Getting kids hands on for their heart.
- Winning idea
What is the challenge your project is going to address and how does it connect to the theme?
NICE Guidance recommends that ECG is completed for initiation and monitoring of certain medications to monitor and prevent any potential adverse effects.
Not tolerating ECG results in
- difficulties in prescribing medication that is required
- difficulties monitoring prescribed medication
- Increased risk of potential adverse effects.
- Non-compliance with NICE and Prescribing guidance
- Potential Patient safety concerns
- Increased patient distress in repeated attempts to obtain ECGs for monitoring
We have been working with Paediatric services, Cardiac Investigations and exploring and utilising a variety of visual aids and desensitisation techniques to improve the experience of the child having an ECG. However we still have approximately 30% of children that as yet have not been able to tolerate an ECG, raising patient safety issues.
Use of the handheld device would be a clinical indicator of any potential adverse effects improving prescribing adherence to monitoring and reducing patient safety fears.
What does your project aim to achieve?
ID CAMHS plan to provide quality improvement utilising digital technology improving the health of the children by utilising the Kardia Mobile hand held device as a clinical indicator of their heart function in those that are not able to tolerate the 12 lead ECG. This will improve patient safety by early identification of any potential abnormalities and appropriate treatment can be implemented reducing the likelihood of long term health conditions.
This project aims to
- improve patient safety regarding initiation and monitoring of prescribed medication
- adhere to NICE and other clinical guidance through improved clinical monitoring of the heart, where 12 lead ECG is not tolerated.
- utilise digital innovations in quality improvements and reduce health inequalities.
“Poor quality healthcare causes health inequalities and avoidable deaths.” (Mencap 2018). Monitoring for prolonged QT is especially important in children prescribed anti-psychotic medication and these children often experience significant challenges with the ECG procedure.
How will the project be delivered?
ID CAMHS have developed a medication monitoring service in a multisensory environment with use of interactive projector and various communication aids and therapeutic interventions to improve compliance with clinical procedures. Staff have completed training to be able to offer ECG at the clinic rather than at the acute hospital which has improved compliance with ECG monitoring to approximately 70%.
A combination of
- Audit of current adherence to clinical monitoring
- Patient/family feedback on possible alternatives to ECG
- Review of digital innovations utilised in other areas of practice
Has lead us to introducing hand held devices for ECG monitoring when ECG cannot be tolerated.
- Co-production of implementation of the quality improvement
- Patient/family feedback
- Staff feedback
- Audit of compliance with clinical monitoring required to meet NICE and prescribing guidance
- Audit of abnormalities identified and early intervention to reduce serious adverse effects of medication
How is your project going to share learning?
The project will be shared with the Q Community through updates on the online platform.
We will also promote the project through regional and local QI forums including the Northern Ireland Regional HSCQI Website and Southern Trust QI annual events.
We will also take opportunities to share findings through professionals’ forums; present at relevant webinars or conferences such as the Registered Nurse Learning Disability Professional Development Forum, the All Ireland ID CAMHS Network along with other forums and service development networks the team are involved with. Information regarding service developments and quality improvement s will also be shared widely via various social media platforms and forums.
How you can contribute
- The experience of any Q members who have implemented similar technologies
- Are their additional technologies we should be considering?
|7 Nov 2022||Evaluation report and share findings at local and regional forums|
|21 Nov 2022||Engage key stakeholders to identify their needs and expectations|
|21 Nov 2022||Establish baseline to gather current compliance with clinical observations (ECG)|
|5 Dec 2022||Establish project evaluation requirements - Including Monitoring|
|5 Dec 2022||Share and support implementation with other services.|
|9 Jan 2023||Purchase Kardia Mobile Equipment|
|16 Jan 2023||Commence Staff Training|
|6 Feb 2023||Pilot and test Kardia Mobile with children at clinic/home settings|
|10 Apr 2023||Conduct further PDSA tests to refine solution|
|4 Sep 2023||Review audit and data gathering detailing compliance with ECG monitoring|