Homerton Hospital deaths inquiry highlights failings in night time nursing
PUBLISHED: 12:00 11 November 2016 | UPDATED: 12:03 11 November 2016
A probe into two deaths at the Homerton Hospital has highlighted failures in nursing care at night.
The Hackney hospital has made changes to the way it checks on patients following the deaths of two seriously ill people earlier this year.
The trust found both were inadequately monitored by nursing staff after they were moved off intensive and acute care units onto wards.
The Homerton’s chief nurse Sheila Adam said: “Lessons have been learned from both cases.”
The deaths were made public in June when the Health Service Journal (HSJ) revealed an audit of patient monitoring was underway at the hospital in Homerton Row.
The magazine published a leaked email from Ms Adam to nursing staff which said two serious incidents had occurred as a result of nurses “not always carrying out appropriate monitoring or observation of patients in the evenings and at night”.
Results of the hospital’s inquiry into the deaths, published by the HSJ this week, show in one case a nurse was given inadequate information about a patient’s condition and the need for increased observation.
In the second case there was a delay transferring an acutely ill patient from intensive care onto a ward and their condition deteriorated.
The trust found this was not “effectively escalated and communicated” between nursing staff and there was no “timely response” to the patient’s worsening health as a result.
Ms Adam said the hospital’s investigation showed “a key factor in one incident was an ineffective handover regarding the severity of the patient’s condition”.
The hospital carried out an audit of observations on 100 patients over one night in August following the deaths.
In six per cent of cases it found greater frequency of checks should have been carried out.
It has since made changes to intensive care discharge procedures and patient monitoring to improve care.
Ms Adam said: “We will continue to monitor night time observations and inform all ward sisters and senior nurses of the need to ensure that all patients receive the correct frequency of observations at all times of the day.”