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Care Opinion

CPE Screening

Posted By Immunosupressed

"CPE Screening"

About: Forth Valley Royal Hospital / Clinical assessment unit

(as a service user),

I was admitted to CAU via A&E earlier this year with Chest Pain. When the porter took me round to CAU at 5am there was no one around to greet me, I was put in the cubicle nearest the entrance, on a trolley with no sheet, just a piece of paper beside the ECG machine. 

A nurse appeared 30 mins later, what followed was the tick box admission procedure which included questions to screen for CPE. As I had been a patient in an English Hospital ( for less than 24 hrs ) in the past year I was informed that I would need to have swabs taken for CPE testing and was given a leaflet. 

After the nurse left I tried to get some sleep and was awakened by a noise by my cubicle, the nurse was sticking a poster up but made no attempt to communicate what it was. When I got up to check it was a red circle with the words check with nurse before entering room, even though I was in an open cubicle. It made me feel like a leper as no explanation had been given. 

Later that morning I was transferred to another cubicle in CAU, I had used one of the toilets and was informed a note would be put on the door as the toilet was now only to be used by me. There are only 2 toilets for the whole of CAU. When I asked what the mode of transmission for CPE was no one could tell me, the leaflet I was given had no explanation. How can staff prevent transmission of infection if they don’t know how an infection is transmitted? 

I was transferred to AAU area 3 to a single room where I spent a few days. Infection control visited and were able to tell me the more of transmission, apparently I would need to have been incontinent of a vast amount of faeces to transmit this infection, the chances of me having it were slim. 

When a single room was required I was transferred to a 4 bedded bay with shared toilet facilities  making me question why I had ever been isolated in the first place. 

In no way was this process patient centred, I ticked a box which led to more boxes being ticked. It took no account of my need for information, the embarrassment I felt at being singled out in this way and my confidence in the knowledge level of the staff. I am immunosupressed but there was no acknowledgement that other patients are a bigger risk to me than I was to them. I was told by a few staff that the CPE screening had been introduced without staff training or resources. 

My overall care was good and I don’t want this to be viewed as a complaint as such. Please when introducing new policies think about the impact on patients, provide information that’s fit for purpose and train staff properly, it’s the least that patients should expect. 

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Responses

Response from Judith Rooney, Service Manager, Emergency & Inpatient Care, NHS Forth Valley 5 years ago
Judith Rooney
Service Manager, Emergency & Inpatient Care,
NHS Forth Valley

Submitted on 07/09/2018 at 15:04
Published on Care Opinion at 16:53

Thank you for taking the time to feedback about your experience in our Clinical Assessment Unit at FVRH. I'm sorry that your experience was a negative one and that we did not meet your expectations.

How we communicate and effective sharing of relevant information with our patients is key to building trust and ensures patients feel in control of decisions regarding their ongoing care.

I intend to share your story with the Team so they can reflect on how your experience made you feel.

I would be happy for you to contact me to discuss your experience further if you thought that would be helpful.

You can reach me on 01324 567085

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Update posted by Immunosupressed (a service user)

Judith, thank you for replying. Whilst how this incident made me feel is important I do think that staff training and the quality of written information provided is just as important.

I don't think that the CPE info leaflet is fit for purpose, it doesn’t discuss modes of transmission and there is only one line detailing what happens when you are screened. It says “ you may be put in a single room “, that implies a level of discretion. Why is there a lack of information about this? Why make a big fuss one day about me sharing toilet facilities and then transfer me to a shared room on another? The lack of consistent treatment is very confusing for patients.

Can you assure me that all staff have had training in CPE and can describe the mode of transmission etc to ensure that consistent information is given? This is obviously a priority area for the hospital given its prominence in the admission process.

Response from Carolyn Mckenzie, Senior Charge Nurse, Acute Assessment Unit, NHS Forth Valley 5 years ago
Carolyn Mckenzie
Senior Charge Nurse, Acute Assessment Unit,
NHS Forth Valley

Submitted on 10/09/2018 at 17:09
Published on Care Opinion at 17:46

Thank you for your feedback on your time within our clinical assessment unit. I am sorry to hear about your experience as this is not the experience we would hope for our patients. I appreciate that this must have been very upsetting for you.

We are taking your concerns as a senior team very seriously and I will be speaking with all the team to share your experience.

In order to make improvements we will be working with the infection control team to see how we can improve our processes within the unit.

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Response from Patrick Rafferty, Head of Nursing, Ambulatory & Investigations, NHS Forth Valley 5 years ago
We are preparing to make a change
Patrick Rafferty
Head of Nursing, Ambulatory & Investigations,
NHS Forth Valley

Submitted on 11/09/2018 at 16:09
Published on Care Opinion at 16:37

Dear Immunosuppressed,

Thank you for taking the time to comment and reiterate your concerns regarding staff training and patient information, in particular around CPE screening and isolation.

Following your concerns I have discussed your feedback with the Infection Control Team and we agree that there are improvements that can be made with the current patient information sheet. As an action the Infection Control Team have committed to review and update the information so that it accurately reflects current advice and practice, and where possible, reduces any ambiguity.

I also agree that staff education is important and can confirm that at time of introduction there was staff training in AAU, supported by our Infection Control Team, over a period of four months. Working with the Infection Control Team I will continue to support ongoing training and education both locally within the assessment areas and across the wider hospital.

I apologise for any confusion or embarrassment you may have experienced during your recent stay and I hope that we can use your feedback to make a positive change going forward.

If there are any aspects you would like to discuss further then please do not hesitate to contact me via our patient relations team on 01324 566660.

Best wishes

Patrick

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Update posted by Immunosupressed (a service user)

Thank you Patrick. I am a frequent user of services at FVRH due to my underlying rare, complex disease and on the whole the care is great, I don’t want my comments to detract from that.

Can I suggest that Patient Insight be sought when you are updating the patient information sheet to make sure it’s fit for purpose? The informational needs of staff and patients can vary, who better to comment on any changes than the group it’s intended for, namely patients?

Response from Patrick Rafferty, Head of Nursing, Ambulatory & Investigations, NHS Forth Valley 5 years ago
We have made a change
Patrick Rafferty
Head of Nursing, Ambulatory & Investigations,
NHS Forth Valley

Submitted on 04/10/2018 at 23:19
Published on Care Opinion on 05/10/2018 at 10:42

Dear Immunosupressed,

I wanted to update you on the proposed change to the information available to patient's regarding CPE screening, the infection control team in Forth Valley have fully updated the information leaflet. I agree that the input of patients is valuable and as such we are in the process of seeking input and comment from our patient and public panel.

As someone who has particular insight I would also like to extend the invite to you to have a look and provide any feedback, although please do not feel under any obligation to do so, I'm already very grateful for your input so far.

If you would like to discuss further with either myself or someone from our infection control team then please contact me.

Best wishes

Patrick

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Update posted by Immunosupressed (a service user)

Dear Patrick,

I was sent a copy of the new patient information sheet and supplied some feedback last year. I haven’t heard anything since but would be grateful for an update, specifically has my feedback been incorporated in the patient info sheet in order to make things clearer for patients?

Thank you

Response from Patrick Rafferty, Head of Nursing, Ambulatory & Investigations, NHS Forth Valley 5 years ago
We have made a change
Patrick Rafferty
Head of Nursing, Ambulatory & Investigations,
NHS Forth Valley

Submitted on 28/01/2019 at 11:25
Published on Care Opinion at 15:42

Dear Immunosupressed,

Thank you for getting in touch, I have spoken with our infection control team, and the latest update is that yes the received comments were incorporated into the document. The updated guidelines are now being assessed by our patient panel prior to implementation.

Once again, thank you so much for your helpful input into this, I would be more than happy to share a copy of the updated guidance.

Kind regards

Patrick

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Update posted by Immunosupressed (a service user)

Patrick, I would be grateful for a copy of the updated guidance.

Thank you

Response from Pauline Donnelly, Person Centred Manager, Department of Nursing, NHS Forth Valley 5 years ago
Pauline Donnelly
Person Centred Manager, Department of Nursing,
NHS Forth Valley

Submitted on 06/02/2019 at 10:24
Published on Care Opinion at 16:43

picture of Pauline Donnelly

Dear Immunosuppressed

I hope you are well, I was wondering if you could get in touch, I have a copy of the updated guidance that I would like to share with you. I was wondering you could drop me an email with your contact details to pauline.donnelly1@nhs.net

I look forward to hearing from you.

Kindest regards

Pauline

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Update posted by Immunosupressed (a service user)

Of course Pauline, I will e mail just now.

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