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Shortage of paediatric nurses poses surgery danger, says report

Many hospitals that provide paediatric surgery lack sufficiently qualified nursing staff, a major patient safety report has warned.

The National Confidential Enquiry into Patient Outcome and Death report into children who died after surgery surveyed 290 hospitals on their surgical services for children.

While the report noted that 71% of patients received “good care”, it found cases where hospitals lacked adequate numbers of children trained nurses to provide immediate care for sick children when admitted, and many hospitals did not have appropriate systems for the management of pain following children’s surgery.

NCEPOD asked whether there was at least one registered children’s nurse per nursing shift on the non critical care ward which admitted children for surgery. In 8.3% of hospitals this was not the case.

The report said these hospitals “fell well below existing national standards” that state a minimum of two registered children’s nurses per shift should be on duty 24 hours a day in all children’s wards and departments.

“These hospitals need to review the nursing provision and ensure appropriate levels to meet national standards,” the report said.

In addition, NCEPOD found only a quarter of hospitals had an acute pain nurse with responsibility for children.

Report co-author David Mason, NCEPOD clinical co-ordinator and consultant paediatric anaesthetist, said: “We need to ensure that there are nursing and medical staff with the appropriate skills to look after these very sick children, including staff with experience to manage acute pain.”

Royal College of Nursing chief executive and general secretary Peter Carter described the findings as “deeply disturbing”. He said: “There is clear evidence that patient safety decreases where there are insufficient numbers of nurses and it is vital that all trusts meet the minimum number of children’s nurses in all areas where babies, children and young people receive care.”

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