Page 7 - World of Irish Nursing April 2018

10 NEWS

INMO pushing on at national level to

address ED overcrowding crisis

As part of its drive at a national safety measures had been placed on wards, that the to the issues the Organisation
level to address hospital and implemented as per the 2016 de-escalation policy immedi- has raised with it. Specific clari-
ED overcrowding, the INMO agreement. ately applies. fications sought include:
has sought specifically that the Where implemented cor- At the ED Taskforce Forum on • In light of the persistent, gross
HSE Acute Hospital Division rectly, the ED Agreement March 12, 2018, the INMO again overcrowding in your hospi-
intervenes in hospitals where brokered between the INMO sought clear plans from each tal, can you please advise the
the trolley numbers are simply and the HSE in January 2016 hospital on how they intended plan/policy in relation to bed
out of control, and where local has made remarkable improve- to deal with the predicted utilisation across the region?
management is not adhering to ments and better use of extra surge of activity post bank-hol- • In addition we seek the policy
the ED Agreement of 2016. beds, both in community and iday weekend. The Organisation relating to the utilisation of
This requires site visits, which acute hospitals. RCSI Group sought that national directives level 2 hospitals for all day
the INMO has requested. HSE figures clearly demonstrate issue from the Acute Hospital surgery and day diagnostic
management must intervene this and hospital overcrowding Division to ensure that weekend procedures
where there is a clear breach has improved and ED over- discharges took place and that • What policy was put in place
that has caused, or contrib- crowding in all that group’s senior decision makers were ros- within the Hospital Group
uted to, additional volumes of hospitals has been halved in tered in all EDs. for the utilisation of beds
inpatients being cared for in the past year. There is evidence that some to assist patient flow in the
EDs. This places extraordinary The INMO is clear that man- admissions are for diagnostic region? When was this most
pressures on INMO members agement needs to focus on tests only and the INMO has recently reviewed and can
attempting to provide the best precise implementation of the requested that HSE and Group you advise of the outcome of
care possible while protecting agreement. INMO officials are CEOs deal with this immedi- said review?
their registration and their own meeting both local hospital ately by ensuring fast-tracking • When was the most recent
health and safety. management and Group CEOs of diagnostics to avoid unnec- risk assessment on the effects
The INMO to get the focus placed firmly essary admissions. of these appalling working
sought a on implementation of the INMO IROs will be advising conditions, on nursing staff,
cessation escalation policy and, when the reps in each ED of the HSE’s and the outcome of same?
of all elec- patients are inappropriately response, hospital by hospital, The INMO has notified the
tives in the director of the Acute Hospital
acute hos- ED Agreement clearly states: Division, Liam Woods, that in
pital sector, the event that risk assessments
due to the “During periods of escalation, the provision of good clinical care will determine the environments
high level of continue to be a key priority. In circumstances where staff have not been to be unsafe, the Organisation
attendance enabled to deliver this care in a timely manner in line with established expects management to fulfil
clinical protocols, examples of which are set out below, management
in EDs and reiterate that staff will not be held personally accountable for system obligations under the Safety,
the pres- risks over which they have no control. We have a shared concern that Health and Welfare at Work
sure this places on staff in the care is provided in a timely manner including items listed below: Act by implementing imme-
departments. • Manchester triage system diate measures to alleviate
As a result, on Monday, • MEWS protocol for sepsis the risks posed to staff and
March 12, 2018, the HSE issued • Head Injury that not doing this has conse-
an instruction throughout the • Administration of medication quences under that legislation.
system for electives to cease • Non-delivery of fundamentals of care The INMO recognises that
and the Minister for Health • Follow up Investigation results this is a very difficult working
made additional funding avail- • Paediatric protocols to include Children First guidance, PEWS, dis- environment for members and
able to increase homecare charge planning, parental education. our aim is to maintain focus on
“To the extent that there is delay in this area, it will be a call for
packages. €5 million was made immediate decision by management and collective implementation this by continuing to highlight
available to the HSE Social Care in order to reduce the risk. To the extent that these issues persist, fur- the issues in the media and
Division to accelerate discharge ther escalated action will be required by management. It is anticipated by continuous direct dialogue
in order to release the pressure
with employers.
that concerns in this area would be raised by nursing staff in writing or
WIN Vol 26 No 3 April 2018 wrote to Hospital Group CEOs, tions under which staff are working which will include the level of IROs if any of the above meas-
Members are urged to advise
on the acute hospital system.
verbally with management.
“And due cognisance will be taken by management of the condi-
In addition, INMO officials
ures are not being implemented,
staffing for the level of activity.
requesting evidence that risk
who will in turn demand inter-
“And, it is agreed that the activation of Step 1 in the Escalation Plan
vention by employers.
assessments had been under-
simultaneously recognises that the workplace is evolving into an
– Phil Ní Sheaghdha,
taken of each department,
unsafe environment with a heightened level of risk.”
INMO general secretary
to determine whether staff