Jennifer Gregson
Ward Sister ,
Erewash PCT
Tel: 0115 930 5522 ext: 293
Email: jennifer.gregson@erewash-pct.nhs.uk
Summary:
The key aims of the Purple Flower initiative are to improve the nutritional care that inpatients receive who are identified at nutritional risk.
This system was developed in partnership with the initiatives from the Essence of Care Nutritional Benchmark and was adapted from evidence documented in the Nursing Standard Magazine. The Purple Flower process involves placing a purple flower placemat at the bedside of patients to alert staff that the identified patient requires assistance with eating and drinking.
This simple but cost effective system complies with maintaining patient confidentiality whilst enhancing an important but overlooked aspect of patient care.
Abstract:
The main aims of this service change are to improve the nutritional care of patients who were identified at risk, along with improving service delivery whilst maintaining the patients’ privacy and dignity.
The Purple Flower system was identified from evidence based practice at Cardiff Royal Infirmary, which was documented in the Nursing Standard Magazine. The process was adapted from a red tray system that was used by Cardiff Royal Infirmary to using place mats or coasters with a purple flower design on, on one of the wards at Ilkeston Community Hospital.
By developing this new way of working it has enhanced communication and team working across different groups of hospital staff.
This initiative has been embraced by partnership working between all of the staff on the ward where the system has been introduced. Through regular communication and staff meetings the Purple Flower system was embedded into practice on the ward with the front line staff having full involvement in the initiative.
The quality of nutritional care to patients is monitored on a weekly basis via the Patient Experience Tracker electronic data tool.
All patients are encouraged to give their feedback on the service they have received; this includes questions in relation to the presentation, quantity, temperature of the food served and the suitability of the environment in which the patients eat.
The staff meet to discuss the results, they identify any issues raised and decide on actions to improve the service further.
In February 2005 a Nutritional Support worker role was introduced, who liaises with all ward staff and the dietetic team at Ilkeston Community Hospital.
This new approach has helped to develop the auxiliary nurse and housekeepers’ roles.
Auxiliary nurses are now responsible for assisting the named nurses on the ward with the nutritional care of the patients by carrying out duties such as weekly weights along with ensuring all the food charts are filled in correctly.
Housekeepers are now responsible for ensuring food charts are up to date and they also provide fortified milk to identified patients.All inpatients have a nutritional assessment on admission, which identifies individual needs regarding their nutritional status and need for feeding support.
This information is reviewed on a weekly basis and has significant importance to patients who are particularly at risk. The nutritional scores help staff to monitor the initiative, as these highlight patients that are losing weight.
The purple flower system has significantly reduced the amount of patients with weight loss.
Through the feedback received form the Patient Experience Tracker patients can also see real changes and improvements, giving them the opportunity to be involved in the improvements made.
Since the introduction of the system the nutritional status of individual patients has improved which has been identified through the weekly nutritional assessments. This includes indicators such as weight gain, hydration and skin condition
This system has developed individual patient centred care through identifying individual patients needs whilst helping to maintain their privacy and dignity. Patients are now also offered alternative food choices giving them greater involvement in their care.
This new initiative has been recognised as complying with the Caldicott regulations and has a positive impact on issues relating to maintaining the privacy and dignity of patients.
There are now improved working relationships between the catering services department and ward staff to enhance the nutritional care of patients.
The team involved in this initiative are now exploring ways of introducing this system onto the other ward at Ilkeston Community Hospital.
Details of the project have been in the Primary Care Trusts staff newsletter and are also on the Erewash Service Improvement Website, which all staff have access to.
A presentation of the projects progress was carried out at the local Excellence in Erewash Service Improvement Awards 2005. The regular communication and team working of all the staff involved has helped to sustain this initiative for the last two years.
The implementation of this system, which was identified through evidence based practice, has highlighted that the new way of working is meeting patients needs and has transformed nutritional assessment from a paper exercise to a practical tool which enables those patients that are at risk to be identified and supported.
The system is a simple but effective method, which has been implemented at a minimal cost.
This project was entered into the Erewash Service Improvement Awards in 2004.
