A side room on a surgical ward has been turned into a homely and private space for patients to be with family and friends. This initiative won the Enhancing Patient Dignity category in the 2018 Nursing Times Awards
A team of general surgical nurses has transformed, at low cost, one of the side rooms on Lundy Ward, North Devon District Hospital, into a homely and private space for patients to spend time with family and friends. Opened in June 2018, in its first six weeks the room hosted patients who had received a life-changing diagnosis, a patient with a learning disability and patients at the end of their lives. This simple initiative, which is easy to replicate, is a great example of how to enhance dignity and person-centred care.
Citation: Lilley G, Murdoch J (2019) Enhancing dignity with a private space for patients and families. Nursing Times [online]; 115: 2, 48-49.
Authors: Gemma Lilley is ward sister; Jo Murdoch is staff nurse; both at North Devon District Hospital, Northern Devon Healthcare Trust.
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- Award category sponsored by TENA (an Essity brand)
Lundy Ward at North Devon District Hospital in Barnstaple is a surgical ward with 22 beds organised in one four-bed bay, one five-bed bay and 13 side rooms. Many of our patients – notably children, people with learning disabilities and patients at the end of life – benefit from having a relative or friend staying with them. As a team of general surgical nurses, we wanted to improve the hospital experience, both for patients and their loved ones, by transforming one of the side rooms into a homely place for them to spend time together.
What was our purpose?
Our inspiration came from several recent admissions of young people who had received a terminal diagnosis. Acknowledging the importance for patients of having their loved ones around them during difficult times, we wanted to provide them with a place of safety and peace in a less-clinical environment that would alleviate their stress and anxiety.
The project was based on patient engagement and staff empowerment. We were keen to listen to what patients and families valued, and empower nurses to respond accordingly. We wanted to push the boundaries of what inpatient care can look like.
What does the room look like?
From our 13 side rooms, we chose the one with the largest floor space, an existing en-suite bathroom and views over the rolling hills of Devon. We tried to consider as many factors as possible when decorating and furnishing the room, and equipped it with curtains, blankets, comfortable seating, sensory lighting, additional plug sockets and tea- and coffee-making facilities.
The room features:
- Shelves for personal effects so people can bring objects such as cuddly toys or family pictures;
- A digital TV/DVD player with a USB/HDMI port so people can watch television or videos, and listen to the radio – or some of our talking books;
- A fold-up bed so that a relative or friend can stay overnight.
Toiletries are made available to those whose stay is unscheduled. The room is accessible to people in wheelchairs and is fitted with appliances to help those who are frail. Information on support services such as the local hospice is available. Most items can be easily removed, so the room can be changed back to a regular acute surgical room when needed.
During the day, a patient can spend time in the room with their relatives and friends. A sign on the door indicates that they are having a quiet time and the team needs to respect their privacy. At night, the room can accommodate a patient plus one relative or friend.
“A simple idea that encompasses everything this award represents” (Judges’ feedback)
How did we go about it?
In November 2017, we set up a focus group to exchange ideas and take on tasks, calling for volunteers from staff members. Staff responded enthusiastically. Ward sister Gemma Lilley empowered one band 5 nurse (Jo Murdoch) and one band 2 nurse (Tracey Hearse) to lead the project. They ensured the focus group was representative of the multidisciplinary team.
We involved many roles and specialties: our palliative care teams, end-of-life lead, a local hospice, Admiral nurses, learning disability nurses, a health and safety officer, the infection control team, and the director of nursing. As no other ward or unit in the hospital had a similar facility, we wanted to ensure trust-wide engagement and knowledge sharing. We researched cost, viability, health and safety, and infection control and prevention. Donations and environmental funding from the trust gave us a total budget of £750 for the project.
The project is not just about the room itself, but also about humanising care. All clinical staff received training around building relationships with patients. Protected time was allocated for the training, which was delivered at the hospital by Jo Murdoch. Staff have been encouraged to see the person behind the condition, take time with patients, and show interest and compassion. Training sessions continue to be provided as required.
How was the room received?
The room – called ‘the Snug’ – opened in June 2018 and has surpassed our expectations; Box 1 contains some of the positive feedback we have received. In its first six weeks, it hosted 10 patients, ranging from those who had received a life-changing diagnosis to one patient with a learning disability and patients at the end of life. It is a work in progress, there is a suggestions box outside the room and we plan to regularly review feedback from patients, relatives and the team to keep improving care. We would also like to transform another side room on our ward.
Box 1. Relatives’ feedback
“[I was grateful for] the ability to get up at 3am and make a coffee to try and stay awake for my husband who [was] nearing the end of life so that I could massage his hands – a skill taught to me by a nurse earlier that day.”
“I wanted to stay overnight with my dad who had dementia and had become increasingly confused. I was more than happy to snooze in a chair, and then a bed came into the room. I couldn’t believe it!”
“Being able to have a shower in an en-suite bathroom knowing my son who was recovering from major surgery was close by [was invaluable].”
The project can be easily replicated on other wards and in other disciplines. The plan is to roll it out across North Devon District Hospital, where every ward is to have a ‘Snug champion’ and a ‘Snug box’ (which will contain key items needed to transform a side room). Quarterly progress updates will ensure the project stays patient focused. We are also in talks with other hospitals in the South West that may want to set up similar projects. Key points to bear in mind when doing so are outlined in Box 2.
The NHS is under great strain, but this does not mean care should be compromised. While understanding budgetary constraints, we should be innovative and bold. Ultimately, this is about providing person-centred care, preserving dignity and nurturing a culture of compassion.
Box 2. Advice for setting up a similar project
- Be brave and bold, do not be afraid of change
- Learn from each other, from previous experience (good or bad) and from people’s feedback
- Keep developing your project by listening to patients and their loved ones
- Educate all staff about the importance of compassion and humanity
- Having a relative stay in hospital is a source of comfort for patients especially for children, people with a learning disability or those at the end of life
- Ward side rooms can be transformed into a private space for patients and families
- Person-centred care requires finding out what is important to patients and their loved ones
- Person-centred care also requires educating staff about the importance of compassion and humanity