Objectives

In 2011 the Children’s burn service separated from the adults to become a dedicated 5-bedded unit. Initially there were 2.6 WTE (whole time equivalent) children’s burn nurses and 1.0 WTE play specialist, with an additional  3 WTE general paediatric nurses. At this level of staffing the service was considered unsafe. This poster will review the procedures taken to address these issues and provide a service compliant with the National Burn Care Standards (2013). 

Methods

Concerns about staffing levels were highlighted externally and following a meeting with hospital management an increase in staffing levels was approved and two nurses were rostered per shift instead of one.

Standards for Burn Care were introduced in 2013, giving further impetus to our concerns. A self-assessment of the service was completed demonstrating compliance against the standards which was followed by a peer review. 

Results

The Peer Review Report was positive, but expressed serious concerns regarding staffing levels which added support for further recruitment. 
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Additional funding enabled the service to expand by 3 further WTE nurses, a ward clerk and clinical nurse specialist.

Discussion / conclusion

The original staffing establishment was based on historical data. However, since 2011 the paediatric burn service has experienced a five-fold increase in the number of referrals, partly because of national recommendations.

Initially, formal training and education were neglected, compounded by ever-increasing patient numbers. A programme of training is now in place, allowing staff to complete an accredited burns course and the EMSB.

Financial constraints within the NHS have led to more a stringent requirement to demonstrate the reasons underlying requests for additional resource.  Our experience of engaging constructively with internal trust management, our burns network, as well as the peer review process based on national standards, indicates that positive change is achievable even in times of austerity.

Growing our paediatric burn care service; staffing, standards and peer review