A FORUM on ONTARIO MEDICINE: business and professional Information from various contributors edited by Dr.Alex Franklin MBBS(Lond.)Dip.Phys.Med(UK) DPH & DIH(Tor.)LMC(C)FLex(USA).Fellow Med.Soc.London, Liveryman of London Society of Apothecaries. Freeman of City of London. Member Toronto Faculty club & Toronto Medico-Legal society.
19 Dec 2013
UK DAILY MAIL:: ERROR in "NIL BY MOUTH" at ROYAL BOURNEMOUTH HOSPITAL
Elderly patient starved because a 'nil by mouth' sign meant for the previous occupant of her bed had not been removed
Royal Bournemouth Hospital in Dorset under attack from hospital inspector
Care Quality Commission inspection found alarming care of elderly patients
One was left naked on top of a soiled sheet and other forced to wet the bed
Another left on the verge of malnutrition because they couldn't reach food
By Anna Hodgekiss
PUBLISHED: 11:49 GMT, 19 December 2013 | UPDATED: 11:53 GMT, 19 December 2013
An elderly patient starved because a ‘nil by mouth’ sign meant for the previous occupant of her bed had not been removed.
A damning report into care at the Royal Bournemouth Hospital also found that another elderly patient was left completely naked on top of a soiled sheet, while others were forced to wet the bed after their repeated calls for assistance went unanswered.
A dementia patient was also left on the verge of malnutition because they were unable to reach food or drink left for them.
The Royal Bournemouth Hospital in Dorset has received a damning hospital inspection report. Patients were found to have had fluids and food restricted by mistake while others were left lying in soiled or wet beds
The Royal Bournemouth Hospital in Dorset has received a damning hospital inspection report. Patients were found to have had fluids and food restricted by mistake while others were left lying in soiled or wet beds
The terrible treatment came to light after the Care Quality Commission, which inspects hospitals, visited in October.
The two-day inspection singled out wards three and 26 for being particularly bad and understaffed.
The report states the family of an elderly woman were surprised to find the ‘nil by mouth’ sign on her bed and were shocked when it was realised it wasn’t meant for her.
Yet it took another five hours for the patient to be given water, such was the lack of staff on the ward.
The report states: 'One person on ward 3 told us they had come to visit their relative and had been surprised to find they had a sign above their bed saying "nil by mouth", which told staff not to offer this patient food or fluids orally.
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'The relative had questioned this with a nurse, who told them that their relative was due to undergo an investigation, which meant that they couldn’t eat or drink.
'They then asked the nurse to find out what this investigation was. When the nurse returned they said that the patient was not in fact meant to be ‘nil by mouth’ but that the sign had been left on the bed from a previous patient.
'This meant that the patient had missed breakfast and lunch, and had not received fluids
since their admission to the ward.
'The concerned relative went on to say that although this mistake was discovered at 2pm, when they returned to the ward at 7pm their relative had still not been given water to drink.'
The report also highlights the case of a dementia patient who lost a significant amount of weight because they were unable to reach their food just inches away.
Professor Sir Mike Richards, the Chief Inspector of Hospitals
Royal Bournemouth Chief Executive Tony Spotswood
Despite the scathing report from the chief inspector of hospitals, Professor Sir Mike Richards (left), Bournemouth chief executive Tony Spotswood (right) said there was no reason for him to resign
It reads: 'Despite them being able to eat independently, food and drinks had been left out of their reach and left to go cold.
'As a result, their relative had lost a significant amount of weight on the ward.
'When they asked about the weight loss they were told that staff had weighed their relative that morning and they had weighed 90 kilograms.
'As they felt that this did not seem correct, they asked staff to weigh them again. On that occasion they weighed 69 kilograms.
'They said that the ward had given their relative a Malnutrition Universal Screening Tool (MUST) score of zero after the first weight was recorded, which needed to be changed to a three after the second weight was recorded.
Dorothy Simpson, 84, telephoned her family from the hospital because she could not breathe, and died 20 minutes later
Dorothy Simpson, 84, telephoned her family from the hospital because she could not breathe, and died 20 minutes later
'This score of three showed that their relative was at risk of malnutrition.'
The Royal Bournemouth was one of the first to be inspected by the CQC in the wake of the Mid Stafforshire scandal, following complaints about the level of care there.
The inspection found that nurses on ward three accepted staffing levels were ‘horrendous’.
The chief inspector, Sir Mike Richards, concluded: 'The trust did not employ enough staff, even though it was fully aware that nearly all its beds were occupied all the time.
Professor Sir Mike Richards, the Chief Inspector of Hospitals, said: 'Whenever we inspect we will always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people's needs? Is it well-led?
'At Royal Bournemouth Hospital, we were told about basic nursing care which was not being given to patients on two medical care wards. We heard from five patients who told us they had been left to wet or soil their beds.
'The hospital had a high occupancy rate and there had been ongoing use of escalation beds when a ward or unit was full - even though these beds could not meet patients' needs properly.
The 64-page document also said that stroke victims were 'not always given the urgent care they needed'.
Surgical services and outpatient departments also came under the microscope at the hospital managed by The Royal Bournemouth and Christchurch Hospitals NHS Trust, which serves 550,000 people.
'A number of services were not always safe, effective, responsive, caring or well-led,' stated the CQC report.
'In particular we found that medical care (including care older people's care) was inadequate.
'There were widespread and significant negative views from patients and staff.'
The outpatients' department was found to have infection control risks. The main outpatient reception, the floor sinks and the waste bins in the female toilets were not clean.
The sluice room - a specially designed cleaning room - was cluttered with 'obsolete equipment' and stacked with used clinical dressing packs.
The Royal Bournemouth was one of the first to be inspected by the CQC in the wake of the Mid Stafforshire (pictured) scandal, following complaints about the level of care there
The Royal Bournemouth was one of the first to be inspected by the CQC in the wake of the Mid Stafforshire (pictured) scandal, following complaints about the level of care there
The report said: 'Staff entered the sluice with dirty packs, adding to the pile, and left without washing their hands.'
Despite the report beign scathing of the leadership of the hospital, chief executive Tony Spotswood said there was no reason for him to resign.
He added: 'We accept the broad findings of the report and would like to apologise to those patients who received poor care.
'Clearly it is unacceptable but many of these issues have now been set right.
'We have put in place a number of changes in relation to staffing and care of the elderly and we have already seen a number of improvements within the last six weeks.
Paula Shobbrook, director of nursing at the Royal Bournemouth, added: 'I don’t want patients to be frightened about coming to hospital.
'We have recruited more nurses; 57 newly qualified nurses are now working on our wards and we have new ward sisters who are committed to raising standards.'
Read more: http://www.dailymail.co.uk/health/article-2526334/Patients-left-soiled-sheets-locums-poor-nursing-Hospital-chief-inspector-slams-two-leading-hospitals-unsafe.html#ixzz2nvdpTWcw
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