"A&E and Juniper Ward"

About: Darent Valley Hospital

Anything else?

My wife was admitted via A&E, Medical Short Stay to Juniper ward with breathing difficulties.

I can't fault the A&E - she was assessed within 5 minutes and whisked away to A&E for immediate care and attention. No waiting around. In A&E triage immediately highlighted the issue, to little oxygen and to much CO2 in her blood. She was put on oxygen straight away, while blood and other tests and scans were completed. initial (and final) prognosis was 'Initial Diagnosis of COPD, combined with a major chest infection. Lots of questions repeatedly asked about history by different people, but necessarily so.

Confusing advice was sometimes given about possible treatment pathways, including the need for Oxygen support at home, which subsequently didn't arise. We felt that there appeared to be to many chiefs, with people wanting to find something to overrule the initial diagnosis. However, the cross referencing did work, although we experienced long delays in the wait for a CT scan (one aborted due to misunderstanding about what was required) which prolonged the stay in hospital.

We found the A&E and Short Stay staff, overall to be excellent, supportive and reassuring. They dealt with us (patient and NOK) with compassion and humour. There appears to be an issue with taking blood among some staff, with my wife being subjected to a total of about 40 different needle pricks before veins were found. With the number of bloods needed, this cause substantial bruising and discomfort on arms, backs of hands (and on one foot). Surely medical professionals should be better than this?

My spouse was moved to Juniper ward at 23.30 at night on the 2nd night, which disturbed her and caused her anxiety, so she begged the use of their phone to let me know. On Juniper ward, while the staff were both caring and professional, they seemed to be under enormous pressure and short handed. Evidenced by their inability to clear beds of departing patients, keeping new patients waiting. Whether it's time management or poor organisation I'm not sure - but more staff and supervision would help them a great deal.

The standards of cleanliness were not perfect, cleaners just appearing to flip dust of ledges, down onto patients? Given my wifes condition, this was less than ideal. The Public Gents toilet were always grubby and the gents in A&E had blood on the floor which stayed there for several visits. Given that hygiene is imperative in hospitals, surely this can't be considered acceptable.

in summary - we were glad we went there and not Queen Elizabeth, and feel overall that the hospital staff do their best in trying circumstances, but the areas commented on here, if addressed, would increase the overall patient care and experience and allow the hospital to be a truly great place to to be treated.

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Response from Darent Valley Hospital

Thank you for taking the trouble to post your comments, at a time when I am sure you have other concerns to occupy you. We value feedback and use it to guide our improvement projects across the Trust. I am delighted to hear that your experience in A&E was a good one though was concerned to hear that there you felt there was a lack of consistency and accuracy in the advice you were given. I note your comment on the variety of people involved in your wife’s care. I am sorry if this seemed confusing and can reassure you that the intention of all concerned was to ensure that ‘no stone was left unturned’ in terms of getting the diagnosis right. I regret the delay caused by a misunderstanding of what was required from the CT which was requested. I have asked the Matron for A&E to look into this aspect of your comments. Phlebotomy (taking blood samples) is as you suggest a core skill for both nursing and medical staff. Not all nurses undertake phlebotomy though we are increasing our numbers constantly as they go through training and succeed in acquiring their competency. I am truly sorry for the distress and discomfort it would have caused to your wife. I am concerned to hear that you felt that staffing on Juniper ward was inadequate, particularly as the Trust has invested £3 million in the last three years to increase nurse and nursing assistant numbers. Whilst I am not aware of the exact circumstances on the days you refer t I have asked the Matron for the area to look into this. It was surprising to read that you found areas of the Trust to be less clean than you would have liked. The Trust has a good reputation for cleanliness with low levels of complaint in this area. We are externally independently inspected each year and have always achieved a good report. I have passed your comments regarding the dusting and general state of the toilet on to our Contract Manager for her to investigate. Bodily fluids should be cleaned by nurses who are trained in the specifics of disinfection for certain types of fluid. As the spill was in the gentlemen’s toilet, it is unlikely nursing staff were aware of it. Should you find anything of this type on a future visit I would ask that you report it to a member of staff who can then arrange for cleaning to take place. The reputation of the Trust is incredibly important to us with Patient Care our key focus. We were placed in the top 20% of hospitals in the country in a recent national report, of which we are proud but not complacent. We constantly strive to ensure that our staff and the environment enable us to provide professional care and exceptional quality. We are grateful to you for helping us with this challenge. I do hope that your wife is recovering and will be home with you very soon. Kate King Interim Director of Nursing 01322 428658.

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