P3 The yellow lanyard team – gloucestershire foundation NHS trust COVID-19 initiative

BackgroundAnticipating the COVID-19 pandemic burden, Gloucestershire NHS Foundation trusts Associate Chief Nurse Craig Bradley proposed the yellow lanyard initiative to utilise specialist respiratory nurses to educate, train and support trust wide health care staff in managing these patients; albeit outside their clinical speciality. The yellow lanyards allowed early identification of this frontline specialist respiratory nursing team integral to ensuring adequate clinical standards were maintained whilst delivering a 24/7 holistic care to the ever increasing COVID-19 patient admissions (figure 1a & 1b).What we didThe yellow lanyard team consisted of 40 nurses working on two sites across the Trust [(Gloucester Royal (GRH) and Cheltenham General Hospitals (CGH)]. Our role particularly focused on non-ventilatory training (Continuous positive airway pressures) a leadership strategy employed by the Trust to manage COVID-19 patients with high FiO2 requirement in a respiratory high dependency unit (HDU) setting. The respiratory HDU was expanded to 31 beds compared to a normal capacity of 10 and all patients requiring non-ventilatory support only were managed on it unless deemed at high risk. We also liaised with our lung physiology department daily for equipment calibration and programming enabling us to manage the quick turnover of patients admitted. Additionally we offered training opportunities to all staff including NEWS monitoring, documentation, adequate use of personal protective equipment, oxygen management, initiating Hi-Flow nasal oxygen, and escalation of patients to intensive care alongside delivery of conventional respiratory care.OutcomeOur strategies upskilled healthcare worker to manage the ever increasing case load of COVID-19 patients using enhanced decision making, critical thinking and improved communication skills preparing them to work in the ever changing environment. The yellow lanyard team was an asset during the pandemic available 24/7 and successfully managed patients to recover from their illness (figure 1c).Abstract P3 Figure 1The yellow lanyards - Gloucestershire Foundation NHS Trust COVID-19 initiativeFuture plansThe trust aims to expand the respiratory HDU currently being used for patients receiving aerosol generating procedures and utilise the skill set of our trained staff with the prospect of offering immediate support for patients in case of a second wave of COVID-19.