Sponsored by Velindre University NHS Trust
Eve Lightfoot is named the RCN in Wales Nurse of the Year 2018!
Eve, a District Nursing Sister within Hywel Dda University Health Board, became increasingly concerned that there was no education for staff about sepsis or the early recognition of deterioration in patients in the community.
She began to raise awareness of the issue, started a research internship and undertook a research project. Her work is now leading to sustainable change not just locally but also on a national level.
Eve was a unanimous choice for the judging panel, demonstrating passion, unwavering commitment and determination. They recognised that she has been driven to improve patient safety and empower nurses to make decisions which enhance patient outcomes.
Helen Whyley, Interim Director, RCN Wales, said: “Eve is a great role model not only for nursing in the community but for nursing as a whole in Wales. She is an inspirational leader who is skilled in influencing and achieving significant change across care sectors. Eve has gained huge respect from all those she works with.”
Helen Whyley, Interim Director, RCN Wales, addresses the guests at the awards
Ruth has dedicated her life’s work to supporting the health and well-being of people with learning disabilities. She has worked with learning disabilities in a range of residential and community settings in both England and Wales.
Ruth is internationally acclaimed as an expert in her field and acts as a champion on issues of health inequality, social justice, safeguarding and co-production. She has demonstrated through her career an enormous contribution in all aspects of nursing, including education, research and practice. Her work is pioneering, as it includes service users at all stages of the research process, from developing the initial question and protocol, through to the publication and dissemination of results. Above all, she is a superb ambassador for learning disability nursing.
Ruth has been awarded a Fellowship of the RCN for services to research in learning disability nursing and is also a member of both the International Association for the Scientific Study of Intellectual Disabilities and of the British Institute of Learning Disabilities. In 2016, Ruth was awarded an OBE in the Queen’s Birthday Honours in recognition of her services to learning disability nursing
Bethan led on a project with patients with haematological cancers requiring bone marrow transplants. Patients receive chemotherapy and stem cell treatments which are intensive and highly toxic, causing distressing side effects so needing in-patient stay. However this project is redesigning the pathway that will allow patients the option to receive treatment in their own homes. As well as freeing up acute beds in hospital, it will improve the patient experience, accelerating their recovery and removing them from risk of hospital acquired infection. So called ambulatory care (AC) services have been developed within England and internationally, and are endorsed by NICE (2016) in recent haematology guidelines. Indeed, Bethan herself was instrumental in developing and setting up an AC service in a previous nursing role in London.
Always keen to ensure that patients have been involved in this service change, Bethan gathered and acted upon patient feedback to shape the new service. This huge change to the service has not been without its challenges. However, Bethan’s willingness to take on this challenge has led to its successful completion. Bethan is a credible and compassionate leader and is a shining example of an advanced practitioner who is willing to push the boundaries of practice for the benefit of her patients.
Malisa has been a major driving force for service improvement. Ever willing to take on additional clinical responsibility, she delivers regular nurse-led epilepsy clinics and a high volume of unscheduled epilepsy telephone consultations. She was instrumental in developing and leading a flagship clinical innovation for Cardiff and Vale University Health Board - the acute seizure assessment in the emergency unit by specialist nurses in epilepsy. This development means that patients presenting with first suspected seizure can now have contemporaneous history and witness accounts of the event obtained by a specialist, as well as setting up relevant investigations and providing appropriate information, all at the time of their first event.
Malisa has regularly presented her work to the annual International League Against Epilepsy (UK) meetings and has also taken opportunities to attend European and International Epilepsy Congresses. She is also a valued contributor to the Epilepsy Action Cymru National Advisory Council and also to the Cardiff and Vale Valproate Stakeholders Group. Malisa works closely with Epilepsy Action Cymru speaking at national events and being a valuable resource for the third sector. A talented, hard-working and supportive team player, Malisa is excellent with her patients and is always calm, reliable and punctual. She is always ready to learn and willing to take on new challenges.
Rebecca demonstrates exceptional leadership within the medicine clinical board and has implemented key patient centred changes to improve their experience of Cardiff and Vale University Health Board. She is pivotal in ensuring the development of a new culture of addressing patients’ nutritional and hydration needs. She changes the culture of the wards from a routine meal delivery to a patient-centred individualised culture. Rebecca supports the improvement in standards of meals served, their appearance, availability of food and drinks out of hours and secured additional staffing resources to support this enhanced care delivery.
In addition, she has implemented a new framework for nursing assessment and care for patients experiencing confusion. This patient-focused initiative has proven highly effective by empowering nurses to think about individualising care and listening to the patient and carers before putting more restrictive measures in place. It also embodies the prudent health care principals with marked financial improvements, allowing redistribution of appropriate funds to support other care developments. Rebecca leads from the front championing change. She has been open and listened to staff from all aspects of the health service in this delivery of change, which has boosted morale and engagement.
Ceri has demonstrated exceptional leadership for cardiothoracic nursing services. She has engaged the nursing/medical workforce to deliver services that meet the needs of patients requiring cardiothoracic tertiary care. She has been influential and pivotal in delivering the South East Wales Regional Non ST Elevation Acute Coronary Syndrome (NSTEACS) pilot, supporting the delivery of a new pathway for patients across South East Wales. Last year before the pilot was implemented, the length of stay for patients was nine days. After the start of the pilot, the stay for patients with NSTEACS dropped dramatically to six days. This improved further to four days in October 2017. 43 patients were transferred via the ACS Pilot in October 2017. This is a total saving of 215 hospital bed days across South East Wales, ensuring that this tertiary service provides timely treatment for patients within the 72 hour target.
Ceri works tirelessly to support the directorate and the clinical board. She has been instrumental in working collaboratively with the wider cardiac network -leading and facilitating services. The pilot has been an overwhelming success, treating over 600 patients since its implementation. Ceri is a strong visible leader who engages and empowers staff to reach their full potential
Kerry, a Senior Midwife Manager and Louise, Consultant Midwife, with Aneurin Bevan University Health Board have worked together to help foster choice and control for women undergoing induction of labour. Induction is a common procedure, affecting more than 20 per cent of all pregnancies in the UK, but it is often unpopular with mothers, who feel they are losing control of their labour. ABUHB is the first maternity service in Wales to offer the option of an Out-Patient-focused Induction of Labour (OP IOL), which offers a safe and satisfying option of care for low risk, post-term women. A protocol, patient information leaflet and infographic were designed to support information-sharing, choice and safety. All cases were robustly audited and the views of women were explored through an online survey. To date there have been no adverse outcomes associated with OP IOL in ABUHB. Additionally over 56 per cent of women have commenced labour in their home environment and 72 per cent have experienced a normal birth. Moving forward, the pair plan to increase access to OP IOL.
The judging panel said that both Kerry and Louise are truly inspiring, something evidenced by this woman-centred project that puts patient choice at the forefront. They both demonstrate leadership and have taken staff, patients and their families with them on the project journey. The panel were impressed with how they have shared the project across Wales. Both Kerry and Louise have also engaged students in the project, influencing education and practice.
Shelly’s work has led to the implementation of Wales’ first midwife-led flu vaccination programme, working in partnership with the Director of Public Health and Medicines Management team to develop the plan. Shelly has explored a number of option appraisals to develop a safe and quality plan to improve the experience and access for pregnant women. She led on a range of workstreams to support the implementation from the financial costings, developing a standard operating procedure, and a communication plan with a range of stakeholders - particularly primary care – to ensure a robust training programme is jointly delivered with the Health Board Immunisation Coordinator. The service developments are in line with Welsh Government recommendations that pregnant women receive the influenza vaccine within the antenatal clinic setting. Currently pregnant women in Powys are signposted by the midwives to primary care to receive the vaccine. Uptake rates are considered to be between 65 per cent and 85 per cent.
It is anticipated that this programme will have a positive impact on the uptake of vaccination with pregnant women receiving their flu vaccination from their midwife in an antenatal clinic, rather than having to arrange a separate appointment with their primary care practitioner or pharmacist. This pilot programme will be fully evaluated in the autumn to inform midwifery practice across Wales. The judging panel commended Shelly’s outstanding contribution in achieving executive approval for this programme, driving forward this initiative in response to feedback from women using their midwifery services.
Eve became concerned that there was no teaching about sepsis or the early recognition of the deteriorating patient in the community, as these were perceived as ‘secondary care’ issues, so she started to raise awareness of the issue, and then commenced a research internship and undertook a research project. As a result a Community Situation, Background, Assessment, Recommendation template is being implemented; and National Early Warning Score, vital signs and SBAR are being incorporated into community nursing documentation and GP admission criteria. In addition a new out-of hospital Rapid Response to Acute Illness Learning Set group has been set up in HDUHB and there has been a standardisation of monitoring equipment and an increase in education provided to care homes and managers on sepsis recognition.
Eve is passionate about this work, never taking no for an answer and goes above and beyond what anyone would realistically expect. The panel identified that Eve is an inspirational leader who is clearly skilled in influencing and achieving significant change across care sectors and is driven to improve patient safety and empower nurses. The panel felt she is truly a current and future leader within the world of nursing in the community.
Karen’s passion for enabling access to services for society’s most vulnerable and hard to reach groups is compelling. It has enabled her to develop effective, inter-professional relationships with health and social care colleagues - for example, setting up a mobile unit to better reach out to and meet the needs of the homeless population. This project requires Karen to make effective use of her independent nurse prescriber skills, which she does successfully, with support of the multi-agency team, particularly the GP and mental health team. Karen has also been instrumental in setting up an initiative that seeks to build effective, long term relationships with care homes. Key to this is educating and supporting care home staff and community nurses to implement the National Early Warning Score (NEWS).
Karen was instrumental in setting up the implementation of advanced treatment escalation plans and clinical management plans for each individual resident too and she has implemented frequent reviews for care home residents to prevent unnecessary or over-visiting of care home residents and unnecessary admissions to hospital. It was evident to the panel that this committed nurse leader, by building trust and confidence in those that she and her team are working with, has developed key relationships with health and independent sector partners, therefore ensuring that person-centred care is being realised.
A positive and friendly presence on the ward, Hannah constantly brings fresh ideas to improve patient experience, demonstrating person-centred care. She is creative and original in looking for opportunities to assist patients’ recovery, and takes the lead for themed activities across the working week. The Ward Manager receives regular feedback from patients and their relatives about the difference that Hannah has made to their experience when admitted to the ward. Hannah’s enthusiasm, initiative and commitment to enhancing patient experience led to her being nominated as a Quality Improvement Champion.
Hannah has taken a lead role in improving the information given to patients, and the design and delivery of services offered. Using the QI Methodology, she has collaborated with patients and colleagues to update the design of a ward leaflet to ensure that the right information is given at the right time. This work is monitored through the Locality Patient Experience Group and this good practice is shared across the locality. Hannah’s positive attitude and flexible approach to working with individuals with different mental health presentations means that she is an excellent ambassador for the health board values of caring for each other, working together and always improving.
Andrea has been at the forefront of championing and leading change at Gorseinon Hospital, recently transformed into a reablement centre. In her newly created role as a Rehabilitation Assistant, Andrea’s individual rapport with her patients has encouraged them to engage more with socialisation and rehabilitation, succeeding where other staff members were struggling. By championing the setting up of daily activities for patients, such as ‘Knat and Knitter’ and Bingo, Andrea encourages patients to achieve their recovery goals and to behave more as they would at home. She has also been vital in training other HCSWs on how to re-able patients, and the average stay has now reduced significantly from 44 days to 27, due in no small part due to Andrea’s contribution. Andrea regularly goes above and beyond, from buying craft materials from her own pocket to organising art competitions, even persuading the ward sister and manager to get involved with judging.
Andrea has made such a positive impact on the ward that a new role was created, evolving over time to include training with physiotherapists and occupational therapists. As a result patients are now able to have their physiotherapy and occupational therapy continued throughout her shift, optimising their recovery time. Always looking to improve her patient’s outlook, Andrea is now leading work to support the Social Worker within the MDT by gathering information to enable the social work assessment to be undertaken. Her influence has led to nearly 100 per cent success rate in a recent End PJ Paralysis campaign.
As the strategic lead for chronic conditions, Claire’s work focuses on diminishing the effects of long term illnesses and preventing complications. She has introduced more than 11 self-care programmes into the health board. Leading by example, Claire has tutored courses and motivated her colleagues to improve the journey and outcomes for patients and their families. She has encouraged services to incorporate patient education into the care pathway, particularly for patients living with diabetes, Chronic Obstructive Pulmonary Disease (COPD), chronic pain, cancer and even those requiring podiatry, routine appointments. Education and empowerment have maximised positive behaviour changes in patients with chronic illnesses. Claire connects with patients and is able to engage and encourage patients to volunteer with the health board. As experts in self-management of their condition, patients offer peer support and work in partnership in health care delivery in general practice and secondary care.
Following national and local policy and legislation encompassing Prudent Healthcare and the Social Service Wellbeing Act, Claire is committed to improving the quality of life and well-being for patients. She has ensured that self-management features in all of the national health care plans within the health board. Claire always seizes an opportunity to explore the value and benefits of self-awareness and self-care management. She has a can-do attitude to all her work and as a result leads those around. Claire is an exceptional leader who always goes the extra miles for her patients, colleagues and volunteers.
Stephanie has over 10 years’ experience of serving vulnerable populations across prisons in Wales. In 2017, Stephanie implemented a world-first, peer-research programme for men in prison. This involved employing men in prison as peer-researchers to investigate health and well-being in prisons. The peer-researchers achieved robust outcomes, creating their own academic poster publication (displayed at the Royal College of General Practice Conference Glasgow 2017) and submitting their own academic publication (under submission); all firsts for men in prison. The project demonstrated the value of service user involvement in progressing services, from building the evidence base to suggesting recommendations. The health of prisoners is relatively under researched, and therefore this unique approach to investigating views and aspirations of male prisoners demonstrated a very high quality research programme, which will have a significant bearing on prison health care in Wales and internationally.
This year Stephanie generated additional funds for, and led, the first pilot of screening for latent tuberculosis (TB) in a Welsh prison in line with NICE guidance on TB. This work has generated interest from clinicians and scientists across England and Wales and will be supporting the direction of TB services in Wales in the future. Stephanie is an outstanding leader and a pioneer. She aspires to drive forward prison nursing as a recognised specialism, in addition to supporting nurse-led research across prisons and public health.
Alison set up a pilot scheme that effectively moved the Early Discharge COPD Team from a reactive service to a proactive one. The scheme involved working with primary care, allowing the team to accept referrals for exacerbating patients who were at risk of admission, bridging the gap between primary and secondary care, improving communication, breaking down barriers and preventing avoidable admissions. This was developed in conjunction with GPs to ensure collaborative working and that the service model fitted everyone’s requirements. A new database was also formulated to collect information regarding length of stay, referral rate and source, readmission and admission data that would help the team to identify if changes were improvements. Patient reported outcome measures demonstrated that 89 per cent of patients had a reduced burden of disease after being involved with the COPD Team and 83 per cent had improved measures of health and there were also significant, positive financial implications in introducing this project for Cardiff and Vale UHB.
Due to the innovative and progressive thinking of Alison within the COPD Team, patient care for the chronic respiratory disease cohort in her locality has been greatly improved. The judging panel recognised Alison’s passion and drive to raise the awareness and improve care and outcomes for COPD patients by recognising the increase in unnecessary admissions and patient dissatisfaction. Patients have reported that this service has significantly reduced the burden of their disease while delivering substantial cost savings for the university health board.
The numbers of people being diagnosed with lymphoma is increasing by around 15 per cent a year according to Cancer Research UK, as are the numbers of treatments available. However, this puts considerable pressure on the already-stretched haematology day unit at the University Hospital of Wales. Using her knowledge and experience gained via the CAV UHB Leading Improvements in Patient Safety programme (LIPS) Charlotte, the first Advanced Nurse Practitioner for lymphoma in Wales, developed an idea to improve this patient pathway through the use of ‘off site’ treatment areas including utilising a charity-supported mobile treatment unit. Working in collaboration with the UHB Continuous Service Improvement Team, Charlotte embarked on a 60-day transformation project. Within that time Charlotte defined the project, its measure and analysed and tested improvements, demonstrating her commitment and leadership. A result of the initiative is an offsite nurse-led chemotherapy service and within 60 days a third of lymphoma treatments were delivered off the hospital site.
Two sites are currently being utilised for this service, the Haematology Day Unit at University hospital Llandough and also the Tenovus Mobile Unit located at Nantgarw, Caerphilly. Patients now receive chemotherapy nearer to home and the hospital service now concentrates on complex patients that require medical input and cost savings have been achieved. Feedback from patients involved in the project so far has been incredibly positive. Charlotte has led this project with enthusiasm and tenacity driven by a desire and vision for person centred practice which is shared by the team.
Andy identified a gap in the care of people with a learning disability, taking on the responsibility to change the experience for patients coming into an acute hospital. When faced with a number of cases of patients with learning difficulties admitted to the health board and for whom the care was less than ideal, Andy decided to take on responsibility. He completed a significant amount of work in order to make a real difference to this vulnerable group of patients.
Andy created an algorithm for the assessment of non-verbal patients when assessing them for abdominal pathology and put a system in place so all emergency patients who have a learning disability are sent to UHW only. Prompts were created to health care staff in the initiation of the specific LD care pathway and immediate access to specifically-designed electronic documents such as a “Show me where” pain risk assessment tool, a National Early Warning chart amendment, and the roll-out and utilisation of “traffic light” individualised care information and plan, all of which have been incorporated into an EU department proforma for LD/cognitive impairment care. These tools are particularly important given the known ‘late presentation’ of patients with learning disability to emergency services. Admission of all patients are now tracked and their outcomes audited. None of this would have been possible had it not been for Andy’s passion for this work and his drive to improve the care patients from this vulnerable group receive.
Jonathan is a Registered Mental Health Nurse working on a Psychiatric Intensive Care Unit (PICU), and was nominated as a Quality Improvement Champion due to his energy and enthusiasm for improving both patient experience and clinical efficacy. He used the Quality Improvement Methodology to improve the way that information is shared between a PICU and an acute ward in order to ensure continuity of care and risk management as well as sharing good practice in supporting patients with complex mental health difficulties. Jonathan worked with colleagues to develop a Transfer of Care Document and has taken an active leadership role in facilitating colleagues to complete the document for all patients at the end of the admission. Ensuring the patient is involved in the preparation of the document, Jonathan provides them with a voice in explaining what does and doesn’t work for them and what they require to be in place when transferring back. Jonathan is collecting data to ensure the utility of the Transfer of Care document, refining the document to maximise its potential.
The document has been positively received by the wards and service users and anecdotally there has been a reduction in failed step downs. He is an insightful nurse who is a great team player and who is not afraid to take risks to move things forward. He is well known for his optimism and can-do attitude and also demonstrated his ability to help others overcome obstacles through his approach to coaching and mentorship, leading to him being nominated by one of his students for Mentor of the Year.
Nerys is mentorship lead for Midwifery with Cardiff and Vale University Health Board. Without the support and security of mentors, many newly-qualified midwives (NQMs) struggle when they start employment. Attrition and morale within this group is low, but Nerys’ work ensures that preceptees feel supported and more confident in giving the standard of care expected of them. She developed a Prep for Practice Programme as part of a leadership project hosted between the RCM and Welsh Government that bridges the gap between student and qualification. Nerys persuaded 13 midwives to volunteer to be part of the programme, including a clinical supervisor for midwives, senior clinical midwives, practice facilitator and the previous year’s preceptees.
Nerys worked with previous students and developed record-keeping sessions to increase knowledge of documentation. She set up a preceptee manual including induction information and helpful tips, as well as a Whatsapp group for peer support. Nerys also worked with staff side to secure funding for preceptee badges. These pink stork-themed badges enabled an NQM to be identified as someone who might need a little more support from their multi-professional colleagues. Her work has been published and now other health boards are adopting her programme. The judging panel all agreed that Nerys is an inspirational and visionary mentor and a scholarly expert clinician with a passion for helping people learn and develop and she has been instrumental in changing culture in her area and someone who has made an overwhelming contribution to midwifery practice.
Emma has that special ability to balance the demands of a busy shift caring for women and their families with taking an active interest in supporting and facilitating the learning of the student midwives allocated to her mentorship. Emma is dedicated to her work and has an excellent rapport with the women and families she cares for, acting as an advocate, to facilitate informed choice and applying an holistic approach. She works with women wishing to utilise aromatherapy and hypnobirthing techniques and helped facilitate women’s choices over active birth using bean bags, the birthing pool, CUB birthing stool, upright positions and massage.
She helps develop confidence and skill in all areas of women’s care for those to whom she acts as a mentor, giving them the support and encouragement they need to take the lead role in antenatal, labour and postnatal care. She is particularly keen on linking clinical practice with what NQMs had learned at University and is described as having endless patience to support the development of their skills and knowledge. The judging panel commended Emma for epitomising the positive qualities of a caring and effective mentor for student and newly qualified midwives who goes the extra mile to ensure that learners get the most out of their placements. She is dedicated to her work and imaginative in the way she uses simulation to prepare students for the challenges of midwifery practice.
Jayne is an outstanding leader with a rich background in nurse education and nursing practice. Her commitment to diversity and creativity has led to inter-professional learning, summer programmes, studying abroad opportunities, virtual learning and transgender workshops. The learning environment for student nurses at Swansea University is now progressive, dynamic and aspirational. Jayne’s endeavours to foster a healthy work environment and her pursuit for excellence has seen nursing at Swansea increase in the QS World University Ranking 2018 to 51-100 which is the highest ranking of any subject at Swansea, and is only one of 15 UK universities in the top 100 for nursing. The Guardian University Guide 2019 results have placed nursing at Swansea number 2 in the UK, making Swansea the top University in Wales to study nursing.
Jayne is fully committed to providing the best possible education and experience for students, and she works tirelessly to ensure students at Swansea get the best educational and practice based experiences. She has an excellent working relationship with the local health boards, commissioners, Council of Deans, Chief Nursing Officer of Wales and the Nursing and Midwifery Council which has helped enrich the opportunities for students studying nursing at Swansea. Jayne’s continued mission for the Department of Nursing at Swansea University is to provide the highest quality national and internationally-recognised nursing education, research and innovation.
Laura Beth has transformed the journey for Health Care Support Workers who are participating in further education. She accepted a secondment as Health Care Support Worker Clinical Lead to implement the ‘Developing Excellence in Healthcare - an NHS Wales Skills and Career Framework for Healthcare Support Workers supporting Nursing and the Allied Health Professions’ (WEDS, 2015). In only six months, Laura Beth raised the cancer centre compliance rate from 64 per cent to 100 per cent compliance of the framework. She offered a unique supportive framework that involves dedicated time for staff to meet with the Qualifications and Credit Framework (QCF) instructors, organised cohorts to journey through the framework together in order to provide peer support, individualised pastoral care and recognition of achievement/celebrating success. She has implemented processes and procedures that ensure the continuation of compliance in the future and left clear instruction for managers to induct new staff on to the framework.
Laura recognised the need for training unique to the cancer centre with regards to cancer care and acute oncology emergencies and is developing specific training days for the HCSW so they will be accredited. She also organised the first HCSW conference to be held for the staff in the cancer centre. The day received 100 per cent positive feedback. Laura is an exemplary leader who has adopted a collaborative and co-productive approach with students, peers and stakeholders. Her work has achieved outstanding results for HCSWs and improved clinical practice and patient care.
Demonstrating excellence in both practice and in the learning environment, John-Marc is an active participant in classroom discussions and debates at the Aneurin Bevan University Health Board, drawing on his extensive experience in practice as a Health Care Support Worker. As part of a year two module, and using his own recording studio whilst making use of skills acquired as an audio technician, John-Marc has developed an online audio tool making ‘mindfulness’ accessible to people with learning disabilities. Developed in line with evidenced-based practice, John-Marc is setting up website and social media pages to promote the tool, branded ‘Thought Buddy’. He developed excellent instructions and guidance for the user, and is currently writing up his work for publication to raise the profile of the work. Others could also benefit from using this tool and the work deserves wider recognition.
John-Marc is also an active member of the Welsh Health Student Forum and student representative for the ABUHB RNLD group (previously the Strengthening the Commitment Group) reporting back to fellow students and staff with professionalism and enthusiasm. A passionate and dedicated student, John- Marc has already secured a job offer with Aneurin Bevan UHB, although only coming to the end of year two.
An exceptional student who goes the extra mile for her patients, Lucy-Anne’s aim is to use her knowledge and experience from her studies, clinical placements and volunteering experiences to improve diabetes care in Wales. Lucy-Anne’s interest in diabetes arose from working at a summer camp for children and young people with diabetes in Ohio whilst studying for her Psychology degree. She is now a volunteer for Insulin Pumps Wales and helps to run a North Wales meet up for the diabetes community. She is involved in the Insulin Pumps Wales social media group as well as the design of content for the website, aimed at both health care professionals and people in Wales living with diabetes, aiming to “Educate. Empower. Evaluate. Evolve”. Lucy helps to ensure information on the website is credible and easily understood in order to help support people with diabetes across Wales.
Lucy-Anne is also actively involved in university activities, supporting other students through a range of different activities. She has a sound knowledge base, which she applies, to deliver dignified, person centred care. Mentors have said it is a pleasure and privilege supporting her. Taking time out of her busy schedule to help prepare fellow students for their debate assessment as part of a year two module, Lucy- Anne always encourages students to read and develop their knowledge of current evidence to inform their developing knowledge and consequent decision-making. Lucy- Anne’s passion for improving diabetes care is continued throughout her academic work, and her clinical reports are outstanding, reflecting her enthusiastic and caring nature.
An experienced community and palliative care nurse, Rachel started her current role and move into advanced practice in a trainee Advanced Nurse Practitioner role with a focus on frail elderly patients in care homes. The role was developed by the Amman Gwendraeth cluster in response to local primary care pressures and recruitment and retention challenges in the locality. Since working in this role, Rachel has demonstrated considerable leadership skills, forging relationships with patients/residents and their families and care homes. After liaising with GPs from several different practices initially, their needs and expectations were incorporated into the work plan.
Rachel has been able to demonstrate outcome data that met and exceeded expectations for improvement for the role. Over a six-month period the total home visiting rate for GPs reduced by 60 per cent; home visiting to care homes reduced by 85 per cent and in one care home there was a reduction of 49 per cent in hospital admissions. Overall, there has been an improved patient experience as all patients are seen, assessed and care planned/delivered by one health professional in their own home on a timely basis. Feedback from patients and colleagues clearly demonstrate that Rachel is caring, trustworthy and that her input has been invaluable to improving the struggling service.
Lead nurses in expert clinical skills and professional development, Jane and Cathryn are passionate about older people and their right to dignity and respect. Working in all residential and nursing care homes within the borough of Gwent, equating to 126 care homes, they believe that residents need the same access to services as the general population, requiring a skilled and experienced workforce. Since joining the Professional Development and Integration Team, Jane and Cathryn have aimed to empower care home staff to feel confident in discussing and implementing advance care planning and to provide care home staff with education to make empowered evidence-based decisions regarding their residents’ health care needs.
Despite having to overcome barriers such as poor training attendance, lack of manager ‘buy in’, inappropriate teaching environments as well as lack of staff interest, they have delivered training to the workforce in 120 care homes across Gwent. This has had considerably positive outcomes, including raising the percentage of ACPs for general residential home from 0 per cent to 39 per cent (and still rising); a 41per cent reduction in 999 calls for non-injurious falls and more residents given the choice regarding their end of life wishes. As well as training non-NHS and care home staff, they often step outside their role to support wider care delivery, supporting the district nursing team over Christmas and the WAST in nurse in-reach during winter pressures.
As a Senior Practice Nurse and S.E. Wales Regional Nurse for the Macmillan Primary Care Cancer Framework Programme, Juliet has achieved excellence in her field of work and made significant service improvement to professionals, cancer patients and their families. As an increasing number of people are now living with cancer, meeting the needs of these patients is a substantial challenge, especially with limited resources within primary care. Juliet has led service improvement work to meet these challenges by developing a structured educational cancer foundation programme for practice nurses and advance nurse practitioners, co-produced with the Wales Cancer Network. Juliet is a strong supporter of the recovery package, a series of interventions for patients including treatment summaries, holistic needs assessments, identifying key workers and the co-production of care plans. The positive impact of the recovery package is apparent through patient and carer stories as well as nurse and GP feedback, and is underpinned by data highlighting how her work has improved communication.
Juliet is also leading a Macmillan project to support practice nurses across the region to implement the ‘recovery package’ in their day-to-day work in their GP practices. Direct evaluation from practice nurses reveals they now feel more empowered, knowledgeable, confident to ‘talk cancer’ with patients and more aware of local social and national services available to support patients’ needs as a direct result of Juliet’s work. The scope of Juliet’s work as a role model, mentor, and leader has extended beyond her nursing profession and her peers significantly value her gentle, yet highly effective ‘can do’ positive mantra, along with her dedication and enthusiasm.
An experienced nurse in Primary Care with a strong development and learning ethos, Ginny has an insatiable appetite for learning and enthusiastically encourages all of those whom she works alongside and mentors. Last year Ginny had a quality improvement audit accepted for a poster presentation as an example of good practice at the CNO Wales conference. The purpose of the audit was to improve the management of patients with Type 2 diabetes, managed via a GP surgery. Structured patient reviews highlighted inconsistent prescribing practice, as well as a period of increased staff turnover resulting in a reduced service number of diabetes clinics. Ginny was instrumental in establishing a call and recall system and nurse-led structured patient reviews were re-established. The conclusions of the audit resulted in patients being prioritised through optimising prescribing. A multi-disciplinary team approach reduced the risk of potential harm and ensured safety was prioritised and professionalism and trust was promoted through transparency. The process has established regular medication reviews for patients with Type 2 diabetes.
Colleagues comment that “she has always been supportive” and that she is a strong “role model in general practice”. She regularly finds interesting, evidence and research based articles and then disseminates them to colleagues across the patch, promoting a shared learning environment to encourage the advancement of others.
Suzanne has implemented changes and initiatives, greatly impacting on patient flow and patient safety. By ensuring ward spinal nurses are involved in patient care whilst they are still in ITU, and by introducing a system making it more seamless for patients who are transferred from ITU to the ward, both patients and their relatives are now able to become familiar with ward staff prior to leaving ITU, alleviating stress and anxiety. Suzanne is the lead on a working group striving to implement a competency document for Facia Iliac Blocks for both doctors and specialist nurses to ensure that all staff meet the recommended criteria before practicing independently. This has improved patients’ experience in terms of reducing their recovery time, improving pain management and significantly enhancing post-operative rehabilitation. Suzanne has presented her work on this at the Chief Nursing Officer conference, the RCN conference and the British Geriatric Society conference.
She has collaborated with clinical fellows and has launched guidelines for all traction care including Thomas splints - this she teaches to ward and medical staff alike. She is integral in the management of patient flow throughout the trauma wards and emergency department, and she does this with professionalism and compassion whilst trying to ensure that patients are placed in the areas most suited for their injuries. Suzanne fully recognises the importance of influencing the wider multi-disciplinary team and is an excellent role model to which other nurses can aspire.
Natalie works in the Unscheduled Care Division, taking the lead in emergency admissions and the Elderly Frail Unit. During last year’s challenging winter period, Natalie made a positive impact by opening a “Winter Pressures” ward to support safe care and improve patient flow for acute adult patients. Through effective leadership, Natalie ensured the governance agenda was met to ensure a safe environment of care and safe patient care on temporary wards with temporary staff. By planning ward services, creating a recruitment plan to ensure any agency shift was kept to a minimum and only required in extenuating circumstances, and by carefully selecting a ward manager with experience, Natalie ensured that the temporary winter ward was a success for both patients and staff. Natalie clearly demonstrated that her management of change to open this temporary ward was exceptional, ultimately impacting positively on patient care.
Natalie goes the extra mile – every day, she supports above and beyond, her standards are second to none (and not for compromise); she is absolutely patient-focused, she always finds time to talk and time to care for patients, relatives and staff and she faces any challenges head on. Natalie clearly demonstrate the values and leadership to problem solve and achieve the resolution.
Michelle’s passion for safeguarding children has been ably demonstrated by her work as both a health visitor and as lead nurse, developing effective safeguarding supervision for health visitors and other disciplines. Michelle has undertaken an MSc in advanced practice and evaluated the influence of the domestic abuse conference call on health visiting practice. She later moved into education, where she has been influential in further developing the safeguarding module for health visiting students. More recently Michelle has undertaken a pilot project with Cardiff and Vale University Health Board to explore group supervision for health visitors in relation to safeguarding children. The pilot project will progress into a wider ethnographic study at PhD level to influence future safeguarding children supervision practice and improve care.
Michelle is Wales Chair of the Executive Committee for the Community Practitioners and Health Visitors Association, working closely with other UK representatives, raising the profile of health visiting and school nursing from a Welsh perspective. She has published two papers in the last year, one linked to domestic abuse conference call and one in relation to effective assessment of health visitor students, combining two competency frameworks. Her passion for safeguarding children is evident and she adopts innovative and creative ways of getting the messages across to students. It was Michelle’s depth and breadth of knowledge and the opportunities she has taken to shape practice both nationally and internationally that most impressed the judging panel and members commended her commitment to contributing to the growing evidence base for nursing practice in safeguarding through her PhD study.
Janet leads and manages the Looked After Children health team, contributing to the development and implementation of specialist programmes for vulnerable children placed away from their homes - providing day-today expert knowledge, support, guidance and supervision to those children, young people and their foster carers and other professionals. Janet has developed the health board’s Looked After Children policies in line with national legislation and strategy and worked with dental and sexual health leads to develop both dental and sexual health pathways for LAC. More recently, Janet has developed guidance for the identified health service provision to local authority and private residential homes. She has also been instrumental in leading on child sexual exploitation work regionally and has represented the health board nationally, which has led to her introducing the CSERQ15 (Child Sexual Exploitation Risk Assessment Screening Tool) in the HDUHB region.
She is described as a highly respected, motivated, innovative, passionate and enthusiastic practitioner who positively contributes to the work of the Safeguarding Team in Hywel Dda University Health Board. The judging panel was struck by Janet’s passion and commitment to vulnerable looked after children and young people. Her long commitment and enduring investment is evident, as is her tenacity, resilience and compassion to ensure equality and good outcomes for children and young people in care within her health board catchment, the judges said.
With a background in mental health and adult nursing, Aled leads an innovative, policy-relevant, research programme which is improving nursing practice and healthcare in Wales, the UK and internationally. Aled moved into higher education at Swansea University in 1997, completing his PhD on nurse-patient communication in 2006. He has published widely, with over 40 articles, book chapters and research reports. In the School of Healthcare Sciences, Aled engages in research-led teaching and leads the Optimising Service Delivery and Organisation Research Theme. This brings together researchers at different career stages who conduct studies improving health care services and practice.
Aled’s research leads directly to NHS innovation and improvement, generating evidence in critically important areas such as ‘speaking-up” and raising concerns about poor care, nurse staffing levels, resilience, and care planning and coordination. Aled’s existing research into staff experiences of speaking up has already exerted a direct impact on patient care, having informed improvements across NHS Wales. Building on his whistleblowing research Aled secured an ESRC/Cardiff University Impact Acceleration Award to collaborate with Cardiff and Vale UHB to develop its Freedom to Speak Up Safely (F2SUS) (‘safety valve’) policy. In the area of nurse staffing, Aled led research informing the Welsh Government’s decision to introduce Nurse Staffing Levels (Wales) Act 2016, briefing ministers and government advisers. He is currently academic lead on the All Wales Nursing Staffing Group.
Angela has been responsible for implementing the Resuscitation Service clinical audit data, in the Cardiff and Vale University Health Board, which has been highlighted as best practice by the Rapid Response to Acute Illness Learning Set (RRAILS) and the Welsh Resuscitation Forum – the forum for all Resuscitation Practitioners across Wales. The aim was to maximise collection, analysis and distribution of essential data related to Resuscitation and Emergency Care throughout the UHB to improve direct patient care and safety through resource planning, including educational requirements, in line with organisational policies and strategies, also in compliance with national and international guidelines and recommendations. CVUHB is the only health board in Wales that has a complete data set.
Angela is recognised for her expertise in resuscitation and her work at CVUHB implementing change from accessing and acting upon Resuscitation Service clinical audit data. This allowed the promotion of best practice via the creation of a Rapid Response to Acute Illness Learning Set (RRAILS) in conjunction with the Welsh Resuscitation Forum. Thanks to collaboration with the Business Intelligence Warehouse, an electronic resuscitation cube has now been created, allowing data to be reported in the form of a multi-dimensional cube and dashboard. This project has progressed to the next stage, whereby data collection is now possible at the patient’s bedside and is automatically, rather than manually, uploaded, allowing clinicians to spend more time with their patients. This can help identify patients most at risk and improve care outcomes. The project recently won the UHB Research and Development Award.
Kath and Sandra work as a clinical nurse specialist team within the Children’s Hospital for Wales, caring for children and young people with cystic fibrosis. They both display a passion for their job and always put the patient at the centre of their work. They strive to ensure that the voices of patients are heard. Their dedication has ensured that the specialist nurse role has developed to ensure that all of the children and their families they care for, who are diagnosed with this life-changing disease, receive the high standard of nursing care they deserve. They actively seek feedback from the children/young people on their caseloads to ensure that the service they are providing is what the patients and families want, including specialist help in ensuring that young patients are ready for school and can integrate well into this new environment.
They have also made positive changes to improve the service including work with some young patients who were struggling with their condition and with the very real concept of what was their life expectancy. The children worked with a team of health professionals to produce a booklet called “All About Me” that they presented to classmates, with the nurses present. This helped classmates to understand and help the children affected. The judging panel said the pair demonstrated their passion and enthusiasm and a forward thinking approach and the children and families they look after have said Kath and Sandra put their hearts into helping them enjoy a good quality of life.
Carys is a learning disabilities nurse working with children with severe learning difficulties and challenging behaviours. She has developed staff awareness of safe working practice and the best modes of communication for these children and young people and liaised with schools, developing care plans to ensure a child has a safe and happy transition from home to hospice. She is passionate about developing the care team’s skills through training sessions on the best practice of care for these specialised children. Carys is an advocate for the children and families in her care, ensuring their needs are heard and promoting a positive environment while doing it; she is compassionate, understanding and patient with children and families and has worked closely with end-of-life care of children, providing distraction and fun through times of what would be sadness and/or pain. She encourages children to participate in activities within the hospice as well as promoting memory making through art.
Carys is a mentor to learning disabilities students and thrives on teaching these students the importance of her role and promoting her passion about the challenging behaviours of children with complex health needs. This young nurse is a truly inspirational leader in paediatric palliative care and her overwhelming passion for her work was demonstrated to the judging panel in her understanding of children with complex, paediatric palliative care needs who display challenging behaviours and by her advocacy for the children and families in her care.
Page last updated - 15/01/2019