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PANDA

PANDA. Sue Chapman, Professor Judith Ellis, Caroline Joyce Great Ormond Street Hospital NHS Trust London, England. Background. Clinicians increasingly aware children admitted UK hospitals more complex and nursing care needs dependent

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PANDA

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  1. PANDA Sue Chapman, Professor Judith Ellis, Caroline Joyce Great Ormond Street Hospital NHS Trust London, England

  2. Background • Clinicians increasingly aware children admitted UK hospitals more complex and nursing care needs dependent • Documentation DoH (2001) outlined recommendations for admission to Paediatric High Dependency (HD) and Intensive Care (IC) units. • RCN guidance (2003) recommends appropriate staffing levels for children’s wards, high dependency and intensive care settings. • New pay structure with Knowledge Skills framework and assessment supporting competency development of all staff • Potential to charge commissioners for higher dependant children on wards

  3. PANDA Project Aims: To develop a tool that will: • Identify the number and location of children who require increased nursing support within the ward environment. • Calculate nursing staff requirement based on the actual acuity and dependency of children • Identify the number and location of complex children with multiple health problems. • Highlight staff training needs relating to ‘high dependency’ skills. • Identify where HD/IC is being delivered outside of PICU for funding to be sought through HRG 3

  4. Airway Respiratory Post Surgery/ procedures Cardiac/ arrhythmias Monitoring / Drug therapy Shock / sepsis / immunodeficiency Renal/ fluids Neurology Other 9 care category groups

  5. PANDA process • Data scanned and checked manually • Collated data on shift-by-shift basis • Enter funded bed establishment • Enter required ‘Uplift’ for sickness, annual leave etc • Identified highest ranking dependency for each child on each shift

  6. Acuity & Nursing Dependency

  7. Example Feedback

  8. Shift by shift analysis

  9. Informing training needs • Generic needs • Skills specific needs • Ward needs • Hospital needs • National needs

  10. Identified HD training priorities • Fluid management • ECG monitoring • Oxygen therapy • Airway assessment • Complex child protection • Assessment of the acutely ill child

  11. Software development • Product under development • Demonstration well received by clinical staff • Installation & Pilot September 2009 • Pilot areas Butterfly, Bumblebee and Sky

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