A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...
A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ... A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...
Board of Directors Part 114 June 2013Couldn’t fault the care. Pleasantly surprised.“I wouldn’t do their job for double the pay!"RNIB could give training to staff in awareness and difficulties for blindpeople.Comments relating to the facilities on the wardNo ventilation in the shower which creates problems for patients withCOPD as there is a build up of steam.TV is too expensive, particularly for pensioners (two patients said this).Toilet too far away on the orthopaedic ward considering the type ofpatients here and their limited mobility.Need to think about arrangement of bedside areas for those with limitedmobility.An air freshener would be appreciated on some wards where the smellfrom bed pans and incontinent patients can be bad.Lights should be dimmed earlier.Comments relating to food and mealtimesFood always cold, including the plates. Don’t always get what isordered. Food not first class. No food available during the night.“Drug rounds coincide with mealtimes which means I get an injection inmy stomach half-way through a meal. I thought mealtimes wereprotected.”Comments relating to staff uniforms and attireStaff should wear soft-soled shoes.Staff should introduce themselves and uniforms confusing.5.3 ConclusionsThere is a general consensus amongst patients right across all thewards we visited that their care is very good at night with little differencebetween their care during the day and night. Staff are seen as caring,hard-working, friendly and attentive. Some patients preferred their careat night.However, some patients also felt that the staff are too busy. Mostpatients felt their care had not been affected by how busy the staffwere, but where that had occurred, many were understanding that theywere doing their best.In some cases, the fact that staff were so busy had affected patientcare with some drugs given late, procedures not carried out and a veryfew patients left in pain, discomfort or dirty.Most patients felt that wards did have adequate nursing staff providedthere were no emergencies, patients were not too poorly or there wereno confused patients on wards (other than medicine for the elderly7The Hospital at NightQuality/Performance
Board of Directors Part 114 June 2013wards). When these situations arose, nursing staff were stretched andthis could have an adverse impact on the care other patients received.Some of the difficulties patients perceived nursing staff as having weredown to a shortage of doctors at night. There is only one Registrar onsite at night with other doctors on call and so patients who are not anemergency may wait hours to see a doctor or have medicationprescribed.A majority of our patients had not slept well whilst with us and the mostcommon reason given was noise - other patients and staff being themain sources. Patients understand that a hospital is a strangeenvironment and noise is inevitable with poorly people around them butsome sources of noise are avoidable, such as staff talking too loudlyand patients being moved late at night. The lights were also a problem,not being dimmed early enough in the evening and being too brighteven when dimmed.One fifth of patients had had to wait in excess of 10 minutes to havetheir call bell answered, with a few waiting up to half an hour. This isworrying for patients, however busy the staff. Three patients had notbeen given a call bell, which they were unhappy about but 14% hadnever needed to use their bell which some remarked reflected thequality of the care they were receiving.6. Recommendations1. Ensure night staff are informed of the high esteem patientshold them in.2. Consider providing more nursing and HCA staff in areas withincreased dependency as and when required.3. Medical cover at night needs to be improved.4. Remind staff to keep unnecessary noise to a minimum and todim lights early and low enough.5. Ensure all staff have adequate training in the management ofconfused and disruptive patients wherever they may be in thehospital.6. Where escalation beds are in use an alternative to theelectronic call bell needs to be provided for patients.7. Consideration should be given to an audit of the timeliness ofadministering late night medication to ensure this is being givenon time and when needed.8The Hospital at NightQuality/Performance
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Board of Directors Part 114 June 2013wards). When these situations arose, nursing staff were stretched andthis could have an adverse impact on the care other patients received.Some of the difficulties patients perceived nursing staff as having weredown to a shortage of doctors at night. There is only one Registrar onsite at night with other doctors on call and so patients who are not anemergency may wait hours to see a doctor or have medicationprescribed.A majority of our patients had not slept well whilst with us and the mostcommon reason given was noise - other patients and staff being themain sources. Patients understand that a hospital is a strangeenvironment and noise is inevitable with poorly people around them butsome sources of noise are avoidable, such as staff talking too loudlyand patients being moved late at night. The lights were also a problem,not being dimmed early enough in the evening and being too brighteven when dimmed.One fifth of patients had had to wait in excess of 10 minutes to havetheir call bell answered, with a few waiting up to half an hour. This isworrying for patients, however busy the staff. Three patients had notbeen given a call bell, which they were unhappy about but 14% hadnever needed to use their bell which some remarked reflected thequality of the care they were receiving.6. Recommendations<strong>1.</strong> Ensure night staff are informed of the high esteem patientshold them in.2. Consider providing more nursing and HCA staff in areas withincreased dependency as and when required.3. Medical cover at night needs to be improved.4. Remind staff to keep unnecessary noise to a minimum and todim lights early and low enough.5. Ensure all staff have adequate training in the management ofconfused and disruptive patients wherever they may be in thehospital.6. Where escalation beds are in use an alternative to theelectronic call bell needs to be provided for patients.7. Consideration should be given to an audit of the timeliness ofadministering late night medication to ensure this is being givenon time and when needed.8The Hospital at NightQuality/Performance
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