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Nurse shortage and poor infection control found at Colchester hospital


Insufficient staffing levels, poor hygiene and infection control procedures, and nursing staff not always treating patients in a caring way are among the problems found at Colchester General Hospital by inspectors.

The Care Quality Commission, which visited the hospital in November and December, used urgent enforcement powers at the time to place conditions on Colchester Hospital NHS Foundation Trust’s registration procedures to improve patient assessment, discharge and transfer.

Its report from an inspection of the hospital’s urgent and emergency services and medical care provision was released last week, revealing both services to be “inadequate” overall.

“The trust is aware of what action it now needs to take”

Mike Richards

Inspectors “routinely observed” poor hand washing techniques from staff between patients and poorly completed patient records.

During their assessment of the emergency assessment unit they saw a nurse wearing gloves while checking some paperwork, adjust an alarm on a monitor then give another patient some intravenous medication, with the same gloves on.

They also saw nurses and care assistants carrying out tasks such as taking blood pressures, temperatures and helping patients, without washing or sanitising their hands inbetween.

In the A&E department, inspectors were concerned about how staff treated patients, particularly those who were very unwell, dying or deceased.

Some patients who had been in the emergency department overnight were not routinely offered drinks or snacks, with one  who had not been offered refreshments until they were  transferred to the ward the following day.

On the follow up visit on 23 December, inspectors observed an elderly patient in the resuscitation area whose blanket had slipped leaving them naked underneath.

As the cubicle curtains were pulled back, the patient was visible to people walking through the department, the report noted.

“This patient’s dignity was not being respected and we had to ask a nurse to assist and protect the patient’s dignity and make them comfortable,” said the inspectors.

“Inspectors visited at a time of unprecedented demand… [our] clinicians were very busy and working under considerable stress”

Lucy Moore

They identified a lack of experienced emergency department nurses with specific skills in areas such as triage. Meanwhile, the resuscitation area was found to be understaffed, with one qualified nurse to four patients, when guidance states there should be 1:2 or 1:1 support.

CQC chief inspector of hospitals, Professor Sir Mike Richards, said: “The trust is aware of what action it now needs to take and our inspectors will return to check on whether the required improvements have been made. We will then decide whether or not it is appropriate to remove the conditions placed on the services at Colchester General Hospital.”

But trust chief executive Dr Lucy Moore said the report did not reflect the “unprecedented pressures” the trust was under at the time of inspection, or the “considerable progress” that had been made in the past year.

“While being exceptionally busy can never be an acceptable excuse for providing sub-standard care, it is not unreasonable to point out the inspectors visited at a time of unprecedented demand within the NHS when, frankly, many hospitals like ours were struggling,” she said.

“Many people – including our staff – will not be surprised to read that clinicians were very busy and working under considerable stress,” she added.

The trust has been in special measures since 2013, when CQC inspectors received reports from staff that they had been bullied into changing patient data to help meet cancer treatment waiting targets.


Readers' comments (10)

  • Whilst poor practice can never be condoned I'm sure many of us will feel sympathy for nursing staff desperately trying to work under such pressures. I bet the CQC inspectors didn't ask any of these "bad" nurses how many extra hours they were working unpaid and whether they had even managed to get any breaks. I'm sure staff sickness rates would have reflected the high stress levels. So,so easy to blame those struggling at the coal face.

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  • They don't care about nurses because nursing is for women who cares about women. If 99% percent nurses were male they will be a no staff shortages and a better pay. Look doctors getting paid good salary because it is labelled as a male job. 99% of doc are male so they have to work 9am to 5pm. Let the junior doctors stay one while the consultant and register are having a gin or running their own surgeries privately

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  • People outside of nursing don't understand the pressure staff are under, particularly in A & E. Because, so many people watch the TV programme 24 hours in Emergency at King's, where there are multiple staff lounging around, banging their own drum and spruiking the busyness of their department, whilst they all congregate at the desk. Get that programme off the TV, staff - stop encouraging it. It is very, very negative publicity.

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  • I have to be honest and say being busy is absolutely no excuse for not offering patients snacks or drinks and having an attitude towards patients or, God forbid, leaving patients exposed and naked!!!
    I work in acute admissions and whilst I don't feel I gave my patients the best care I would like, I can honestly say hand on heart I give the basic of nursing care!
    I agree that programmes like 24 hours in A&E are not the best depiction but quite frankly, this treatment of patients at this hospital, my animals get better treated at a vet!!

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  • The activities observed by the CQC appear to be due to long standing bad habits, and no monitoring of standards or organisation of departments. Poor hand washing and infection control techniques are habits that develop over time.

    Yes, things will naturally slide when the department is very busy, but this sounds more like long term staff shortages, which the chief exec reported here does not mention.

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  • sounds like any a and e dept in the country they should visit more unannounced then they would see how it really is, instead of the sanitised version presented when they are aware of the visit

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  • No excuse for poor hand washing, use of PPE or non-compliance with the WHO 5 moments. THESE are basics no matter how busy nurses are.

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  • Anonymous | 3-Feb-2015 10:58 am

    thanks for promoting the WHO model of hand hygiene. you may like to join the dance!

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  • From a number of comments above it seems that there some people that find it difficult to take critisism, well join the real world of Nursing Homes .The CQC in the past have closed down numerous Homes for a lot less than this without a second thought, as we all know the situation found in this NHS trust by these inspectors is not new and it has been covered up for years. At last the CQC seems to have grown teeth, can we now look forward to a more rteasonable and even handed approach?

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  • It looks that they don't use RTLS at the moment. RTLS can provide automatised Infection Control immediately improving managing of infection with the help of Big Data, knowing who was in danger of infection. It helps with organization of patients in ED. Staff obviously doesn't understand the importance of Infection Control while 1 of 25 patients in U.S. get Hospital-Acquired Infection according to CDC:

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