Plus dietitian, speech & language and social work.
Real input, not ward rounds without seeing or speaking to the patient.
Not box-ticking or minimal/no records.
Key to it all - compassion and MDT communication .
A house of card can collapse with just one card removed.
JM Reid retweeted
Before an older relative leaves hospital in England, NICE guidance on moving between hospital and home for adults with social care needs lists what should happen.
One health or social care practitioner should be responsible for coordinating the discharge. The person should be given a complete list of their medicines. The hospital doctor should make sure the GP receives the discharge summary within 24 hours.
A GP or community nurse should phone or visit people at risk of readmission 24 to 72 hours after they leave.
If you do not know who is coordinating the discharge, ask the ward.
This needs to be said over and over again. Every failure can’t be clocked up to “error”. Laziness and negligence are not errors. And they can and do cause death, often of the most vulnerable patients.
Neglect of nutrition, hydration and other basic physical and mental needs are common in care of the elderly, even in facilities proclaiming to specialise in elderly care and can be difference between life and death.
Another finding of neglect (Safeguarding investigation) against Mid and South Essex, with poor records criticised by coroner
"not fed and hydrated properly"
Death of 86 Jill Rose, former nurse
Can't find published PFD yet
Condolences to family
yellowad.co.uk/nhs-trust-und…
JM Reid retweeted
No screening means no numbers. No numbers means no problem, as far as the board can see.
A hospital that does not measure delirium has no way to show how much it has, or whether its care is improving.
A damning statistic indeed & begs the Q, what are the statistics for others not qualifying as people - the very elderly/frail, mentally impaired, just anyone very vulnerable & unable to self-advocate, whereupon medical power may trump the right to adequate care and even life.
💯 Medics wield immense power and influence through their notes. They’re not the place for playing fast & loose with the facts or making wild guesses & character judgements with inappropriate words, snap scores and wee crosses +. Definitely not the place for exclamation marks ‼️
#Oliverscampaign
A bit of advice for medics when writing up a patients notes, don't write something you wouldn't say to the patients face,
STOP with the mother blame
If you wouldn't write it about your loved ones. Don't write it about your patient.
Keep to the facts
JM Reid retweeted
"Denies pain" means little from a patient who is unable to say where it hurts.
In dementia and delirium, pain shows up as agitation or silence.
Use an observational pain tool, treat, reassess.
Painkillers before tranquillisers.
#delirium
JM Reid retweeted
The delirium checklist that fits on a glove: PINCH ME.
Pain, INfection, Constipation, deHydration, Medications, Environment.
Then add what it can miss: sodium, glucose, calcium and oxygen.
#delirium
ALT Card headed "BEFORE THE SCAN" and "PINCH ME". Pain. INfection. Constipation. deHydration. Medications. Environment. Footer: "Six bedside checks, then add sodium, glucose, calcium and oxygen." @think_delirium
If Michelle O’Neill’s understanding of the law is akin to that of a medieval monarch, it’s because she stands against a medieval anti-Catholic coat-trailing klan that in any healthy modern society would be consigned to history.
But nice gaslighting.
What has happened in Portadown over the last 48 hours has ramifications which will echo for years. Michelle O’Neill has shown an understanding of constitutional law which is closer to that of a medieval monarch than a democratic government minister.
belfasttelegraph.co.uk/comme…
One of many important questions that nobody asks.
It’s as if it doesn’t matter but it matters very much. It determines how they are treated and very often it results in them being treated as a lost cause.
In hospital, ask early: what could this person do two weeks ago?
That baseline should guide mobility, delirium assessment, discharge planning and rehabilitation.
#geriatrics
JM Reid retweeted
In hospital, ask early: what could this person do two weeks ago?
That baseline should guide mobility, delirium assessment, discharge planning and rehabilitation.
#geriatrics
JM Reid retweeted
Every time inquiry learnings come to a board meeting (which is every single day) respondents should imagine that there is a public gallery filled with those harmed by the original events, watching. Maybe that would stop them being no more than an item on a very busy agenda
JM Reid retweeted
An older person can survive the acute illness yet leave hospital less able to walk, wash or think clearly.
Preventing avoidable decline is part of the treatment.
#hospitalcare pubmed.ncbi.nlm.nih.gov/3265…
Inevitably.
Thirlwall inquiry.
"The move towards a 'no blame' culture in the NHS, starting in 2000, was a mistake."
thirlwall.public-inquiry.uk/…
ALT Screenshot of paragraph 4.26
It is beyond shocking how many staff simply don’t get this and/or don’t care.
A hip fracture is more than a broken bone.
Pain, delirium, immobility, nutrition, medicines, continence and discharge planning all affect recovery.
That is why orthopaedic and geriatric care work best together.
#hipfracture nice.org.uk/guidance/cg124
Review, reflection 🥱 … same old same old from RQIA & DoH about a doctor whose conduct was known, protected and facilitated by all around & above him. No accountability, again. Promotions and pay rises all round, again. No one is sucked in by these template soundbites any more.
Stormont Health Minister Robbie Butler has issued an apology after a review prompted by concerns over the work of a former consultant neurologist revealed the “devastating impact” on his patients and their families.
The Regulation and Quality Improvement Authority (RQIA) review was prompted over the work of Michael Watt, who has since been struck off.
Read more: tinyurl.com/ycrn7973
💯. The reality is that staff use relatives to do their tasks, whilst treating them as a nuisance if they query care. Too often, when families leave to get rest, care declines, sometimes with worst outcomes. Families are left with the guilt of trusting staff to care.
Nobody can keep vigil forever. Families can sit for long periods at at the bedside of a loved one with delirium. Often afraid to leave but getting increasingly exhausted.
Clear information from staff is the solution here.
Explain what is going on, what safety measures are in place, and give them confidence that they can go and rest and return the next day.
#delirium