Nursing and Triage Residential Tool minimises distress for residents and improves care

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An innovative Nursing and Triage Residential Tool (NaRT) which was initially run as a pilot in 2017 in two residential homes, has now been successfully rolled out to more than 263 homes across England and Northern Ireland.

The tool was devised and predicated on the Manchester Triage System which this year celebrates more than 25 years and has been streamlined so non-clinical staff are able to follow a clear process which guides care workers as to the correct action to take.

This has led to a significant reduction in 999 calls, as well as ambulances attending nursing homes, minimising the distress to the resident of having an unnecessary admission to hospital.

Such is the success of NaRT, North West Ambulance Service (NWAS), which undertook the pilot in tandem with ALSG, revealed that NWAS receives just over 1million calls per year, of which c.10% of the calls are from care homes and of those, approximately 30% are discharged at the scene. This equates to around 30,000 patients per year, where ambulance resources attended residential homes unnecessarily.

One-fifth of Accident & Emergency patients are from the over 65 years and over, and care home residents in this age category, were seven times the admissions rate compared to England as a whole and of these, 40% of admissions from care homes were for conditions which potentially could be managed outside of a hospital setting or avoided completely.

Commenting on the NaRT system, Stephanie Allmark, Northwest Ambulance Services said: “Minor injuries and illnesses can be effectively managed, assessing and referring residents to a more appropriate pathway of care without the intervention of 999.

“Without the use of the NaRT tool, 999 remains the first port of call for care homes however, staff know their own residents extremely well and NaRT gives them the confidence to follow an easy to use structured process, with clear steps as to whether an ambulance will be required. No diagnoses is needed, just a simple checklist has to be completed.

“Of course we recognise that in order for NaRT to be introduced into a care home, it needs collaboration from all agencies, from the ambulance service, to urgent and primary care services, as well as the nursing and residential homes but the statistics are proving this is an effective tool.”

Full training of NaRT is given and is now operational in 263 nursing and residential homes across England and Northern Ireland. https://carehomes.necsu.nhs.uk/ (Capacity Tracker)

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