OK, so I’ll make this clear from the start, I do NOT have a problem with the Welsh Assembly Government’s recent announcement to introduce colour-coded uniforms for nurses in NHS Wales. It will undoubtedly help patients identify who’s who. But more importantly here, there needs to be adequate laundry services and sufficient change of clothing to assist in reducing cross infection. Is this guaranteed? Given the fact that in this article the Assembly only “hopes to have laundries in hospitals”, let’s hope it’s more than just an aspiration.
On another point – the same article has the Chief Nursing Officer Rosemary Kennedy quoted as saying “We do have doctors floating around with white coats flapping around behind them. We have got very lax.”
This is disparaging of the many doctors in NHS Wales who are hard working, often for many excessive and continuous hours to plug gaps in rotas. They are far from “floating around”. Little wonder then that Wales is not top of junior doctors destinations with comments like this.
I don’t really think doctors and white coats “flapping” or otherwise is the real issue here when it comes to hygiene. They are no more of an infection risk than any other type of hospital clothing. What matters most is having comprehensive laundry facilities, with fresh clothing frequently available. We can of course hope for this!
This highlights a bigger issue about NHS uniform policy and it’s something that the BMA’s Welsh Medical Student’s Committee (WMSC) has been trying to get clear guidance and a straight answer on for some time now.
18 months ago the WMSC wrote to the Health Minister asking for clarification regarding hospital hygiene and “white coat” protocols and the committee, despite repeated attempts, is no closer to getting an answer on this, with the policy seemingly decided on an individual trust basis. So, our more junior members, when on rotation, are going to different hospitals, where in some cases, they can wear white coats and in others, are told it’s not acceptable to wear them. All this confusion still remains, despite the fact that an All Wales Uniform Working Group was set up by the WAG to look into white coats protocol amongst other things, more than a year ago. Not much “flapping” going on there then!
Showing posts with label infections. Show all posts
Showing posts with label infections. Show all posts
Tuesday, 12 May 2009
Wednesday, 22 April 2009
Pressures on NHS bed risks patient safety
Today, we’re highlighting the dangers of cramming patients onto hospital wards, at the same time as the number of beds on wards, are falling.
Because we’re so concerned, we’ve just held a media briefing with Dr Andrew Dearden, Chair of Welsh Council and Dr Stefan Coghlan, Chair of the BMA’s Welsh Consultants Committee.
Figures show that over a ten year period (1997-98 to 2007-08) the total number of NHS beds in Wales fell by nearly two thousand. But, in that time the percentage bed occupancy increased from 78.7% to 82.8%1, which has led to our growing worry for the safety of patients.
Dr Coghlan outlined in the briefing how the NHS is being pushed to breaking point with more patients being treated and despite managerial efforts to reduce the time that patients spend in hospital, the average length of stays, is actually increasing, as the number of beds available for them, is shrinking. This is putting an intolerable strain on staff and causing a great deal of stress and confusion to patients. We certainly wouldn’t be able to cope in a crisis. It is just unsustainable.
The situation has been getting worse during the first few months of this year. A worrying combination of unprecedented emergency admissions, more planned surgery to meet access 2009 targets and so called efficiency savings with pressure to balance the books by the end of the financial year has resulted in unacceptable bed pressures. NHS managers have been holding crisis meetings on a daily basis about where to put patients. We seem to be getting to a point where it’s a case of ‘any bed will do’.
“Hot-bedding” where patients are moved around wards as beds become free appears to be a worrying trend too. Three or more patients could have been in the same bed, on the same day. This constant swapping can cause real confusion and distress, particularly for more elderly patients, who end up not knowing where on earth they are. This makes it very difficult for families visiting, to locate their loved ones, even for doctors to find their own patients. It may not be the best use of a consultant’s time, trying to track down patients and we have heard instances of patients being forgotten about, as they are moved from ward to ward.
And it is the most vulnerable that this impacts upon. The elderly, infirm patients who are most affected by being moved, are also the patients most likely to be moved from wards, to accommodate new admissions. Moving elderly patients can precipitate acute confusional states and general deterioration in their health.
Over-crowding and moving people around hospital wards can increase the risk of contracting and passing on infections, such as C.difficile. Last month, the Welsh Conservatives obtained figures showing that in 2007-08, more than 3000 people aged over 65 contracted the C.difficile infection.
NHS Trust finances could be a possible reason for the decline in bed numbers. There are extra financial pressures on managers at the moment, to balance their books, before the planned NHS reorganisation becomes fully operational in October. And one of the easiest ways of making efficiency savings is to cut bed numbers, regardless of the dire consequences this can have for patient care.
So, the BMA is calling for a change in bed occupancy policy, with less emphasis on dwindling bed numbers, at a time when we have a growing ageing population, who need more long-term treatment in hospitals. Patients, in particular elderly ones, are being put in danger and this must not be allowed to continue.
We also feel it would be beneficial to change the way statistics are collated and reported so that they better reflect what is going on in Acute hospital beds.
It would be good to hear from any members or the wider medical profession, if they've encountered any of the above issues...
Statistics available at http://www.statswales.wales.gov.uk/tableviewer/document.aspx?FileId=1996
Because we’re so concerned, we’ve just held a media briefing with Dr Andrew Dearden, Chair of Welsh Council and Dr Stefan Coghlan, Chair of the BMA’s Welsh Consultants Committee.
Figures show that over a ten year period (1997-98 to 2007-08) the total number of NHS beds in Wales fell by nearly two thousand. But, in that time the percentage bed occupancy increased from 78.7% to 82.8%1, which has led to our growing worry for the safety of patients.
Dr Coghlan outlined in the briefing how the NHS is being pushed to breaking point with more patients being treated and despite managerial efforts to reduce the time that patients spend in hospital, the average length of stays, is actually increasing, as the number of beds available for them, is shrinking. This is putting an intolerable strain on staff and causing a great deal of stress and confusion to patients. We certainly wouldn’t be able to cope in a crisis. It is just unsustainable.
The situation has been getting worse during the first few months of this year. A worrying combination of unprecedented emergency admissions, more planned surgery to meet access 2009 targets and so called efficiency savings with pressure to balance the books by the end of the financial year has resulted in unacceptable bed pressures. NHS managers have been holding crisis meetings on a daily basis about where to put patients. We seem to be getting to a point where it’s a case of ‘any bed will do’.
“Hot-bedding” where patients are moved around wards as beds become free appears to be a worrying trend too. Three or more patients could have been in the same bed, on the same day. This constant swapping can cause real confusion and distress, particularly for more elderly patients, who end up not knowing where on earth they are. This makes it very difficult for families visiting, to locate their loved ones, even for doctors to find their own patients. It may not be the best use of a consultant’s time, trying to track down patients and we have heard instances of patients being forgotten about, as they are moved from ward to ward.
And it is the most vulnerable that this impacts upon. The elderly, infirm patients who are most affected by being moved, are also the patients most likely to be moved from wards, to accommodate new admissions. Moving elderly patients can precipitate acute confusional states and general deterioration in their health.
Over-crowding and moving people around hospital wards can increase the risk of contracting and passing on infections, such as C.difficile. Last month, the Welsh Conservatives obtained figures showing that in 2007-08, more than 3000 people aged over 65 contracted the C.difficile infection.
NHS Trust finances could be a possible reason for the decline in bed numbers. There are extra financial pressures on managers at the moment, to balance their books, before the planned NHS reorganisation becomes fully operational in October. And one of the easiest ways of making efficiency savings is to cut bed numbers, regardless of the dire consequences this can have for patient care.
So, the BMA is calling for a change in bed occupancy policy, with less emphasis on dwindling bed numbers, at a time when we have a growing ageing population, who need more long-term treatment in hospitals. Patients, in particular elderly ones, are being put in danger and this must not be allowed to continue.
We also feel it would be beneficial to change the way statistics are collated and reported so that they better reflect what is going on in Acute hospital beds.
It would be good to hear from any members or the wider medical profession, if they've encountered any of the above issues...
Statistics available at http://www.statswales.wales.gov.uk/tableviewer/document.aspx?FileId=1996
Subscribe to:
Posts (Atom)
Posts
