 February 2020 20:38
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@KirstinRobins17 @WeDistrictNurse #wedns So this is what we aspire to |
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@KirstinRobins17
25 February 2020 20:38
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@HeatherBain9 #WeDns totally!We have to remember that not everyone can type with a laptop balancing on their knees! My team have been fab & I have a routine I stick to so I don’t see any less patients and am just as productive but we all have coping mechanisms! I find it helps as I’m dyslexic |
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@WeCommNurses
25 February 2020 20:39
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Thinking about #silencetovoice #WeDNs if others in multidisciplinary team can see our notes, it helps to demonstrate what we're doing (all that tea drinking....) https://twitter.com/Silverangel882/status/1232404350242344965 |
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@MISSALLYSONTHO1
25 February 2020 20:39
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@WeDistrictNurse #WeDNs We use CNIS which is only accessible by DN service and an abridged version on Clinical Portal. Recently as part of a shared care initiative we have started using CP to leave documentation/notes for other HCPs. But they need to know they are there first. |
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@MarielyonsBrown
25 February 2020 20:40
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What’s the process for bank staff and students ? Are they provided with iPads etc? #wedns |
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@WeCommNurses
25 February 2020 20:40
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#wedns so many different systems? https://twitter.com/stuart4lees/status/1232404894897856514 |
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@mjosiris
25 February 2020 20:40
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@WeDistrictNurse Our GPs can’t and ward staff can through our board’s electronic records but it’s cumbersome for them to find our entries and no one trains them to do so. Relevant data missed when a patient is admitted. #wedns |
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@emmaloufrain
25 February 2020 20:41
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@WeDistrictNurse Ours will be seen (hopefully!) by all our community colleagues ie palliative care, urgent care teams etc.....however we need to link with acute services better! #weDNs |
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@WeCommNurses
25 February 2020 20:41
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Wow, sounds complicated @Stuart4Lees #WeDNs https://twitter.com/Stuart4Lees/status/1232404894897856514 |
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@HeatherBain9
25 February 2020 20:42
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#wedns This is interesting so who are DNs writing records for ... https://twitter.com/Silverangel882/status/1232404350242344965 |
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@CareHome_Nurse
25 February 2020 20:42
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@MarielyonsBrown Our recent 3rd year students got logins and iPads as had their own patients. Access for bank staff still an issue they are working through just now. #WeDns |
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@KayreenMcKenna
25 February 2020 20:43
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@WeDistrictNurse Despite being a health and social care partnership, our systems are not integrated. We do however have access to clinical portal which is used by the acute sector, however we cannot converse through it directly. #wedns |
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@MarielyonsBrown
25 February 2020 20:43
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@KayreenMcKenna @WeDistrictNurse Do learners ie student nurses and district nurse students have access to iPads etc ? #wedns |
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@emmaloufrain
25 February 2020 20:43
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@StellaWelsh @WeDistrictNurse This is brilliant! How has this supported admission avoidance or reduced length of stay in the acute? #weDNs |
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@WeCommNurses
25 February 2020 20:43
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Fabulous chatting #WeDNs. 15 mins to go & please don't forget #WeDNs on each tweet so we can catch your words #silencetovoice |
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@KirstinRobins17
25 February 2020 20:43
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@WeDistrictNurse #WeDns ours are seen by anyone else using system one if patient has consented/agreed to share care. So for us all community services including some hospital services and GP and they can see all our entries. Prisons are also using system one more and more. |
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@WeCommNurses
25 February 2020 20:45
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Here's a question and one I don't think you've answered yet #WeDNs ???? 6. Who makes decisions in your Trust around documentation development – both design of care plans (software) and also choice of system (hardware)? i.e. Are DNs involved in these decisions? |
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@WeCommNurses
25 February 2020 20:45
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@KayreenMcKenna A missed opportunity? #WeDNs |
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@AMD_barra
25 February 2020 20:45
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@KayreenMcKenna @WeDistrictNurse I’ve never thought of this. We are also a health and social care partnership. #WeDNs |
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@WeCommNurses
25 February 2020 20:46
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Great question @MarielyonsBrown Also, sessional staff? #WeDNs https://twitter.com/MarielyonsBrown/status/1232405744542244872 |
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@KirstinRobins17
25 February 2020 20:46
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@WeDistrictNurse #WeDns that’s a great question!! I do t know entirely!! But I know various colleagues have been on working parties looking at specific processes and care plans etc. |
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@WeCommNurses
25 February 2020 20:47
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Another excellent question #WeDNs ?? Thank you @emmaloufrain https://twitter.com/emmaloufrain/status/1232405856181981185 |
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@mjosiris
25 February 2020 20:47
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@AMD_barra @WeDistrictNurse @Silverangel882 Yes I can see it would be esp if you are accessing other records/ordering equipment etc you need to concentrate - I look forward to trying it soon as we are moving towards digital #wedns |
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@WeCommNurses
25 February 2020 20:47
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RT @KirstinRobins17: @WeDistrictNurse #WeDns ours are seen by anyone else using system one if patient has consented/agreed to share care. S… |
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@WeCommNurses
25 February 2020 20:47
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@KirstinRobins17 Excellent #WeDNs |
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@HeatherBain9
25 February 2020 20:47
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@KayreenMcKenna @WeDistrictNurse #wedns I have to admit I find this all so frustrating...the technology is there but we have had no lead in community nursing take this forward. How do we address this across the four countries of the U.K.? @QNI_Scotland @TheQNI |
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@KayreenMcKenna
25 February 2020 20:48
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@MarielyonsBrown @WeDistrictNurse #wedns we do not have iPads. Student nurses do not have their own laptop to use, they would however use their mentor’s laptop and use their one personal sign in to document. The mentor would be ‘tagged’ in this entry for them to oversee it. |
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@MISSALLYSONTHO1
25 February 2020 20:48
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@mjosiris @HeatherBain9 @WeDistrictNurse @KayreenMcKenna @FionaCMcQueen @stevebaguley #WeDNs there are differences even within healthboards. With some areas being told to write minimal notes of care plans are robust but other areas being told to have both robust care plans and notes. Personally, I feel more comfortable having detailed but clear notes. |
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@exerciseBham
25 February 2020 20:48
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@WeDistrictNurse With heartfailure patients a lot get admitted to hospital because other health care professionals can't access their notes #WeDNS |
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@HeatherBain9
25 February 2020 20:48
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RT @WeDistrictNurse: Here's a question and one I don't think you've answered yet #WeDNs ???? 6. Who makes decisions in your Trust around docu… |
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@CareHome_Nurse
25 February 2020 20:48
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@WeDistrictNurse #WeDns I honestly dont know the answer. But I'm thinking that as all healthboards/trusts are using different it makes things less going up. A national strategy might make continuity of care better? Anyone else have an opinion on this? |
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@WeCommNurses
25 February 2020 20:49
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We know the feeling @Silverangel882 #WeDNs https://twitter.com/Silverangel882/status/1232406367014727681 |
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@EmmaHaran1
25 February 2020 20:49
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Yes DN’s can definitely contribute to making changes and are best placed to improve processes and practice #WeDNs |
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@KayreenMcKenna
25 February 2020 20:49
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@MarielyonsBrown @WeDistrictNurse #wedns SPQ DN students would already have their laptop as they would have been working at a community staff nurse prior to gaining entry onto the course :) |
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@MarielyonsBrown
25 February 2020 20:49
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@WeDistrictNurse Yes ! I’m part of a short life working group looking at care plans and assessments just now #wedns |
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@WeCommNurses
25 February 2020 20:49
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RT @KirstinRobins17: @WeDistrictNurse #WeDns that’s a great question!! I do t know entirely!! But I know various colleagues have been on wo… |
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@emmaloufrain
25 February 2020 20:49
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@WeDistrictNurse Absolutely we are leading the way designing documentation fit for purpose within our area.....very lucky to say we are listened to and supported to develop easier ways to work! #weDNs |
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@WeCommNurses
25 February 2020 20:50
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Top question @HeatherBain9 #WeDNs Time for DNs to take control & lead? https://twitter.com/HeatherBain9/status/1232406870524076032 |
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@WeCommNurses
25 February 2020 20:50
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RT @KayreenMcKenna: @MarielyonsBrown @WeDistrictNurse #wedns we do not have iPads. Student nurses do not have their own laptop to use, they… |
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@KayreenMcKenna
25 February 2020 20:50
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@WeDistrictNurse #wedns very much so. There have been no changes in communication between health and social care. |
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@emmaloufrain
25 February 2020 20:50
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@WeDistrictNurse We also ALWAYS ask various levels of staff to trial new assessments/paperwork/templates to make sure it works for them in practice #weDNs |
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@MarielyonsBrown
25 February 2020 20:50
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@emmaloufrain @StellaWelsh @WeDistrictNurse Very positive #wedns |
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@HeatherBain9
25 February 2020 20:50
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#wedns who else thinks this is not acceptable going forward https://twitter.com/kayreenmckenna/status/1232407020097220608 |
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@CareHome_Nurse
25 February 2020 20:51
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@WeDistrictNurse #WeDns I don't know who made the decisions, but I'm thinking that as different boards/trusts use different software it creates problems with continuity. Maybe a national strategy is required? |
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@WeCommNurses
25 February 2020 20:51
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@MISSALLYSONTHO1 @mjosiris @HeatherBain9 @KayreenMcKenna @FionaCMcQueen @stevebaguley But isn't your documentation a professional decision? Not one for managers to define? #WeDNs |
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@KayreenMcKenna
25 February 2020 20:52
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@MISSALLYSONTHO1 @mjosiris @HeatherBain9 @WeDistrictNurse @FionaCMcQueen @stevebaguley Without a doubt! It’s my registration after all and I will include everything I need to to protect my patient and myself. I will continue to provide good, structured care plans, but also write my notes with everything relevant included! Concise, of course! #wedns |
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@WeCommNurses
25 February 2020 20:52
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Wow this is something ?? @exerciseBham #WeDNs This really is about the importance of documentation. https://twitter.com/exerciseBham/status/1232407053735546882 |
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@MISSALLYSONTHO1
25 February 2020 20:52
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@WeDistrictNurse @mjosiris @HeatherBain9 @KayreenMcKenna @FionaCMcQueen @stevebaguley #WeDNs I think so, at the end of the day it’s my #NMC registration and I am going to detail what I feel is right in my note taking. |
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@WeCommNurses
25 February 2020 20:52
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@angelalongwort1 @EmmaHaran1 @MISSALLYSONTHO1 @HealthierLSC What is LPRES ? #WeDNS |
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@MarielyonsBrown
25 February 2020 20:53
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@KayreenMcKenna @WeDistrictNurse Is it the same process for your post reg district nurse students Kayreen ? #wedns |
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@mjosiris
25 February 2020 20:53
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@WeDistrictNurse I was involved in the initial meetingswith the digital provider - they asked what I wanted - I told them I want ‘the dream’ I want to be able to access/order/update/assess in real time in or around the person’s home. We are trialling soon so we shall see ??#wedns |
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@WeCommNurses
25 February 2020 20:53
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Brilliant @MarielyonsBrown #WeDNs #silencetovoice https://twitter.com/MarielyonsBrown/status/1232407220853395456 |
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@emmaloufrain
25 February 2020 20:53
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@exerciseBham @WeDistrictNurse This makes me so sad!! #weDNs |
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@WeCommNurses
25 February 2020 20:53
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Fabulous @emmaloufrain #WeDNs https://twitter.com/emmaloufrain/status/1232407266621566976 |
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@HeatherBain9
25 February 2020 20:54
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#wedns we no empirical evidence of this nature to support change https://t.co/JDJFj32R9R |
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@MISSALLYSONTHO1
25 February 2020 20:54
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@WeDistrictNurse @mjosiris @HeatherBain9 @KayreenMcKenna @FionaCMcQueen @stevebaguley #WeDNs Furthermore, we have a professional autonomy and a responsibility to safeguard that patient. For the benefit of the pt and my colleagues I am going to record all relevant details. |
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@WeCommNurses
25 February 2020 20:55
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Last few minutes #WeDNs and here are a couple of thoughts from your excellent contributions. Could there be some joining up between those of us who are working on documentation systems? |
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@KayreenMcKenna
25 February 2020 20:55
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@MarielyonsBrown @WeDistrictNurse #wedns SPQ DN students would already have their laptop as they would have been working at a community staff nurse prior to gaining entry onto the course :) |
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@KirstinRobins17
25 February 2020 20:55
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@exerciseBham @WeDistrictNurse #WeDns that’s awful our HF nurses use system one so we can see their records ?? |
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@exerciseBham
25 February 2020 20:56
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RT @KirstinRobins17: @exerciseBham @WeDistrictNurse #WeDns that’s awful our HF nurses use system one so we can see their records ?? |
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@HeatherBain9
25 February 2020 20:57
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#weDNs we need empirical evidence of this nature to support change https://twitter.com/exercisebham/status/1232407053735546882 |
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@exerciseBham
25 February 2020 20:58
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RT @WeDistrictNurse: Wow this is something ?? @exerciseBham #WeDNs This really is about the importance of documentation. |
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@WeCommNurses
25 February 2020 20:58
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The Department of Health report from 2013 on mobile working (link in our pre-chat info) found so many extraordinary benefits from supporting mobile working. Couldn't we as DNs take the lead in making this happen better? #WeDNs |
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@KirstinRobins17
25 February 2020 20:59
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@exerciseBham @WeDistrictNurse #WeDns our community ones do as well as our community diabetes rises and community Parkinson’s nurses etc |
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@mjosiris
25 February 2020 20:59
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@WeDistrictNurse That would be amazing to see mobile working in other boards/trusts #wedns |
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@HeatherBain9
25 February 2020 20:59
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#wedns this needs some action https://twitter.com/wedistrictnurse/status/1232409628006395904 |
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@tiddleschick1
25 February 2020 20:59
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@WeDistrictNurse Trying to include DN with discussions I'm involved in through documentation groups but time is precious and patients come first. Lots being pushed at board level and by acute services #weDNs |
Stats
Total contributers:
20
Total tweets:
201
Total reach:
1,226,762
