THE DEPARTMENT of Health has just published its 11th Essence of Care benchmarking document, which outlines best practice for the ‘care environment’.
The benchmark has a wider focus than its predecessors – covering any healthcare setting as well as the patient’s own home. It focuses on seven key factors:
- access to the care environment;
- culture among staff in the environment;
- infection control precautions;
- personal environment;
- linen and furnishings
So far the Essence of Care series has proved popular with nurses.
‘They are a very good set of standards,’ said Margaret Howat, acting head of practice development at Homerton Hospital NHS Foundation Trust in east London. ‘The Healthcare Commission uses it for its core standards and it’s just really good guidance for us,’ she added.
However, the previous 10 benchmarks have had a much narrower and often more clinical focus, looking at issues such as pressure ulcers, continence and nutrition.
There is some concern that, while the new document pulls a lot of best practice guidance into one place, nurses could be overloaded with too many audits to carry out.
Take the infection control precautions, for example. No nurse would disagree with best practice indicators suggesting that staff should wash their hands, that trusts should have an infection control policy and that appropriate systems should be in place in case of an infection outbreak.
But these indicators are merely replicating guidance found elsewhere.
‘If people are auditing to Healthcare Commission core standards, the Infection Prevention Society national standards and the Patient Environment Action Team assessments, and then they’re doing this on top – I can’t see how it will be of benefit,’ warned Judy Potter, chairperson of the Infection Prevention Society.
‘I think it’s important that people use the findings of other audits to inform this, rather than having to duplicate the work,’ she said.
Ms Howat agreed that the new benchmark could take up a lot of time. ‘It’s such a big benchmark that it makes me slightly anxious,’ she said. ‘I think it’s important that you just pick out the bits that aren’t covered elsewhere.’
But she welcomed the document’s reinforcing of basic care elements, such as being courteous and tidy, saying that emphasising the fundamentals of nursing was always appropriate.
However, some best practice indicators fall well outside nurses’ remit.
The document suggests car-parking charges be kept at a minimum and soft furnishings be therapeutic in colour. In such cases, nurses’ role would be restricted to arguing for change on behalf of patients.
‘You can be the patient advocate, Ms Howat said. ‘Even when it’s outside a nurse’s area, they can take it to people and say this is what we need to achieve. If the trust isn’t providing car parking you can say “excuse me, but it’s in this standard”. It can be a useful lever.’
The benchmark will no doubt prove very useful but nurses may question its scope, especially if it involves duplicating tasks.