News / Hospital report finds room for improvement
SOME improvements are needed in the way Lerwick’s Gilbert Bain hospital cares for its elderly patients, according to government health inspectors.
A four person inspection team who spent two days at the hospital in late March found a positive atmosphere, with well-organised staff and contented patients getting on well.
However in their report published on Thursday, Healthcare Improvement Scotland HIS) said there were 11 areas where improvement was required to meet national standards.
These included:
- better working with Shetland Islands Council’s social work department on planning patient discharges;
- better personalised care plans for individual patients; and
- speedier assessment and reviews of the risks of patients’ developing pressure ulcers.
The inspectors toured three wards on 27 and 28 March this year, speaking with staff, watching staff and patients interact during three separate 20 minute periods, and interviewing patients.
They said they found a calm and well-organised environment with good relations between patients and staff, and that all the 11 patients they spoke to and the 14 who completed questionnaires were positive about their experience at the GBH.
Their concerns ranged from the minor, such as one ward referring to bed rails as “cot sides”, which HIS considered did not “promote patient dignity”.
However they were concerned that eight patients had experienced delays in being discharged and called for better working relations between the hospital and the social work department to make sure this did not happen.
On the other hand they praised the joint working between various agencies for patients diagnosed with dementia or other cognitive impairment.
While there were no major criticisms of record keeping and personalised care plans for patients, there was concern also that not all elderly patients were screened and assessed for cognitive impairment and given a personalised care plan as soon as they were admitted to hospital.
All patients were also not assessed within the six hour maximum guideline for risk of pressure ulcers or always regularly reviewed.
Nutrition plans for each patient were not always carried out within the 24 hour maximum, with five out of nine patients reviewed having to wait up to five days. And weekly reviews also did not always take place, with one patient having to wait 18 days.
The inspectors warned that such delays meant a patient who was at risk of malnutrition might not be identified.
Mealtime arrangements were generally praised, apart from breakfast on one of the wards where there was a shortage of staff, as was the availability of hot snacks outside of mealtimes.
Inspectors also did notice one patient trying to eat their dessert with a knife.
The inspectors also said the hospital should continue with its plans for an emergency snack box for patients.
NHS Shetland chief executive Ralph Roberts said staff would take the need for improvement on board, especially making sure there was consistency in record keeping, clinical assessments and discharge planning.
But he generally welcomed the report, saying: “I am pleased to note that all patients who talked to the inspectors said their care in hospital was good and this report demonstrates that we provide high quality older people’s care in Shetland.
“This is testimony to the efforts of staff who strive to provide high standards of care every day”.
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