North Shore Hospital report - New Zealand Doctor

Health and Disability Commissionere) This is one area which is very difficult to comment on. The family obviously had manyconcerns, and [a senior Registrar] is reported to be very distressed that his attempts seemto have been belittled by the family. I do not believe I can comment on the adequacy ofthe communication. The perception of [the family] was that this was not enough, but thisis not supported by documentation and comments made by the medical staff.f) The co-ordination of care by all medical staff is also difficult to ascertain, although it isdocumented that a very large number of medical and Allied Staff had input into his care.WDHB in their report to the HDC on 26 February 2008 stated, ―despite the great workand effort by all the multi-disciplinary team, this does not seem to have been wellexecuted, leaving [Mr D] and the family ill informed, frustrated and dissatisfied with theepisode of care.‖In Summary:Apart from some failure of the multi-disciplinary team to co-ordinate care, I find no evidenceof inappropriate medical management. There were some issues raised, relating to nursing,perhaps mitigated by shortage of Health Care Assistants and an extreme workload.[Mrs E]Executive Summary:On 17 October 2007, [Mrs E] was referred to ECC by her general practitioner, with symptomsof shortness of breath. She is concerned that during her time in ECC there were lengthydelays in her IV line being attached, and delays in nursing staff responding to her requests forassistance. Overall, she felt that she did not receive timely care while in ECC, and nurseswere ―brusque‖.After her transfer to ward 10 early that morning, [Mrs E] is concerned about long delay innurses answering call bells, lack of nursing care, lack of assistance when moving rooms,delays in turning her drip back on, failure to adequately treat her respiratory symptoms anduncaring and unprofessional behaviour by staff. It also appears that, at some stage, [Mrs E]was left without a patient identification bracelet. Furthermore, [Mrs E] was particularlyconcerned about the standard of hygiene on ward 10 (she also commented that her oxygenmask was dropped on the floor while in ECC and then replaced). [Mrs E] also querieswhether her shortness of breath was adequately managed.Specific Complaints:1. Delays in medical and nursing assistance.2. Lack of nursing care.3. Uncaring and unprofessional behaviour by staff.4. Standard of hygiene.5. Adequacy of medical management.Expert Advice Required:Please comment on the standard of care provided to [Mrs E] in ward 10. Explain whatstandards apply and whether they were complied with. Please include comment on:a) the appropriateness of the management of [Mrs E‘s] respiratory condition.Through her previous occupation as a nurse, and as a Board Member of WDHB, [Mrs E]outlined many concerns relating to staff, communication, cleanliness, patient comfort andoutpatient clinics. All these points (a total of 27) have been very thoroughly responded to by140April 2009