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1 |
The
Charter for patients and clients states that once it
has been decided that a patient should be admitted to
hospital, the patient should have to wait no longer
than two hours in the Accident and Emergency Department
before being admitted to a ward (EHSSB, 1999). Therefore,
ways need to be found of reducing the long waiting times
in Accident & Emergency Departments. At the same
time, however, other ways of giving care to older people
should be developed so they do not always need to be
admitted to hospital. |
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2 |
The
Charter for patients and clients also states that every
patient admitted to hospital should have a named nurse
and be given clear information about the care or treatment
s/he will receive in hospital (EHSSB, 1999). Therefore,
each patient should have a named nurse who will discuss
the patient’s care plan with her/him, ask whether
s/he prefers to be called by a first name or last name,
co-ordinate the nursing care and make sure that any
questions or concerns which the patient may have are
addressed during the hospital stay. |
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3 |
Ward
managers and staff nurses need to wear name badges and
introduce themselves to older patients, so that older
patients know they are the nurses responsible for the
patients’ care in hospital. |
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4 |
Health
and Social Services Trusts may wish to look at the reasons
why older patients are moved about in hospital and find
ways of reducing the number of moves. In particular,
hospitals need to look at whether it is appropriate
to admit older patients to Admission Wards or Medical
Assessment Units at first, rather than admit them straight
to medical or surgical wards. |
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5 |
The
Department of Health, Social Services and Public Safety
has recommended that emergency operations on patients
with fractures should be carried out within 48 hours
of attending an Accident and Emergency Department (2002b).
It is strongly recommended that the relevant hospitals
meet this standard, particularly for older patients
who need emergency hip surgery. |
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6 |
Nursing
staff in surgical wards should make sure that older
patients who need help with personal care (such as washing,
dressing and eating) get the help they need. Nursing
staff in medical and surgical wards need to make sure
that patients on special diets always get their correct
meals. |
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7 |
To
promote patient privacy and dignity, ward routines should
limit patient privacy only where this is necessary and
separate washing and toilet facilities should be provided
for women and men. In addition, some nursing staff and
doctors need to improve their attitudes to older patients
and make sure they always treat them with respect. |
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8 |
Where
patients are given new medications they should be told
the reasons for the medications and their possible side
effects, and they should be given an opportunity to
ask questions about the medications. Where older patients
have operations carried out, nurses need to make sure
that they get enough medication afterwards to treat
any pain they have. |
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9 |
Guidance
from the Department of Health, Social Services and Public
Safety states that consent must be sought from patients
before carrying out an examination or giving care or
treatment (2003). Nurses and doctors should make sure
that nursing and medical procedures are adequately explained
to patients and consent is sought from patients before
the procedures are carried out. |
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10 |
Nurses
should refer older patients with continence problems
to a continence advisor. |
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11 |
Nurses
need to be more sensitive to how the death of a patient
on the ward can affect other patients in hospital. |
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12 |
Leaflets
on how to make a complaint should be available on the
ward and, if needed, the staff should help the patients
(or their relatives) to make complaints. |
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13 |
Where
older, surgical patients are being discharged, their
ability to carry out activities of daily living such
as washing and dressing should be assessed and any help
needed at home should be organised. In addition, all
older patients need to know who to contact if they feel
unwell again. |
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14 |
Trusts
need to look at ways of involving older patients, and
older people generally, in commenting on issues relating
to hospital care and planning for discharge from hospital.
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Recommendation
for Health and Social Services Trusts and the Eastern
Health and Social Services Board (EHSSB)
Guidelines from the EHSSB state that patients should
not be charged for short stays in homes that are
organised as an alternative to continuing hospital
care (letter sent to Trusts in 2002). Trusts need
to make sure that patients who are discharged to
residential or nursing homes for short periods,
where they would normally be kept in hospital, are
not charged for the admissions to the homes. The
EHSSB should make sure that the Trusts are keeping
to these guidelines.
Recommendation
for the Eastern Health and Social Services Board
The EHSSB needs to make sure that the Trusts act on
the above recommendations so that the care given to
older people in hospital meets the standards set out
in this report.
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