Call to make ward rounds 'cornerstone of hospital care'

 
Ward round Ward rounds have become neglected, the royal colleges say

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Vital ward rounds are being neglected in hospitals - to the detriment of patients, experts say.

The royal colleges of physicians and nursing said they needed to be re-prioritised and become a "cornerstone" of daily life in hospitals again.

The guidance said they were essential for communicating with patients, monitoring progress and arranging treatment and discharge.

But it said too often key staff were not available to take part in them.

This meant doctors were left to do them themselves without the input of other staff, particularly nurses.

The royal colleges said the problem had arisen because staff were being stretched too thinly and poor organisation meant they were not always carried out at the most appropriate times.

The guidance is the second time in three months the two colleges have published advice jointly.

Dr Linda Patterson, Royal College of Physicians said nurses and doctors need support from hospital management to spend more time with patients

In July they issued standards for the monitoring of vital signs, such as blood pressure and pulse rates.

It is part of a concerted effort to ensure the basic foundations of good care are in place amid concern that the combination of financial pressure, increasing admissions and the complex nature of modern medicine have skewed priorities.

'Crucial reading'

Dr Linda Patterson, clinical vice-president of the Royal College of Physicians, said: "We have heard from patients that care can be fragmented and not holistic.

Start Quote

High quality, consistent ward rounds in every hospital would contribute to a more patient centred culture in the NHS - this is crucial reading for the government and trusts”

End Quote Katherine Murphy Patients Association

"Despite being a key component of daily hospital activity, ward rounds have been a neglected part of the planning and organisation of patient care.

"There are no national guidelines or templates on how to run a ward round, there is still considerable variation across hospitals.

"We often under estimate the importance of ward rounds for patients, and sometimes don't allow enough time for patients to discuss their anxieties or for relatives to be involved with care."

The guidance makes a number of recommendations to hospitals to help them get ward rounds right.

These include preparing properly by holding a pre-round briefing, carrying them out in mornings to allow the completion of tasks during the day and ensuring a nurse and other staff crucial to the care of the patient are present.

Patients and their relatives should also be provided with a "summary sheet" clearly presenting the information discussed during the ward round.

It also includes examples of best practice, including the approach taken by University College London Hospitals, which has drawn up a ward safety checklist - based on the World Health Organization's surgical safety checklist - which is used to ensure staff carry out all the correct checks during ward rounds.

Katherine Murphy, chief executive of the Patients Association, said: "High quality, consistent ward rounds in every hospital would contribute to a more patient centred culture in the NHS. This is crucial reading for the government and trusts."

 

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  • rate this
    +4

    Comment number 126.

    Nurses and doctors will never win against the bureaucrats. The more efficient they become the more they will see cuts. When the NHS is privatised expect to see patient care sacrificed on the altar of profit.

  • rate this
    +1

    Comment number 125.

    @118 'Megan'
    ~~
    We are getting better at diagnosing the early signs of stroke to improve early intervention. Yes, I agree - post stroke intervention and rehabilitation is severely lacking compared to post heart attack follow up.

    The evidence shows that stroke victims, with speech paralysis, are the most vulnerable in hospital without family and friends and the system after discharge.

  • rate this
    +2

    Comment number 124.

    #116.lizzie

    So your answer would be - what exactly? Red flashing lights on our palms and a Carousel a la Logan's Run for us oldies?

  • rate this
    +4

    Comment number 123.

    I'm watching the news and getting more cross by the second!! There is no excuse for bad nursing but modern training does not make good nurses that know how to observe and CARE! Paperwork comes before nursing care and it is WRONG. Let me at the administrators and I will tell them how to improve things, its not rocket science!!

  • rate this
    0

    Comment number 122.

    Don't just blame this government for bleeding the NHS to death. All the parties see the NHS as a white elephant and want to see outside investment take over.

  • rate this
    +2

    Comment number 121.

    To the enthusiasts for privatisation of health - We could spend 17.9% of your GDP on health as the USA does, instead of 9.6% as we do in the UK. However, despite this vastly greater expenditure our average life exprectancy is 80.1 years, whilst in the US it is 78.37 years. The NHS may not be perfect but it provides a lot of benefit for the money we choose to spend on it.

  • rate this
    +2

    Comment number 120.

    I dont understand how and why things have changed so much since I was in training. We ALWAYS had ward rounds, notes made, weights and drugs recorded, care plans, and each nurse had specific patients to look after on every shift.Bring back training on the ward and go back to some of the old disciplines that over three years training on the ward became second nature. Ditch the uni training!

  • rate this
    +3

    Comment number 119.

    @116 'lizzie'
    ~~
    I think we get your point - "too many of you, and too few of us is the problem, larger older population."

    You suggest that a larger older population have nothing to contribute. Would you prefer older people do not insult your vision and everyone should look like X-factor and not allowed outdoors or go to work in daylight. When you get old - will you wonder why society shuns you?

  • rate this
    +1

    Comment number 118.

    When in hospital 4-5 years ago after a stroke, I was surprised by the complete lack of any sense of purpose: I'd expected something more like a sports training camp where the whole focus was on getting each patient better, but everything drifted vaguely and 'might' get attended to, maybe. No schedules, no timekeeping. Very frustrating to an organised person!

  • rate this
    0

    Comment number 117.

    When we look back at the condems tenure in govt and its legacy for britain it will not be to measure what we have gained but rather to mourn what we have lost.

    Mr Hunt and his cronies will kill yours and my NHS if we let him.

  • rate this
    -1

    Comment number 116.

    too many of you and too few of us is the problem. larger older population, iller elderly, advances in technology means more interventions, cuts menas losing front line..and don't say it doesn't because it does and has. what do you want with limited resources, surgery, care or an extra round? you need both but you can't have both..choose

  • rate this
    -2

    Comment number 115.

    People have no respect for nurses nowadays without these silly comments. To say we need to re prioritise is a farce. Tell me. Your demented gran is in hospital. Do you want her unfed/no painkillers/left in her incontinence or bursting for the toilet or not being washed until after lunch. or does that not matter as long as we do a ward round. Get your facts straight. Two nurses for this a joke!!!!!

  • rate this
    +9

    Comment number 114.

    Our money needs to be targeted where it is needed, not on managers, the clip board brigade, modern art, health tourists, IVF, non essential cosmetic surgery, wage demands, etc... but on matrons, sisters, nurses, Doctors, medical equipment, trained cleaners and key support staff. lets get back to an NHS without government or union interference.

  • rate this
    +1

    Comment number 113.

    @110 'leftrightleftright'
    ~~
    Believe me, I never jest about form-filling. I was pointing out to @102 'Max' that as an NHS out-patient his/her post is not indicative of NHS out-patient experience in reality, but more to do with private hospitals, or private care.

  • rate this
    0

    Comment number 112.

    Fear not- Jeremy is in charge now and everything that has started to be addressed without his help will become his first priority. Hope his research assistant is aware of his qualities though he doesnot want to take too much upon himself without J sanctioning it..

  • rate this
    +2

    Comment number 111.

    If you say something should have an increased priority, you need to say what other priority you intend to downgrade to compensate, or where the money for increased staffing will come from.

  • rate this
    +1

    Comment number 110.

    @108 - Don't jest about form filling, mum was in hosp in March and the form filling was horrendous for her, us and the staff. It was just repeating the same info time and time again. Whilst i can appreciate that there has to be some sort of back up against mistakes this was just form filling for the sake of it.........a waste of staff time.

  • rate this
    +2

    Comment number 109.

    Talk about stating the blindingly obvious.

    It staggers me that in this day & age that this is NOT a priority as a matter of good hospital practise and foundation for patient care.

    Why, in this day & age, is this still a major problem that the Government down to Hospital Management do not realise this? I remain angry at this unexcuseable neglect.

  • rate this
    +2

    Comment number 108.

    @102 'Max'
    ~~
    Are you sure about seeing two nurses, a doctor and a consultant filling out the same forms - or perhaps you forgot you were in a private hospital?

  • rate this
    +3

    Comment number 107.

    As other people have said the last govt threw money after money at the NHS and what did it achieve under their tenure?


    ----Well it ranked in the Top Two by outcome and Number One by cost effectiveness in the World amongst Public Health Services by 2008 in Two highly reputable international surveys up from 13th in 1997.

 

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