Zonal Nursing at the Ayr Clinic
Hugh Hill & James Dalrymple
Movember 2012
Introduction
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Meaningful involvement
Effective and evidence based practice
Embedding and delivering a recovery model
Busy, active and engaging wards
Person centred care
Getting the balance right between safety and
freedoms
The Impact of Enhanced Observations
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Up to 6 patients 1:1 or 2:1
Increased stress levels
Motivation levels reduced
General lack of hope
Similar experiences of mental health settings they had
been in before
The Teams Mission?
• To explore viable alternatives to traditional
observation methods
• To examine related research and good practice
articles and visited other hospitals that were
operating alternative engagement strategies
• To develop a proposal and project plan
• To consult and develop a new system
• To work with patient and the MDT to find a better
way for patients and staff.
What is Zonal Nursing?
• Staff are allocated to specified zoned areas in the
ward rather being assigned to an individual
patient
• Via an established ‘Zoning’ system patients are
allocated an individual risk assessment
• Patients can move between areas and be
monitored discretely
• A security nurse and floor walker manage and
monitor the zones
Changing Culture
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Improving communication at every level on the ward
Testing trust and confidence in each other and teams
Ownership and commitment to the process
Putting patients front and centre
Flexibility in roles and approaches
Getting the patients to work with us
Supervision and support
After 10 months?
• The environment is less restrictive
• It is conducive with delivering better therapeutic
intervention
• Activity has increased allowing staff to develop
protected time and introduce structured
programmes for people in the ward
• Culture of positive risk taking
• Supporting recovery
Specialing
Less is more?
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Staffing numbers
Supervision
Morale
Meaningful week – 25 hours minimum
Therapeutic environment
Greater freedoms, responsibility and options
Incidents
Fun
What next?
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RCN and MWC Nominations
Presenting the work – articles, workshops, posters
Full evaluation – February 2013
Extend across the hospital
Share practice – (Thanks to Dykebar and Leverndale)
Conclusion
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Drivers for change
Evidence base
Ownership at team level
Involving patients
Substantial improvements in ward experience
Substantial improvements in nursing opportunities
A positive step for change.
References:
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STEEL, M., 2012. Breaking with tradition. Activate, 6(10), pp. 5
CARR, P., 2012. Using Zonal Nursing to Engage Women in a Medium Secure
Setting. Mental Health Practice, 15(7), pp. 14-20
Movember Facts
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The average life expectancy for men in the UK is four years less than
women
Prostate, colon, lung and breast cancers account for over half of the
cancer diagnosis in the UK
Prostate cancer is the most commonly diagnosed cancer in men in the
UK. Over 40,000 men are diagnosed with prostate cancer ever year and
there are 250,000 men currently living with the disease
1 in 9 men in the UK are likely to face prostate cancer in their lifetime.
This is comparable to the 1 in 9 women that are estimated to get breast
cancer
2,209 men in the UK were diagnosed with testicular cancer in 2009
47% of testicular cancer cases occur in men under 35 years and over
90% occur in men under 55 years
42% of men were classified as overweight in 2010 (in England) compared
to 32% women
Obese men are 5 times more likely to develop type 2 diabetes and 3
times more likely to develop cancer of the colon
It’s not all bad news – see Health is for Life at Movember.com
Movember – changing the face of men’s health