A Visitors' Charter for all Wards at The Ipswich Hospital NHS Trust

Information for PatientsA Visitors’ Charter for all Wardsat The Ipswich Hospital NHS TrustDMI ref: 1988-07.inddBased on a Proposal prepared by Mike Holdsworth & Tony Bakerfor the Cancer Services User GroupThe Ipswich Hospital NHS Trust

Contents:Why is a Visitor’s Charter considered necessary?The Ipswich Hospital Ward Visitor PolicyStakeholders in a Visitor’s CharterWhat is the aim of a Visitor’s Charter ?What will the Visitor’s Charter achieve?Scope of this Visitor’s CharterPoints covered in this Visitor’s Charter:• Hygiene• Food & drink brought in by visitors• Numbers of visitors and length of visits• Respect for the patient• The visitor’s perspective• Treating people with mutual dignity and respect• Contacts

Why is a Visitors’ Charter considered necessary?Visiting family, relatives and friends are welcomed at Ipswich Hospital. It is recognised that theirinvolvement can be a significant encouragement for the patient, and adds to the therapeutic valueof a patient’s treatment, well-being and recovery.In order to maximise the value of visits, the Visitors’ Charter is intended to improve visitors’awareness of the issues that may affect the patient’s experience. The Visitors’ Charter will providestandard guidance for hospital visitors, to the benefit of all patients, visitors and staff.This Visitors’ Charter sets out general guidance covering all wards and complements individualpolicies that have been drawn up to cover specific service areas within the hospital such as thechildren’s wards, Intensive Therapy Unit (ITU), Theatres And Emergency Assessment Areas.The Ipswich Hospital Ward Visitor PolicyThe visiting times across the Trust are 3.00pm – 4.00pm and 7.00pm – 8.00pm. These times havebeen implemented in the interest of patient safety, dignity and respect.Stakeholders in a Visitors’ Charter• Visitors• Patients• Staff, including medical, nursing, support and volunteers• Other visitorsWhat is the aim of a Visitors’ Charter?The aim of the Visitors’ Charter is to help visitors make a positive and appropriate contribution tothe patient experience in a way that recognises and respects the needs of all patients, staff andvisitors alike.What will the Visitors’ Charter achieve?• Improve the patient and visitor experience.• Increase visitor responsibility and partnership working with staff.• Assist in controlling possible health risks to patients.Scope of this Visitors’ CharterThis Visitors’ Charter, Applies to all wards across the Trust.Points covered in this Visitors’ Charter• Hygiene• Food & drink brought in by visitors• Numbers of visitors and length of visits• Respect for the patient• The visitor’s perspective• Treating people with mutual dignity and respectEach of these will be considered in the following sections by examining the aim and the associatedissues.

HygieneAim:• To reduce the risk of visitors passing on infections to patients, particularly those who arevulnerable to infection.Issues:• Visitors must ‘clean your hands’ before entering – spirigel, hand disinfectant is available at theentrance to all wards and department areas. You may be asked to wash your hands with soapand water when there is an infection of C. Difficile.• Visitors are asked to use alcohol-based handwash or gel before entering and on leavingthe ward. Visitors may also be asked to wear plastic aprons and/or facemasks when visitingvulnerable patients In areas where there is an increased risk of infection.• Prospective visitors with a contagious illness (e.g. coughs, colds, ‘flu, stomach upset, measles)should not visit patients until past their infectious stage. If you are unsure, please telephonethe ward first.• Visitors must be aware of the need to maintain high standards of hygiene and cleanliness toreduce the spread of infection or contamination.• Visitors must not sit on the beds.• Visitors who have any questions or concerns about hygiene are asked to raise these at the timewith the Ward Sister/nurse in charge of the ward.Food and DrinkThe Trust provides meals for patients to meet their varied needs, however, visitors are allowed tobring in food for patients in line with the following guidance:Aim:• To ensure, as far as is reasonable, that patients’ food brought in by visitors is safe andappropriate.Issues:• Patients receive specific guidance on diet & nutrition, and what to avoid because of healthrisks.• Treatments and illnesses can induce variations in a patient’s appetite, taste and preferences.• Patients who are ill are likely to be more susceptible to illness caused by poor food hygiene.• A favourite food can have therapeutic value for the patient, but visitors must respect thepatient’s limitations and seek guidance from ward staff prior to bringing in food.• All food and drink brought into hospital must be transported and kept in a manner that doesnot allow for the growth of bacteria. This includes keeping food at the correct temperatureand using appropriate wrapping material. Particular care needs to be taken with foods such asmeat, chicken, fish and dairy products and avoiding foods that have particular health warningssuch as shellfish, soft, unpasteurised cheeses.• The safest foods and drinks are those provided in manufacturers’ packaging. Even so, attentionneeds to be given to ‘consume-by’ guidance, as well as storage instructions.• To avoid the risk of infection, hospital staff are not able to reheat or store food brought in forpatients.• When bringing food into the hospital for patients’ consumption two things need to beconsidered:o All packaging must be taken off the premises, especially when the food has a strongaroma.o Visitors must be aware of other patients needs and wishes.

• All fruit intended for patients should be washed to reduce the risk of contamination.• Partially eaten food must be thrown away as soon as appropriate.Numbers of visitors and length and times of visitsAim:• To implement, the hospital policy of two visitors at a bedside at any one time. Exceptions to thiscan only be made by prior agreement with the ward sister or nurse in charge.• To allow a designated time at patient meal times for patients to eat and not be unnecessarilydisturbed. This is known as “protected meal times” when visitors will not normally be allowedon the ward unless assisting with patient meals.Issues:• This Charter will be regarded as sensible guidance that respects the needs of all patients, staff,and visitors. It may be varied on a case-by-case basis at the discretion of the ward sister or nursein charge of the ward at the time.• Discretion will be exercised when families with children are visiting, or when visitors have totravel a long distance.• Prior to visiting, checks must be made with nursing staff to ascertain whether it is advisablefor young children to visit. In the interest of public safety children under the age of 12 are notencouraged to visit ward areas. Permission to do so must be in agreement with the Ward Sisteror nurse in charge.• Space around bed cubicles is limited, and the number of chairs available is limited by storagespace.• Some wards have day rooms and corridor / garden seating areas which provide pleasant andmore relaxing surroundings for some patients with visitors, thus relieving pressure on thewards.• Routine medical consultation/treatment or ward cleaning will necessitate visitors leaving theirpatient for a period of time in order to provide confidentiality or a clear working area.Respect for the patientAim:• To ensure that the patient and his/her needs are respected at all times.Issues:• All visitors should show consideration to other patients on the ward, and respect the visitinghours, which are designed so that patients have adequate rest.• Visitors are asked to limit the number of visitors at any one time to two at the bedside.• Visitors must co-operate with requests from ward staff that will ensure the efficient operationof medical and support services.• Seriously ill patients may have a number of family members visiting for long periods. On somewards, a Visitors’ Room is available for privacy and, in special circumstances, overnight stayscan be accommodated.• On the other hand, some patients may only be able to cope with very brief visits before tiring.Visitors should be sensitive to a patient’s wishes and condition, and not overstay their welcome.• Visitors who arrive when the patient is receiving treatment or care may be asked to wait inanother area.

• The volume of conversation and other noises should be kept at reasonable levels so as to givedue regard to other patients and visitors. The Trust’s policy is that mobile phones must beturned off on the ward.• Ward washrooms, bathrooms and toilets must not be used by visitors.• Meals and water provided for patients must not be eaten by visitors• Gifts of flowers may be inadvisable in some circumstances; medical / nursing staff can advise.Visitors are asked to limit the number of flower arrangements and all other gifts as space islimited. Cluttered lockers and tables make it difficult for staff to keep the environment cleanand safe.The visitors’ perspectiveAim:• To help visitors feel welcomed and supported, sometimes in traumatic circumstances.Issues:• Visitors will be given information about visiting hours and ward contact points and telephonenumbers. A 3-fold double-sided A4 leaflet will be prepared and made available to visitorsgiving brief, targeted guidance on the major points outlined in this paper.• Visitors are encouraged not to travel to the hospital by car but use public transport andPark&Ride if possible. Where travel by car is appropriate, the Trust has a policy of issuingreduced rate car parking passes to immediate family members of long-stay patients. Furtherinformation is available from the ward sister or nurse in charge of the ward or from the PatientAdvice and Liaison Service.• Information to be made available to visitors on how to contact the Trust’s Patient Advice andLiaison Service (PALS) and chaplaincy services, if required.• There is a Cancer Information Centre available.• To reduce the number of telephone and other enquiries to ward staff, families and friends areasked to:o Identify a member of the immediate family to act as the link between the familyandfriends. Although ward staff are not able to give detailed and confidential informationover the telephone, they can indicate general progress to an immediate family member.o Passing on news to other relatives when visiting is inappropriate.o Use the ward mobile telephone handset and Patientline to speak directly to the patient.Disclosure of information about a patient’s clinical condition and treatment is subject to therules of patient confidentiality and may only be disclosed to other people with the priorconsent of the patient.• With the patient’s permission, arrangements can be made for the next-of-kin / immediate familymembers / partners to discuss a patient’s clinical management and the decisions made with theconsultant-in-charge or a member of his or her team. Requests should be made to the wardsister or nurse in charge of the ward.• Where a patient wishes a visitor to take them off the ward, the visitor must request permissionfrom the ward sister or nurse in charge prior leaving the ward.• Visitors may not eat or drink on the ward.• The Ipswich Hospital is a smoke free hospital and site. Visitors and patients are not permitted tosmoke within the hospital’s buildings or grounds.• Visitor’s rooms are available on some wards and overnight accommodation can be provided inspecial circumstances.• Visitors, with the patient’s permission, may be asked to take patient’s belongings home, asstorage capacity on the wards is minimal. Visitors are asked to inform the ward staff where anyitems of value, including money or jewellery, are either brought into or are being taken out ofthe ward.

• Wards do not have the facilities to undertake the laundering of patients’ clothing. In theinterest of patient comfort and infection control we recommend that family members regularlytake home their family members clothing for washing. If the family have any specific concernsabout washing procedures or any special precautions needed, ward staff will be pleased toprovide advice.• It may be appropriate for someone who normally cares for that patient to attend the hospitalto assist with feeding, personal care or to look after them in some other way (shared care). Thiswill be discussed and agreed with the person by the ward staff, including the availability of anyspecial arrangements.• If at any time a visitor is unhappy with any aspect of the patient’s hospital stay or has asuggestion for improvement, he or she is asked to raise this at the time with the ward sister,nurse in charge or matron for that area of the hospital. Alternatively a visitor may contact theTrust’s Patient Advice and Liaison Service. A leaflet on how to make comments, suggestions,compliments or complaints (called “Speak Out”) is available from all main reception areas.Treating people with mutual dignity and respectAim:• To ensure that everyone is treated with dignity and respect at all times.Issues:• The Ipswich Hospital NHS Trust has a duty to provide a safe and secure environment forpatients, staff and visitors. Violent or abusive behaviour will not be tolerated and decisiveaction will be taken to protect staff, patients and visitors.• The following are examples of behaviour, which are not acceptable:• Excessive noise such as loud or intrusive conversation or shouting.• Threatening or abusive language involving excessive swearing or offensive remarks.• Derogatory racial or sexual remarks.• Malicious allegations relating to members of staff, other patients or visitors.• Offensive sexual gestures or behaviours.• Abusing alcohol or drugs in hospital (all medically identified substance abuse problemswill be treated appropriately).• Drug dealing.• Wilful damage to Trust property.• Theft.• Threats of violent behaviour.• Violence.• Visitors who display any of the above behaviours will be asked to desist and be offered theopportunity to explain their actions. Continued failure to comply with the required standardwill result in the security staff and the Clinical Bed Manager being called and the removal ofthe offending individual from Trust property. The excluded person must be informed they canrequest an immediate review of their exclusion.• The Trust regards any form of victimisation, intimidation, bullying or harassment by a memberof its staff as a serious disciplinary offence which could, in certain circumstances, be regarded asgross misconduct and may result in summary dismissal of the employee concerned.• Visitors seeking further advice or information about the Trust’s policies relating to the aboveshould approach the Patient Advice and Liaison Service (PALS) staff who can be contacted on0800 328 7624.

Produced by:The Ipswich Hospital NHS TrustHeath Road, Ipswich, Suffolk IP4 5PDHospital switchboard: 01473 712233www.ipswichhospital.nhs.ukIssue 2: May 2007© The Ipswich Hospital NHS Trust, 2005-2007. All rights reserved. Not to bereproduced in whole, or in part, without the permission of the copyright owner.