National Admission Avoidance CQUIN
This CQUIN has been developed to ensure that patients with ambulatory care sensitive conditions and similar conditions that do not normally require admission to a hospital bed receive highly responsive urgent care services outside of hospital. CCS NHST Trust are working with colleagues at the Luton & Dunstable Hospital to ensure patients are seen in the right place at the right time and avoid a hospital admission where possible.
Dementia and Delirium – Find, Access, Investigate, Refer and Inform (FAIRI) (National CQUIN)
This indicator forms part of the National CQUIN which aims to incentivise providers to improve care for patients with dementia or delirium during episodes of emergency unplanned care. All patients that access our Emergency Unplanned Care Team, aged 75 years and over are screened for signs of dementia and delirium. Should any patients answer positively to the memory screening question they will be referred to their GP for further assessment. The pathway for memory screening has been agreed across Luton and Bedfordshire.
Dementia and Delirium – Staff Training (National CQUIN)
This indicator forms part of the National CQUIN which aims to incentivise providers to improve care for patients with dementia or delirium during episodes of emergency unplanned care. All staff within CCS will be trained on Dementia Awareness and specialist nurses within Adults Services will be trained on specific dementia training programmes.
A steering group has been developed with members from across the Health and Social Economy within Luton and Bedfordshire. Training programmes will be advertised through this group to Care Home providers to ensure Dementia Training is accessed by all.
Dementia and Delirium – Supporting Carers (National CQUIN)
This indicator forms part of the National CQUIN which aims to incentivise providers to improve care for patients with dementia or delirium during episodes of emergency unplanned care. A carer’s survey will be sent to all patients with Dementia with an informal carer, and/or for their family members. Results of the survey will be shared with colleagues across the Health and Social Care System and responses sent to those that have completed the survey where possible.
School Nursing Integrated Check
This CQUIN is aimed to ensure that we have an integrated school nursing check for each child, allowing all development checks to take place at one appointment. (Weight & Height, and Audiology Check). Staff will be trained to complete all development checks allowing for children to receive their checks within one appointment, reducing DNA rates, time out for schools and for the nursing teams.
Catheter Nurse Initiative
This CQUIN will introduce a new Catheter Lead Nurse into the District Nursing Team. It aims to reduce hospital admissions for blocked catheters, reduce unplanned care visits for blocked catheters and create a catheter clinic for all non-housebound patients. The catheter Lead Nurse will provide training sessions, booklets and sources of information for the District Nursing Teams and for patients with a catheter. A Catheter Clinic will also be set up for non-housebound patients to attend to reduce the amount of catheter appointments spent by the District Nursing Teams. The number of unplanned catheter calls will be monitored throughout this CQUIN to evidence the improvement in catheter care.
Improving Diabetes knowledge of staff and patients within the District Nursing Service
This CQUIN aims to improve the knowledge of diabetes care for both staff and patients on the District Nursing caseload with a Diabetes care plan. Patients with a diagnosis of diabetes are at risk of increased hospital admissions and re-admissions due to hypoglycaemia and hyperglycaemia episodes.
The diabetes specialist nurse will develop a training booklet that will be shared with identified district nursing teams. This will then be delivered to patients on the identified nursing teams caseload with a diabetes care plan. The increase in knowledge will be documented through a PROMS questionnaire that will be completed by both the staff and the patients. The diabetes specialist nurse will also complete a root cause analysis on the number of patients that have been admitted to hospital each month that has a diabetes care plan from both the identified trained nursing team, and an identified nursing team that has not received any training.
Development of a Continence Pathway for Children and Young People
This CQUIN aims to develop a pathway for all children and young people from birth to 19 years with bladder and bowel dysfunction, including children with learning difficulties and physical disabilities, to an integrated community-based paediatric continence service.
The continence service across Luton and Bedfordshire will be scoped and measured against best practice guidelines. Levels of intervention by clinical staff will be defined into three tiers. Throughout the CQUIN staff will be trained at their relevant tier.
Introduction of ‘Well Leg’ OR ‘DOPPLER ABPI’ Clinic
This CQUIN has been developed to enable the TVN team to accept referrals from GP’s for diagnosis DOPPLER-ABPI. This aims to reduce incidence of recurrence of lower leg ulceration. A Well Leg Clinic will be set up from Luton Treatment Centre for patients to access at least twice a month. This will reduce referrals to the hospital with the aim to create a business case in Quarter 4 to allow the clinic to run as business as usual on going.