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Hospital makes partial U-turn on 'do not disturb' tabards

  • 79 Comments

The acute trust at the centre of a media storm over the use of “do not disturb” tabards during drug rounds has decided to remove the controversial wording from the garments.

East Kent Hospitals University Foundation Trust was criticised in several national newspapers by campaign group Patient Concern for the introduction of the bright red tabards for nurses to wear during drug rounds.

The tabards are used by a number of hospitals to minimise interruptions from staff and other patients and so reduce medication errors. However, Joyce Robins, a founder member of Patient Concern, told Nursing Times earlier this week that the tabards sent out the message that patients should not “bother” nurses, which she described as “completely wrong”.

But writing in next week’s Nursing Times, East Kent’s deputy chief nurse and head of quality Steve Hams says this perception is incorrect and the introduction of the tabards was “never about inhibiting the unique relationship nurses have with their patients”.

He says “despite the media furore”, nurses at the trust have found patients liked the red tabards, as “it tells them the most important aspects of their care are being delivered to the highest possible safety standards”.

However, Mr Hams says that, after trialling the tabards and listening to the “wide ranging commentary” on them over the past few days, the trust has decided to remove the phrase “do not disturb” to “make it clear we have never been more committed to doing the very best for our patients, to keep them safe with care and compassion”.

He adds: “Our introduction of the red tabards is related to a broader range of measures to improve safety, reliability, patient experience, staff satisfaction and efficiency of medicine management and has never been about inhibiting the unique relationship nurses have with their patients.

“Our frontline nurses have, like those all over the country, been developing innovative ways to improve safety as well as patient experiences and outcomes - it’s disheartening when the tabloids berate our profession.”

  • 79 Comments

Readers' comments (79)

  • Well what's the bloody point in that? The whole reason these tabards do not work in the first place is that people STILL do not get the message that those of us doing the med round NEED TO BE LEFT ALONE TO CONCENTRATE and STILL interrupt us!!!

    This is essentially making patient care worse, and making our job harder, by pandering to the patients groups and media who do not have a clue what the hell they are talking about!

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  • Here Here, I agree Mike. When a mistake is made, whether minor or major (although all drug errors are serious, I mean serious in that a patient is made seriously ill or dies), the nurses are the ones who are accountable, even though the mistake was made because of interruptions! Please leave the nurses alone whilst doing the drug round. You never know that you, the patient, could be victim to the next error!

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  • silly old bag! when it comes to patient safety it must be the nurses who have the final say and are in command over the procedures they carry out as they have the ultimate responsibility if anything goes wrong, as a captain on an aircraft.

    she has absolutely no say in the matter. is she wilfuly interfering to compromise patient safety?

    "Joyce Robins, a founder member of Patient Concern, told Nursing Times earlier this week that the tabards sent out the message that patients should not “bother” nurses, which she described as “completely wrong”."

    Does this position give her the right to dictate what is right and what is wrong. Is this based on her own personal opinion or a general consensus of opinion from a wide and representative patient population? Has she carried out a survey to gather these opinions? Perhaps the public and patients have more understanding and intelligence than she gives them credit for!

    As I said following a previous article on the subject, it is not possible to satisfy everybody and their will always be criticism but it needs to be understood that the interests and safety of the patients comes first as well as the legal protection of the staff administering the drugs and that it often requires trial and error to find the most suitable system which needs, in the meantime, some tolerance.

    some poor folk with such a narrow world view and nothing better to do with their time just cannot understand or accept change even for the better and will always feel a need to be involved even when not qualified and to interfere.

    How much experience does this person have of administering drugs on a hectic ward where there are constant interruptions?

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  • HEALTH AND SAFETY IS A REQUIREMENT BY LAW. IT IS A REQUIREMENT FOR EMPLOYERS AND EMPLOYEE'S. THE MANAGEMENT DID A RISK ASSESSMENT, IN CONJUCTION TO A ISSUE RAISED REGARDING PATIENT SAFETY. THEY IMPLIMENTED THE RED TABARD WITH THE WARNING WRITTEN ON THE BACK THAT THE NURSE SHOULD NOT BE DISTURBED WHILST DOING THE DRUG ROUND! HOW MUCH CLEARER CAN IT BE?. IT MEANS WHAT IT SAYS. IT DOES NOT MEAN THAT THE PATIENTS ARE NOT ALLOWED TO TALK TO THE NURSES AT ANY TIME. ALSO WHEN THE NURSE IS TRYING TO COMMUNICATE WITH HER PATIENTS, TO SEE WHAT MEDICATION THEY REQUIRE THEY ARE GETTING THAT QUALITY TIME WITH THE NURSE AND MAKING SURE THEY ARE GETTING THE TREATMENT THEY REQUIRE. I APPRECIATE PEOPLE WILL HAVE OPINIONS, AND MAY NEED TO LOOK AT THINGS FROM A DIFFERENT PRESPECTIVE, BUT THE CORRECT DECISIONS, NEED TO BE UPHELD, NOT SURPRESSED BECAUSE THE SMALL MINORITY MAY NOT LIKE THE IDEA.

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  • Anonymous | 1-Sep-2011 6:24 pm

    I agree. Only I would add that there are some patients who do not see clearly or for some reason do not understand.

    I just wonder in the UK if patients admitted to hospital are given booklets to explain briefly and clearly their stay in hospital and what they can expect and what is expected of them. The reasons as you so well outline above for the red tabard and the message on them could also be explained. I think this are an excellent idea and can help to allay some of their anxieties about some administrative procedures and their daily routine on the ward, etc.

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  • You really cannot assume that drug errors occur because of interruptions. As a student doing a drug round with a mentor, there have been times when we have been interrupted or moved on to a patient who is in need of immediate assistance - if there is know one around, you have to help. If I have been in the middle of medication round , I complete what I am doing and lock up the medication trolley then assist. Many nurses with whom I have discussed this issue, are of a similar view. Whether you wear the red tabard or not, interruptions are inevitable from time to time.

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  • Debra Smallbone | 1-Sep-2011 6:56 pm

    I think you will find that nurses with many years experience already know that but errors can and do occur through interruptions and lack of or disturbed concentration. It very much depends where you work but if you have constant interruptions it can make any sort of concentrated work very difficult and better for everybody if there are ways of avoiding them. obviously if there are no other available staff you may have to drop what you are doing and go and help but it is also not ideal if you have to spend far longer than normal on a round because of too many interruptions and it causes delays and a backlog of other work.

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  • Debra, interruptions do occur yes, but they SHOULDN'T be, that is the point! No one is saying you can't lock up the trolley to deal with an emergency, but when you are doing the med round on your own, and you will find this when you qualify, there SHOULD be (although I admit often there isn't) enough staff around to deal with everything whilst you and you alone can concentrate on what you are doing, because the whole point is, we cannot concentrate because of constant interruptions from staff or patients and anything that helps with that, including these tabards can only be a good thing. I would say to you, imagine you are qualified, and imagine if you locked up your trolley to deal with something (more often than not it is a minor thing not an emergency) and you then went back to carry on your med round with patients and staff constantly calling for your attention. It later emerges that you made a serious drug error after going back because your concentration was interrupted and now your PIN and career is on the line. Would you still see interruptions as simple inevitabilities? No, you wouldn't.

    The fact of the matter is, as others have rightly said, WE are ultimately responsible for the meds we give out, so WE will dictate what is and what isn't appropriate to do during a medication round.

    Anonymous | 1-Sep-2011 6:24 pm you make an excellent point very eloquently that makes all these patient safety groups complaints completely irrelevant, during the med round, all our patients get one to one time with us, one at a time!

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  • good post above this one mike and I think we also ought to emphasise that none of us are infallible and can all make mistakes and put our registration on the line. none of us are immune to drug errors, even the most experienced, and the more safeguards we have against these the better. therefore I consider Joyce Robins argument against the tabard it are invalid. Somewhere else you mentioned the tabard is the best we have at the moment and sometime in the future a new idea may evolve from this or an entirely different and better one. this, she should realise is known as progress. I would otherwise suggest that she come up with a foolproof alternative!

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  • this puts professional autonomy and accountability of nursing into question regarding their rights to make decisions about their own practice.

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