Care of the elderly

Summary

The requester asked who is responsible for ensuring elderly patients at Noble's Hospital are safely put to bed in the evenings and if this is a designated duty in job descriptions. The Department of Health and Social Care responded that while it is not a specific line in job descriptions, it is a collective responsibility of the multidisciplinary team, with Registered Nurses delegating tasks to Healthcare Assistants under the supervision of the Senior Sister.

Key Facts

• Assisting patients into bed is not a specific part of any nursing or Health Care Assistant job description.
• The Senior Sister holds 24-hour responsibility for managing all aspects of patient care delivery on the ward.
• Registered Nurses are responsible for assessing care needs and delegating tasks to Healthcare Assistants and Student Nurses.
• Patient care is provided by a multidisciplinary team including Allied Health Professionals like Occupational Therapists and Physiotherapists.
• Patients are assessed individually on admission to determine their moving and handling needs.

Data Disclosed

• 650267
• 2018-11-12
• 2018-11-28
• 24 hour
• 2 people

Original Request

Who has the responsibility to ensure the elderly patients of Noble's hospital are put safely into bed in the evenings if they are not in bed already? Is it a designated duty for any member of staff for example the healthcare assistants or nurses to have this duty on their job discriptions?

Data Tables (1)

Full Response Text

Chief Executive: Malcolm Couch Freedom of Information Team DHSC Digital Cronk Coar Strang IM4 4RJ

(01624) 642621 dhsc@foi.gov.im Website: www.gov.im/dhsc

Our ref: 650267 28 November 2018

Dear ###

We write further to your request which was received on 12 November 2018 which states:

"Who has the responsibility to ensure the elderly patients of Noble's hospital are put safely into bed in the evenings if they are not in bed already? Is it a designated duty for any member of staff for example the healthcare assistants or nurses to have this duty on their job descriptions?"

Our response to your request is as follows: Within the ward environment there are several categories of patients who require assistance with their activities of daily living. As well as the elderly patients, there may also be younger patients who require help to mobilise: for example those who have had surgical interventions or suffered trauma of some kind, those with debilitating diseases as well as those who may be confused or suffering from dementia. Each patient is assessed on an individual basis on admission and at regular intervals, as appropriate, throughout their stay. Moving and Handling needs form part of the nursing assessment whereby the level of dependence, use of aids such as walking sticks, zimmer frames and hoists as well as the number of staff required to safely transfer the patient is determined. Unless a patient is deemed to be well enough to be independent and self-caring, for example someone who may be in hospital for investigations and monitoring, minor surgery or long term antibiotic treatment, then most of our patients will be offered and given assistance to use the bathroom, wash and dress, mobilise around the ward and also helped into bed to rest during the day and to settle at night. The provision of appropriate and effective patient care is the responsibility of all members of the multidisciplinary team on the ward where the patient is being cared for. This includes Allied Health Professionals such as Occupational Therapists

and Physiotherapists who frequently assist patients in the transfer in and out of bed. The Consultant carries ultimate clinical responsibility for medical treatment provided to the patient. Whilst assisting patients into bed does not form a specific part of any nursing or Health Care Assistant job description, the following describes their levels of accountability. The Senior Sister on the ward holds 24 hour responsibility for managing all aspects of patient care delivery and as the ward leader will supervise and develop the team to provide safe and effective care based on current evidence and best practice. This includes ensuring that all ward staff have undertaken relevant mandatory training in all aspects of patient care. Within the team, each Registered Nurse (RN) is responsible for the assessment of care needs of individual patients along with the development, implementation and evaluation of programmes of care tailored to their needs. Throughout the shift, experienced RN’s will supervise and direct Health Care Assistants (HCA) and Student Nurses as well as junior or newly appointed RN’s to ensure that the needs of patients are met. It is the Registered Nurses responsibility to make sure that they delegate tasks and duties appropriately, and that those to whom they delegate complete the tasks to the required standard. During the evening shift, the ward staff begin the process of assisting patients to settle for the night. This will include helping patients to access bathroom and toilet facilities and some patients will require more intervention than others. Staff may be allocated to work together as many patients require the assistance of 2 people to help them into bed and it may be necessary to use moving and handling aids such as hoists. The number of dependent patients and those requiring more assistance on the ward can impact on the time it takes to ensure that all patients are bedded down for the night. Wherever possible, a judgement is made to ensure that this procedure is done in the most efficient manner but due to the nature of healthcare, sometimes a patient may have to wait longer than we would like them to. Factors such as patients whose condition deteriorates mean that they must become the focus of attention which regrettably can cause delays for other patients. The majority of patients have prescribed medications to take before settling and it is usual practice that whilst the RN’s carry out the drug round, the HCA’s commence assisting patients to settle. However, every patient will have been seen by the RN before they go to sleep and all care provided to them will them be documented in the nursing notes and signed for. Please quote the reference number 650267 in any future communications.

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dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

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I will now close your request as of this date.

Yours sincerely