Inspiration: Using iPads in district nursing services

Inspiration: Using iPads in district nursing services

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Whittington Health NHS Trust, District Nursing Service


This innovation came about with the recognition of the increasing complexities of delivering district nursing across a busy inner London Integrated Care Organisation (ICO) covering Islington and Haringey (N1, N7, N8, N15, N 17 and EC1), and the realisation that many issues could be solved by mobile technology.

Many of our staff knew the advantages of smart phones and iPads from their own personal use. The Service wanted to transfer these benefits to improving efficiency and communication, and to supporting patient education and self-care.

The key issues to be tackled included changing the custom and practice around allocation of patients and nurses’ work lists, and our means of communication.

Brief Summary

Following a successful national technology funding bid, the iPad innovation was implemented.

We have 172 district nurses using iPads and so far about three nurses a day of nursing time has been freed up by this innovation.

Implementation process
We would like to highlight ‘collaboration’ as the most important ingredient to the implementation process.

Team collaboration

  • Early involvement of IT staff (applications, deployment processes etc)
  • Staff focus groups to build confidence, buy-in and support, and to fine-tune processes and procedures (eg, morning handover)
  • Robust mobile working plan endorsed by staff, management and IT

Efficient deployment

  • Close collaboration between IT, management team and staff
  • Train the trainer approach
  • Excellent support available to community teams
  • 172 district nurses have received iPads

Improved processes

  • New ways of working included improving standard operating procedures and adopted by staff
  • Supporting routine but also new exciting processes and functionality (Coordinator role, replacement of morning handover etc)
  • From deployment to adoption – the process of change

Service improvements

  • Better patient response time
  • Improved collaboration with other teams (eg, tissue viability team)
  • Increased auditable data
  • Better use of real time data (eg, photographs of wound; whereabouts of nurse)
  • Creates capacity to address unmet demand
  • Team Coordinators are able to locate staff, relay messages and allocate urgent appointments using Find My Friends iPad function
  • Leaders in digital district nursing and other community services
  • Resource allocation more effective (senior nurses been able to see more complex patients)
  • Using GPS and Route planning functionality staff can travel the most efficient route, reducing time spent on unnecessary travel
  • There are a range of mobile working applications designed for healthcare. Using these apps the iPad are a powerful tool to support assessments and delivering treatment. E.g. BNF

Patient benefits

  • Patients have been surprised but happy with much earlier visits
  • Quicker delivery of equipment
  • Use of E documentation on the iPad means this can be emailed and uploaded straight onto RiO
  • More collaboration and access to wider range of information
  • Access to Apps and other education information for patients and their families promoting empowerment and self-care
  • Better patient response time

Staff benefits

  • Senior nurses have been able to see more complex patients
  • Staff are going home on time
  • Staff are not having to wait in the office to get their allocation list
  • Staff have acquired new skills

Organisational benefits

  • Increased productivity
  • Visibility of Whittington Health NHS Trust as a digital ICO
  • Better and quicker allocation of resources
  • Delivery on IT strategy
  • Improved staff safety

Area of work

In relation to the four foundations of our declaration, this project aims to:

  • Happy staff with the right skills

Service user involvement?

This has benefited patients receiving nursing care in their own homes.

Advice for others

At a recent national technology exhibition, a speaker from NHS England suggested that 50% of mobile working initiatives fail, and that failure usually happens at the point of implementation and adoption.
Ensure good staff engagement as changing attitudes to the introduction of new technology is very difficult if people are afraid of it.
Ensure you have a project lead who can speak the same language as the IT staff AND the group who are making the changes.

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