961 Learn share care – a multidisciplinary initiative to improve transitional care training. (17th August 2022)

• Record Type: Journal Article
• Authors: Stewart, Claire; Pounds, Patience; Ofasi, Rosemary; Scannell, Jack; Kilkelly, Benjamin; Muthukumar, Keerthi; Mehta, Shriya; Gotea, Luciana; Howgate, Louise; Hall, Cassandra; Godambe, Sunit; Gozar, Ioana; Wadhwani, Venna; Chaban, Badr
• Is Part Of: Archives of disease in childhood. Volume 107(2022)Supplement 2
• Page Start: A174
• Page End: A174
• Publication Date: 2022-08-17
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2022-rcpch.280
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: The aim of this project was to create a joint midwifery- and neonatal-led training intervention that addresses the learning needs of staff working in transitional care (TC), shares multidisciplinary experience and ultimately improves the care of babies in TC. Methods: Learning needs were identified through three methods; 40 members of frontline staff were each asked to select 5 topics they would like to know more about; 2 months' worth of TC handover lists were reviewed to capture the range of diagnoses and problems encountered and 12 months' worth of clinical incidents from TC were analysed for learning opportunities. This generated four main learning themes around which a study day programme was structured. Course material was then created in a truly multidisciplinary way, with input from 22 members of staff representing every role working in TC including students from midwifery, nursing and medicine. A virtual study day was held to deliver this content which included: question slides to stimulate two-way learning and check understanding, case-based topic tests developed from the clinical incidents reviewed, spot the mistake picture quizzes, video-link interactive questions requiring thumbs up/down or show how many fingers answers (eg.to trancutaneous bilirubinometer (TCB) or not to TCB, how many hours until the next set of observations etc.), voice recordings of patient handovers for participants to try prioritising to learn about the importance of the story and lots of video content of first on scene simulations and skill demonstrations with multiple break points to encourage discussions around what would you do next. The programme concluded with an expert panel session for senior members of staff from all disciplines to contribute to the discussions. Two training dates were scheduled creating an early and late intervention group and registered attendees were asked to rank their confidence on a five-point scale in managing multiple TC scenarios at multiple time points including before, after and one month after to assess for retention of any impact. Results: After training, the early intervention group (n=32) increased their overall confidence in working in TC by +1.9 points out of five compared to late intervention group (n=22) which, without training, had no change in the same time frame (+0.03). Confidence in managing babies with nasogastric tubes (+2.3), being first on scene to a sick neonate (+2.2) and managing neonatal sepsis (+2.1) were the scenarios where the intervention saw the greatest increase in confidence ranking. 100% of attendees to the intervention ranked the usefulness of the training day as 10/10'brilliant' for meeting their learning needs and 88%(28/32) said it exceeded expectations in terms of impacting on their practice. Action points derived from the senior panel discussion led to local guideline and practice changes. Conclusion: Taking a multidisciplinary approach to creating training interventions for areas where integrated working is crucial to care can significantly improve outcomes. A quarterly targeted TC study day can be an effective tool for increasing frontline staff's confidence in managing babies in scenarios that commonly present in TC and should be made available to all staff working on postnatal wards.