Teams of two ensure patients get the best

Nurses are teaming up with a new system aimed at strengthening patient safety and providing better continuity of care.
The Wanganui trial started early last month with a view to rolling it out to the surgical ward next month.
The system was introduced by Sandy Blake, the director of nursing at Whanganui District Health Board, and is based on similar nursing models she worked with in Queensland.
Marie Jarden, clinical nurse manager in Wanganui Hospital's Bakewell ward, and associate clinical nurse manager Colleen Hill, have led the change.
Mrs Jarden said the hospital wards had a high ratio of patients to registered nurses (RN) but this new system improved that ratio.
"It involves two RNs working together with the help of an enrolled nurse to look after a group of patients and it means we've managed to increase the time each registered nurse is able to spend with each patient."
The new system means the workload on the ward has dropped by about 30 per cent. Where one nurse was caring for seven patients, in the team structure they now look after five.
She said patient care and safety was one of the key drivers behind the programme and the medical ward was piloting the scheme.
The team concept was reviewed in a number of other hospitals around the country and overseas and staff in Bakewell ward have been directly involved in developing it.
Mrs Jarden said the model can be adapted in other wards because nurses can, and do, work in different wards from time to time.
"Rolling it out to the other wards mean we can maintain those improved nurse-to-patient ratios throughout the hospital. This system certainly increases the bedside hours of our registered nurses."
She said the appeal of the system was that it teamed two RNs together and care was taken to ensure that the "team" had an adequate and complementary mix of skills.
"So we'll have new staff who will be supported by more experienced staff. What it gives us is a lot more flexibility in the ward."
The RN teams will be looking after between 10 and 12 patients in a ward that can accommodate 32 patients.
Mrs Jarden said although the system had been in place for less than a month the feedback from staff was "very, very positive".
"They say it's exceeded their expectations and gives them more time for direct patient care."
She said it relied on the nurses planning their work and allocating priorities before and during their shift.
The new work model carries on from another innovation introduced in November called "end-of-bed handovers". This initiative sees patients learn who the nurses are for the incoming shift while at the same time the new shift is updated on patient status.
"The patient is part of this update and patients have been telling us that they are hearing far more about the care they are getting and they also have a greater understanding of what's happening to them," said Mrs Jarden.
Incoming teams immediately assess patients before they accept responsibility from the out-going shift.
She said long-serving nursing staff recognised the new team approach as a revival of nursing systems used some years ago.
"We had a type of team structure some years ago but this model still ensures accountability for the RNs.
"Working together [means] they have more flexibility and control in what they're doing on their shift as well. So these teams have a lot of autonomy."
There had been some "fine-tuning" since January.
"A number of nurses are individualists and working within a team structure was something different for them but they're adapting. Some who had reservations are now saying they can see how well the system can, and does, work," said Mrs Jarden.