A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

Board of Directors Part 114 June 20138.Recommendations1. Strong consideration should be given for the need for extra cover/stafffor:a. The Acute Medical Unit (see earlier note regarding anuplift in staff there since the research was done)b. The Clinical Site Teamc. Doctor cover at nightd. Extra HCAs on some wardse. Portering and security arrangementsThis could be achieved by rostering staff differently or byemploying extra staff, as appropriate.2. An extra nursing post for the CST might involve a twilight shift rota. Aband 5 nurse who is suitably trained could act as a float forpressurised areas, particularly in the evenings. Nurse prescribing bymembers of the CST could also go a long way to alleviating theproblems around access to drugs overnight.3. There needs to be a review of the current IT system for summoningporters and a much faster and more flexible response from them isneeded.4. As far as outliers are concerned a training needs analysis should becarried out in order to allow staff to cope with a more diverse casemix.5. In order to promote better team working, trained nurses need toconsider the level of support given to HCAs in carrying out basicnursing care.6. Better and more considerate daytime planning by medical and nursingstaff in advance could reduce workload at night by making sure drugsand intravenous therapies are written up and equipment is stored onthe ward when likely to be needed. Supplies of emergency drugs needto be made more readily available at night and could perhaps bestored in a locked cupboard in the CST office.7. There is an urgent need to provide better food at night. Plated mealscould be available for staff before the catering team go off duty whichcould be subsequently heated in a microwave if appropriate. Wellstockedvending machines need to be sited on both wings of thehospital with fresh healthy foods. Staff also need somewhere to taketheir breaks away from wards, if possible.8. Wherever possible, no patients should be moved to another ward aftermidnight.17The Hospital at NightQuality/Performance