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Tim Wallis Kathryn Smith. First 12 reports published May 2011 –republished in October. Inspection into whether elderly people receive essential standards of care in 100 hospitals in England, focusing on: -treated with dignity and respect -whether nutritional needs being met
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Tim Wallis Kathryn Smith
First 12 reports published May 2011 –republished in October. • Inspection into whether elderly people receive essential standards of care in 100 hospitals in England, focusing on: -treated with dignity and respect -whether nutritional needs being met • 17 off 100 hospitals surveyed were not compliant with basic nutritional needs of patients • 32 more were recommended to make improvements • Recurring concern: people not being given enough to drink • Chair of CQC to write to every hospital identified
14/11/11 “Scandal of NHS care for elderly” • “the Care Quality Commission found old people being left unfed, without water” • 13/10/11 “Too many hospitals in England are falling short in the most basic care they are giving elderly patients”
The Study • Included: All elderly patients on Lulworth, Brownsea, Acute Stroke Unit, Rockley and Lilliput. n=88 • Excluded: patients NBM • One off spot check of the wards. No prior warning of survey
The Recommendations • Presented the findings and recommendations to senior medical and nursing staff • Repositioning table after all patient interactions – education of medical, nursing and cleaning staff • Educating relatives to encourage patients to drink • Visual and memory aids to prompt patients to drink water • The Poster…
The Re-audit • Same Cohort of Patients: Posters had been on wards for > 2 months • Included: All elderly patients on Lulworth, Brownsea, Acute Stroke Unit, Rockley and Lilliput. n=83 • Excluded: patients NBM • One off spot check of the wards. No prior warning of survey
An improvement but we can still do better • We unfortunately cannot give ourselves the gold medal yet… • Improved from 1/3 without fluids in easy reach to 1/4 without • Further education/training of hospital staff • ? Water monitor NA to check all patients to have water QDS • Are there any times of day where it is better or worse than others? We have done the study at approximately 3pm both times
Further Changes • Red jugs for patients at high risk of dehydration • Poor sight • Poor functional capability • Dementia • Delirium