Posted on Friday 6th July 2012
traffic light tool
Traffic light tool
A Dermatology Nurse Specialist at West Cumberland Hospital in Whitehaven has received widespread acclaim for a self-care guide she has developed for patients.
As part of Tracey Riley’s Masters Degree studies, she was asked to identify a problem in practice and propose an innovation to solve that problem. Her observations indicated that patients who had experienced a successful course of treatment and been discharged back to their GP, often regularly suffered on-going symptoms because they were not able to successfully recognise changes or a deterioration in their condition.
The concept for the tool was to help patients assess their own skin status after a course of treatment. Tracey recognised that a patient’s ability to make sense of their world is a factor in self-empowerment, resulting in more positive care outcomes.
Tracey then devised the traffic light tool which was published in Dermatological Nursing in March 2011 and then a follow-up audit article was commissioned for 18 months later - however the article received sufficient positive feedback to be followed up after 6 months.
On completion of a course of treatment patients were given the tool at their discharge appointment and were provided with guidance about how to use it and reminded that they could phone the department if they felt unsure or confused at any time.
Six months after the initiative began, 60 patients were contacted by letter requesting their feedback in the form of a questionnaire so that the tool could be audited. 42 responses were received and of those, 40 used the tool, 36 found it easy to use, 30 recognised a need for further assessment and 39 are still using the tool regularly.
Having the traffic light tool to aid assessment at home was a relief to some who found that being able to put their skin condition into a category that also advised them what to do was helpful and reduced worry about deterioration. One respondent revealed that the assessment tool had encouraged her to ask for help at a time when she probably would have persevered otherwise, at which point her condition would have deteriorated.
After the original article was published, Tracey was approached by three NHS Trusts for permission to use the tool with their patients. The other Trusts commented that it was patient friendly, easy to understand and use and a real incentive for patients to self-manage and maintain positive outcomes after discharge. In addition, Tracey was recently contacted by Ninewells Hospital in Dundee which is one of the top Dermatology Units in the UK, with a request to use the tool in a change of practice at the centre.
The initial success of the traffic light tool would suggest there is a place for it in dermatology practice.
Tracey said: “The traffic light tool is an aide memoire and it does not replace clinical judgment. It is important for patients to realise that their skin changes and the tool is a prompt to help with their self-management.
“I am now looking at developing the tool further by exploring whether a personal pack for patients would be of any benefit. For example, patients are frequently advised to photograph their skin at different stages and to keep a diary if there are personal stress factors that influence their skin, therefore it might be worthwhile to consider a patient portfolio that could accommodate the different aspects of their experience.”