Sunday, 20 January 2008

Connecting Some Dots

Staffing issues/Bed Occupancy/ Fucktwit politicans/ Superbugs


INCONSISTENCY and mismanagement threaten a critical shortage of GPs and nurses, warn two Fylde coast MPs.
Ben Wallace, MP for Lancaster and Wyre, and Michael Jack, MP for Fylde, said a leaked document on cuts to the NHS wage bill showed bad personnel management.
The document, part of the draft version of the NHS pay and workforce strategy for 2008 to 2011 in England, predicted that within four years the NHS will have a shortage of 1,200 GPs, 14,000 nurses and 1,100 doctors.
It also revealed an extra 3,200 consultants the NHS cannot afford to pay and an excess of 1,600 allied professionals, health scientists and technicians.
The Government has announced that more than 900 NHS staff are to be made redundant across the country as part of hospitals reorganisation.
Mr Wallace said: "The whole thing shows the Government's incompetency when it comes to workforce planning.
"It has encouraged people to join the NHS but now is laying people off and, in my own constituency, I hear of health professionals, for example, midwives, who cannot find a job.


From a recently qualified Graduate Nurse

Well, a few day's on the ward and I have neglected to really mention much of what I have been doing. There is still no job, though there have thankfully been a handful more job's posted on the NHS jobs site for my hospital. It would seem that the reason I was not shortlisted for the job on the ward was that there were 47 other student nurses who applied for the post. Yes, 47 students without jobs. I am not making this up, as I saw the pile of application forms. There were over 100 applications made when you add in the registered Nurse's that applied for the post. Good news is that they are going to keep my application if anything else turns up.


St├ęphane Hugonnet and colleagues from the University of Geneva Hospitals, Switzerland, investigated the number of patients admitted to the ICU who developed ventilator-associated pneumonia (VAP), over a four-year period. They then compared this to the number of nurses on duty for each patient in the preceding days. VAP affected over a fifth of the 936 patients who received mechanical ventilation during the study.

The team found that when there were lower numbers of nurses, patients were more likely to catch pneumonia six days or more after being placed on a ventilator. This suggests that bacteria are transferred between patients, or from one site to another in the same patient. This could be due to short-staffed nurses having less time to follow hand hygiene recommendations and proper isolation procedures or being unable to provide adequate care to the ventilated patient. The nurses' training level had no effect on infection rates.

Plus This:

ScienceDaily (Jan. 16, 2007) — Hospital death rates can be reduced by employing more Registered Nurses and the routine use of care maps or protocols, according to a study in the latest UK-based Journal of Advanced Nursing.

A ten per cent increase in the proportion of Registered Nurses employed was associated with six fewer deaths per 1000 discharged patients.
The death rate also went down by nine per 1000 discharged patients when the number of Baccalaureate-prepared (university graduate rather than diploma qualified) nurses went up by ten per cent.
A ten per cent increase in adequate staffing and resources (as reported by nurses) was associated with 17 fewer deaths per 1,000 discharged patients.


Hospital acquired infections such as MRSA and C.Diff. are on the rise. There is much evidence to suggest this is mostly down to two main factors, poor hygiene standards and bed occupancy.

Bed occupancy rates within Lincolnshire are high, very high. 99.2% !!! (Apr 05-Apr 06) The govt. target is 85%.

Several times a year the whole United Lincolnshire Hospitals Trust is on red alert. This refers to the trust having no available beds whatsoever. On 25th November 2006 Lincoln hospital had to close wards as 10 patients had the c.diff bug. One patient died.

Before any more beds and services are cut at our hospital we should ask the Trust board how they can justify further cuts to bed numbers at a time when we have already had one major outbreak at Lincoln and the bed occupancy numbers are massively over government requirements of 85% occupancy.

Quotes from around the press :

"People with MRSA should be treated in isolation, but that does not happen because bed occupancy is running at almost 100 per cent. We have heard of hospitals pulling the curtains around a bed and pinning a note on it to say "isolation".
Katharine Murphy, of the Patients' Association

"Good infection control is being thwarted by high bed occupancy levels, a lack of isolation facilities and too many patients with different conditions being placed together in wards."
Edward Leigh. Public Account Committee,,1260861,00.html

And This:

Staffing patterns and nurses' working conditions are risk factors for healthcare-associated infections as well as occupational injuries and infections. Staffing shortages, especially of nurses, have been identified as one of the major factors expected to constrain hospitals' ability to deal with future outbreaks of emerging infections. These problems are compounded by a global nursing shortage. Understanding and improving nurses' working conditions can potentially decrease the incidence of many infectious diseases. Relevant research is reviewed, and policy options are discussed.

A recent evidence-based practice report sponsored by the Agency for Healthcare Quality and Research concluded that a relationship exists between lower levels of nurse staffing and higher incidence of adverse patient outcomes (14). Nurses' working conditions have been associated with medication errors and falls, increased deaths, and spread of infection (15–30) (Table). RN staffing levels have been associated with the spread of disease during outbreaks (17,22,23,25,28). However, increasing nurse-to-patient ratios alone is not adequate; more complex staffing issues appear to be at work. Many studies have found that the times of higher ratios of "pool staff" (i.e., nursing staff who were members of the hospital pool service or agency nurses) to "regular staff" (i.e., nurses permanently assigned to the unit) were independently associated with healthcare-associated infections (16,17,21,27). The skill mix of the staff, that is, the ratio of RNs to total nursing personnel (RNs plus nurses' aides), is also related to healthcare-associated infections; increased RN skill mix decreases the incidence of healthcare-associated infections (20,29,30). In a recent comprehensive review of the literature, the authors concluded that evidence of the relationship between nurses' working environment and patient safety outcomes, including healthcare-associated infections is growing. They also concluded that stability, skill mix, and experience of the nurse workforce in specific settings are emerging as important factors in that relationship (31).

Anyone see where I am going with this?

And Gordon Brown is going to spend millions on supposed "deep cleaning" instead of creating jobs for front line staff, and redesigning hospitals and creating beds.

I do not need to create a link to my posts about the staffing at my trust or managements attitude towards this problem. Randomly select any of my previous posts and read about it. We do not have enough beds to cope. New nurses cannot find employment anywhere. WE have 3 closed wards at our hospital. They are nightingale wards so cannot be used (as per government orders) but there is no money to refurbish (as per government penny pinching). I know of trusts that have the lowest staff to patient ratios in the country. They have superbug problems. They want rid of hundreds of frontline staff but they advertising for new management consultants.

Gordon, you ignorant slut.

Our domestics are only working 4 hour days and in that time they must serve breakfast and dinner. They are only hiring part timers as domestics. There are 2 domestics to do this in 4 hours and clean the ward as well in that time. The ward is at 100% bed occupancy and is totally overcrowded. They could not clean it properly if you had a gun to their heads.

Everyone understands this and has already connected the dots...everyone except the fucktwits in charge....


Saad Amir said...

Their are some problem caused with the patients so they seek to the hospital.Their are many advantages of the doctors to help the patient in problem.
regards, saad from

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