Student and Educator Community

A collection of personal reflections from members of the 1000 Lives Improvement Student and Educator Community

The quality improvement journey of healthcare students in NHS Wales

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1000 Lives Improvement Student and Educator Community Supporting the Quality Improvement journey of healthcare students in NHS Wales

Driving improvements in patient care 1000 Lives Improvement supports healthcare students in Wales to develop their quality improvement knowledge and skills through their involvement in the Student and Educator Community.

The Community is an active inter-professional network of over 4000 members at six universities across Wales, all enthused by quality improvement and patient safety.

In this collection of personal reflections, nurses, midwives and junior doctors share their experiences of quality improvement as part of the Student and Educator Community, and how they have taken this knowledge into the workplace.

Quality improvement is part of their every day practice, helping them to deliver the best possible care for their patients.

We hope these stories inspire you to get involved in quality improvement activities, and to support you with your career and future aspirations.

‘like’ us on Facebook:1000 Lives Improvement Student Network

Keep up to date with the Student and Educator Community:

or follow:@1000LivesWales

Dr Aidan Fowler, Director of NHS Quality Improvement and Patient Safety, and Director of 1000 Lives Improvement says:

“ Quality improvement knowledge and training are key to ensuring the current and future workforce of NHS Wales can continue to improve the care they provide to patients every day. Staff in every health board and trust are already taking part in Improving Quality Together, the national learning programme for NHS Wales, and it is being integrated into education programmes across our universities. This collection is testament to how healthcare students across professions are committed to the national improvement journey in Wales and applying their skills to improve patient experience as part of their careers.By supporting students with quality improvement activities we can truly embed a culture of improvement.” email us on:

1000livessec@wales.nhs.uk

You can gain skills and experience to help you practice safer care, and access great resources, news and events, national activities, and support to lead improvement work locally.

By joining the Community, you’ll have the opportunity to network with individuals from over thirty degree schemes at six universities across Wales, helping you to build professional relationships and develop skills that will continue throughout your entire career.

Join today! Visit www.1000livesi.wales.nhs.uk and click on

‘1000 Lives Improvement Student and Educator Community’

Join over 4000 students and educators in the 1000 Lives Improvement Student and Educator Community!

Student and Educator Community

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1000 Lives Improvement Student and Educator Community Supporting the Quality Improvement journey of healthcare students in NHS Wales

The main influence for me joining the 1000 Lives Improvement Student and Educator Community came as a result of attending my local Health Board’s ‘Celebration of Nursing day’. The event highlighted how identifying and making small changes to practice had such a big impact on patient care. Having had a small taste of quality improvement, I wanted to find out how I could influence change.

As Chair of the 1000 Lives Student Chapter at Bangor University I have gained so much more than I ever imagined.

I attended the 1000 Lives Improvement National Learning Events held twice a year. I presented at a London Education Conference on the work of the Chapter, and have been supported to develop my skills to create, test and soon to implement my own ‘Improvement Project’.

My quality improvement project consisted of a symbol-based sticker that is located at the bedside and works in conjunction with the intentional rounding log. The symbol communicated three vital pieces of information to safely mobilise a patient to the toilet to reduce rates of incontinence. These three parts were how many members of staff were required to safely mobilise the patient, how regularly the patient needed assistance, and finally how the patient was toileted e.g. commode, bedpan or

bathroom. I was very fortunate to have my project shortlisted for the NHS Wales Awards 2015 Student Category.

The Student Chapter are developing a project to implement a name badge to use while on clinical placement. The stimulus for change occurred as a result of the roll-out of the All Wales national uniform for Student Nurses, where currently there is no visual way of distinguishing between different years of Student Nurses’ education. Our Chapter decided that a name badge could distinguish our name, year of study and which university we are studying at.

The Chapter has empowered us as healthcare students to change how we practice not only clinically but also within our university.

Taking forward the learning and support I’ve gained from the Student Community, I do believe it will enhance my skills and ability as a Registered Nurse.

While attempting to implement my own project as a Student Nurse, I faced barriers to change and it took several attempts to actually test the project. However I am glad that I experienced these challenges as a student.

I had the support from my Chapter’s Educational Supervisor and learnt for myself how to take forward improvements.

This will enable me to be more prepared when implementing change as a Registered Nurse.

As a third year student midwife about to qualify, quality improvement has been an important aspect of my midwifery education and I believe will continue to play a role in my transition from student to midwife.

I have a strong passion for quality improvement and the importance of improving services to ensure the best available care is being delivered. For the past two years I have been a member of the 1000 Lives Improvement Student and Educator Community.

By being a member, I have had the opportunity to attend the 1000 Lives Improvement National Learning Events.

Attending these events allowed me the opportunity to gain a wider understanding of the rationale behind evidence-based practice within healthcare.

A key skill I have developed whilst participating in these events is the importance of interdisciplinary collaboration.

During my time at university I have witnessed professionals coming together from different field of health and social care. Sharing experiences, gaining knowledge and inspiring others with the nuews of positive innovations, result in others committing to making improvements in their own practice. I have recognised that listening and learning from each other allows for development of not only my own personal professional development but also allows collaborative ideas for improvement to be birthed.

I have had the opportunity to complete the Improving Quality Together Bronze award. This developed my skills to help me reflect on my work and find ways to improve the system around me.

I am a firm believer of what should be every midwife’s fundamental philosophy: women-centred care. Fundamentally, all maternity services ought to be underpinned by an educated, professional midwifery workforce working in multi-disciplinary teams to ensure safety and quality for mothers and babies.

I endeavour to put into practice each new skill I learn so that women receive the best care possible. I have the privilege of being at the formation of special memories, being with women as they give birth to their babies by supporting, advocating, listening and empowering them in their transition to motherhood.

It is my ambition as I am about to qualify, to become a midwife that proudly facilitates informed choice, practice evidence based care and to be an advocate for women during childbirth.

Steffan Robbins, former nursing student at Bangor University, is now a Registered Nurse in MEAU at Cardiff and Vale University Health Board

Jonathan Cliffe, former midwifery student at Bangor University, is now a Midwife at Warrington and Halton Hospitals NHS Foundation Trust

Jonathan is pictured far left

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1000 Lives Improvement Student and Educator Community Supporting the Quality Improvement journey of healthcare students in NHS Wales

Helen Price, former nursing student at University of South Wales, is now a Registered Nurse at Royal Gwent Hospital, Aneurin Bevan University Health Board

I became aware of the 1000 Lives Improvement Student and Educator Community during my very first week as a student. I signed up at an information stand, not realising the invaluable opportunity I was about to harness.

Soon after, I was lucky to attend the 1000 Lives Improvement National Learning Event and that was when my QI journey began. During the event I had the opportunity to share a personal situation where a family member experienced inappropriate and poor quality care. Reflecting on the situation I realised not only the impact on the patient as an individual but the effect on the family as a whole. I knew I had to do something to influence the way care was being delivered, however, making a complaint was not the way forward.

After learning about Improving Quality Together to promote change and improvement, I knew this was the path to follow.

The Community was my learning zone, my knowledge base to tap into for resources to guide my journey. Attending National Learning Events has given me the opportunity to develop confidence in my work, whilst gaining inspiration and knowledge from others. I was asked to be a facilitator at one of the student sessions at the event.

This provided me with a platform to be involved in the CNO conference and NHS Wales Awards, where I have won the student category two years running.

During my first year I completed IQT Bronze. Fuelling my thirst for knowledge,

the university supported me to become the first student to complete IQT Silver. I was supported to complete two quality improvement projects whilst on placement.

The first project ‘Be in the Know, Don’t Wrap and Go’ was designed to tackle issues relating to poor continence management. The aim was to decrease the use of inappropriate nappy pads by creating an information leaflet for staff.

The second project ‘Respond with Heart’ was based on the principles of Dr Kate Granger’s #hellomynameis campaign. The mnemonic ‘Heart’ was used to remind staff to humanise and individuals all aspects of care, putting patient before the task.

Recognising the influence and change in practice of both projects, I was awarded a place to attend the International Forum on Quality and Safety in Healthcare.

Being an active member in the Community has provided me with a wealth of experience in quality improvement, networking, political awareness and scoping of new initiatives and access to any experts who have been there to guide and support me.

These experiences have given me the platform from which I can continue my registered nurse career with a breadth of knowledge, ensuring safety and quality are at the forefront of my practice.

I will share with my team and endeavour to teach others the good work that I have learned from the Community throughout the past 3 years. I would advise any student to get involved in the Community in any way possible.

Caitlin Griffiths, former nursing student at Glyndwr University, is now a Research Nurse at Newcastle-upon-Tyne Hospitals NHS Foundation Trust

I first became involved with the 1000 Lives Improvement

Student and Educator Community (formerly Wales Student Chapter) in 2011 before entering my final year of the nursing degree.

I thought it would be a good way of learning more about what happens outside of university and to be part of something exciting.

As a member and final year nursing student, I completed a quality improvement project on mouth care, using tools and skills which I had acquired from the Institute for Healthcare Improvement’s online courses and from attending 1000 Lives Plus conferences.

I presented at national conferences and lectures and was involved with the initial set up of a Student Chapter at Glyndwr University.

Now, at over three years post-graduation I am working as a Research Nurse. I have also worked as a Staff Nurse in Emergency Departments and in Critical Care.

I feel that all of the knowledge and the skills I gained through the Community have made me more aware of my actions and attitudes as a nurse.

I am passionate about doing things the right way because I am aware of the impact that not doing so can have on patients.

Not only has it made me more aware of patient safety, but also generally improving even the most basic of care that I give. An example of this comes from the “Hello, my name is...” campaign - I feel that this immediately aids to build a nurse-patient-carer relationship and I ensure that I introduce myself properly to all patients because of this.

The key thing I learned from my involvement with the Community is not to go along with traditional ways of nursing, but to question what is best for the patient. Being part of it has given me more confidence to be able to do that.

Participating in national events was also beneficial for networking. I met some very inspiring people at the events.

I would encourage others to become involved because we need to have skills to improve healthcare on a daily basis, and as the future workforce of the NHS, you are the people to do it.

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1000 Lives Improvement Student and Educator Community Supporting the Quality Improvement journey of healthcare students in NHS Wales

Mikaela Best, former midwifery student at Bangor University, is now a Midwife at Birmingham Women’s NHS Foundation Trust

My quality improvement journey started as a first year

midwifery student in 2010 when I joined the 1000 Lives Student and Educator Community.

I joined to develop my knowledge and skills surrounding quality improvement, leadership and patient safety.

The Community opened up a variety of networking opportunities for me to contribute to the improvement of patient wellbeing. I attended the Transforming Maternity Services collaborative events throughout my 3 years training. During these events I was encouraged to convey my thoughts and opinions amongst qualified health professionals towards developing key tools used within Welsh clinical practice. These included tools for the recognition and response to the acutely deteriorating woman, reduce the risk of DVT and overall reduce mortality and harm for all women from the antenatal through to the postnatal period.

In 2012, the Student and Educator Community held a Patients and Person-centred care competition which highlighted for me the key role of communication within healthcare provision.

Taking part enabled me to develop my communication skills, fundamental in clinically demanding situations.

As a result I won the prize to attend the International Forum on Quality and Safety Improvement in London. What an amazing experience to be sat alongside such innovative healthcare providers and

inspirational speakers! The event opened my mind to reducing harm and increasing quality to improve patient outcomes across the globe. This learning opportunity conveyed the magnitude of devoting our time to an individualised patient centred care approach.

As a qualified midwife it feels great to be using the key tools which I partook in the development of as a student. Understanding the value of individualised womens’ care and the theory and ‘one-size of care does not fit all’, I always try to uphold this philosophy ensuring my care is tailored to the needs of each woman and her family. Now, 2 years postgraduate I have moved to a new NHS Trust in England and value the Community for the opportunities it provided me with.

It has sparked my curiosity in quality improvement from undertaking a mentorship programme and contributing to clinical audits.

I highly recommend the Student and Educator Community to all healthcare students. The Community is purposeful for all students to develop their knowledge, gain ideas and experience in quality provision of patient wellbeing.

As the next generation of healthcare workers, having the opportunity to promote safety and understanding of quality improvement starts as a student.

The Student and Educator Community might even be the catalyst in your career to make great changes to improve patient safety.

Bethan Wyn Jones is a nursing student at Bangor University

Being a member of the 1000 Lives Improvement Student and Educator Community has allowed me the opportunity to network with other healthcare students across Wales.

During a 1000 Lives Improvement National Learning event in 2014 I had the privilege of meeting Dr Kate Granger MBE, who was inspirational. Dr Granger began the #hellomynameis campaign and I won a competition run by the Community, by sharing my experience in using this simple introduction with my patients and colleagues when out on placement.

As a competition winner, I was funded to attend the 2015 International Forum on Quality and Safety in Healthcare. I met Maureen Bisognano, Chief Executive of the IHI and had the opportunity to network with people from all over the world which could last throughout my career. The atmosphere was electric and I had an unforgettable few days, full of inspiration!

Although I'm a technophobe, being a Community member has given me the motivation to engage with fellow healthcare students and colleagues via social media.

I now have a Twitter account @bethan11111. It’s a great way to be able to keep up to date with the latest news from 1000 Lives Improvement.

My experiences during the first year have reaffirmed my keen interest in nursing education, and even more so, my strong belief that a bilingual service should be offered to patients in healthcare in Wales.

I have recently joined the 1000 Lives Welsh Student Chapter at Bangor University. This group has a passion for quality improvement by identifying and improving any issues encountered which relate to healthcare in Wales. I believe that this experience will further expand my communication skills and my experience of working as part of a team.

My experiences so far have expanded my knowledge and nursing skills.

I have learnt that a universal message runs through healthcare all over the world, namely the importance of communicating with the whole team, including the patients.

My ambition is to graduate and become a professional and excellent nurse. I look forward to continuing as an active member of the Community and to build professional relationships within healthcare ensuring that I have the best knowledge and skills to move forward in my career.

Bethan is pictured far left

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1000 Lives Improvement Student and Educator Community Supporting the Quality Improvement journey of healthcare students in NHS Wales

Saffron Sparkles, former nursing student at Glyndwr University, is now a Registered Nurse based in North Wales

I joined the 1000 Lives Improvement Student and Educator

Community not long after I had started my nursing degree at Glyndwr University.

Learning about 1000 Lives Improvement and the part we, as students, could play in improving care seemed too good an opportunity to miss.

I contacted a fellow student Caitlin, who explained how she benefitted from being a Community member. Caitlin had been supported with her improvement project and invited to present at national learning events. When the time came for Caitlin to graduate, I took on her role as the Glyndwr University Student Chapter Lead.

I knew that I would need to work hard to ensure that the momentum for the Student Chapter was sustained. I attended national learning events, supported workshops organised for students and had the opportunity to connect with Chapters from across Wales.

I presented two quality improvement posters based on the rapid recovery programme at a national learning event and at a celebration of nursing day at th Local Health Board. Recently I had the opportunity to thank the consultant whose work I based it on and it gave me an opportunity to reflect on if I would change anything else and why, for both patients and staff.

I developed my next quality improvement idea based on a reflection of a difficult situation on placement that I turned into a positive learning experience.

I submitted it for the Chief Nursing Officer of Wales Conference 2014 and was honoured that it was selected. I was so proud of fellow Chapter member Annette Thomas as her ‘Take two’ presentation was presented on the day too. Attending the 1000 Lives Improvement national learning events was key to developing my understanding of quality improvement and applying this knowledge to my studies and placements. As a student nurse I achieved IQT Bronze and with support from our lecturer and I also achieved IQT Silver.

It was something I will always treasure being part of, if it weren’t for the enthusiasm of fellow Community members, I may have not become interested and made it such a pivotal part of my nursing degree.

It is a year since I graduated, and I am pleased to say my passion for quality improvement has not diminished. I have introduced the #hellomynameis campaign.

I will be doing my mentor training soon and will encourage students to also be part of the Community and to think about quality improvement as part of their role.

I am thankful for the support from the 1000 Lives Improvement Student and Educator Community. Being a member gave me the confidence which I believe resulted in my nomination for the Student Nursing Times Awards 2014!

I am grateful I had the opportunity to get involved in the Community and the Chapter - it made my student experience one to treasure and I will maintain my passion for improving quality together always.

Marc Franklin is a Foundation Doctor Year 1 at Cardiff University

I have always wanted to think of ways that patient care could be improved. From my first clinical placements as a first year medical student, I would always look to see where improvements could be made to the current system in order to improve patient experience.

As a student, a few colleagues who shared the same interest in quality improvement and I founded the Cardiff Medics’ Student Patient Chapter. Part of the Institute for Healthcare Improvement (IHI) Open School, the Chapter aimed to raise awareness of quality improvement and enable students from all healthcare departments to get involved in quality improvement projects.

One of the most successful quality improvement projects we started was the “Ask One Question” project. This involved students asking one simple question, “If there was one thing I could do to improve your stay here today, what would it be?” Students then could act on the patient’s response and collect their responses to evaluate trends on certain wards.

The project was very successful and has been published in The Permanente Journal after winning an award at The Institute of Healthcare Improvement Annual National Forum in Florida in December 2012. The Project was also shortlisted for the NHS Wales Awards student category in 2014 and is now also part of the Cardiff University School of Medicine curriculum for 5th year students.

Since starting work as a Foundation Year 1 Doctor I have kept my interest in quality improvement.

Not only do I continue to “Ask One Question” to all of the patients I interact with, I always look for ways to improve the patient experience.

The lessons I learnt as a medical student attending 1000 Lives Improvement events and The Institute of Healthcare Improvement Forums have proved invaluable.

As part of the 1000 Lives Improvement Student and Educator Community, I want to continue to raise awareness of quality improvement amongst students.

Marc is pictured third from left

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Supporting the Quality Improvement journey of healthcare students in NHS Wales

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1000 Lives Improvement Student and Educator Community

Kim Davies is a nursing student at Swansea University

I was in my second year as an adult nursing student in Swansea University when I attended my first 1000 Lives Improvement National Learning Event in Llandudno. As a Community member, I joined this exciting two day event with my classmates and discovered that there were two other fellow students attending from Swansea University. We all met at the train station and swapped nursing stories during the journey!

One student, Anita Bari, was the Chapter Leader for Swansea University and told us all she was recruiting members to get the Chapter off the ground and invited us to be a part of the group. The event was pivotal as not only did it increase my understanding of quality improvement, but it also provided a great networking opportunity.

We met the inspirational Dr Kate Granger MBE, who presented her #hellomynameis campaign. She explained the importance of introducing yourself to your patients and fellow colleagues – this really struck a chord with us all!

Feeling inspired and having joined the newly formed Chapter, we returned to university to begin planning our first improvement project!

Within a few months our Chapter launched the #hellomynameis….” identification badges in Swansea University, based on the campaign developed by Dr Granger. The badges encouraged all healthcare professionals to use the simple introduction with all their patients and colleagues. The bilingual

badges were rolled out across our university cohort as our fellow students were invited to wear them on placement.

As a Chapter we wanted to make this small change that would matter to our patients and their families - finally our names were clear to see on the newly designed badge! We wore them as a trial and the response was overwhelmingly positive! We saw that patients were more confident to call on us as they now could see our name clearly (as well as introducing ourselves of course).

We are now hoping that local health boards will consider using the badges and are working with our lecturers to explore how we can encourage them to be adopted.

To develop my quality improvement skills further, I have completed my Improving Quality Together Bronze and plan to complete my Silver level alongside my fellow Chapter members.

As a Community member I have attended many 1000 Lives Improvement events that have really broadened my knowledge and understanding of quality improvement which I hope to continue once I graduate.

I’ve met many interesting and influential people at these events, and through working together I know we can make our healthcare system work better.

Being a part of the 1000 Lives Improvement Student and Educator Community has enabled me to have the confidence that I can make small changes that can make a big difference to my patients and the healthcare system and I would definitely encourage others to join!

Kim is pictured far left

Find out more, visit:www.IQT.wales.nhs.uk

The Community is supporting the introduction of Improving Quality Together, the national learning programme for NHS Wales, into health profession courses across universities in Wales.

Improving Quality Together provides staff, trainees, students and educators with a common and consistent approach to improving the quality of services across NHS Wales. Taking part will help you play a vital role in transforming NHS Wales into the service that people need.

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1000 Lives Improvement Student and Educator Community

Published by: 1000 Lives Improvement (February 2016)

‘like’ us on Facebook:1000 Lives Improvement Student Network

Keep up to date with the Student and Educator Community:

or follow:@1000LivesWales

email us on: 1000livessec@wales.nhs.uk