NT: What were the main findings of the report regarding nursing care?
IM: Not just in relation to post-operative care, right from the outset, referrals need multi-disciplinary involvement in planning what should be happening to patients going through the system.
What is striking is poor communication and lack of coordination of care and lack of protocols for managing those patients at all stages.
If you look at cancer care it is way ahead of the game – this does not seem to have translated into the management of coronary heart disease.
NT: What should the nursing profession do about the situation?
IM : We think that there needs to be more use of multi-disciplinary teams. They need to be involved in reviewing outcomes, auditing results and learning from the things that have taken place so that systems can be improved.
There needs to be a system of grading quality of care so that people can see where they are going wrong.
Nurses have a key role to plan in every stage. But in particular the nursing profession needs to be involved in planning protocols and appropriately configured care plans.
There are problems with these – either they are too complex or not filled in many cases. The nursing profession is good at leading in this area – they could help devise … care plans that are integrated with pre assessment through the whole process of care.
NT: Do you think problems are being made worse by a lack of specialist nurses?
IM: Patients are not necessarily being sent to the correct place for example some patients are going to coronary care units when they should intensive care units…sometimes patients do get sent to the right place. This may be a reflection of the fact that there are not enough specialist practitioners in a particular area.
Interview by Richard Staines