"The nursing and auxillary staff ..."

About: Macclesfield District General Hospital / Accident and emergency Macclesfield District General Hospital / Cardiology

(as the patient),

What I liked

The nursing and auxillary staff were extremely friendly and courteous despite it being the holiday season. All seemed highly professional and well trained and did everything to make my stay as comfortable as possible - thank you!!!

What could be improved

I would have liked more information about what was LIKELY to happen to me. When I entered the hospital the evidence was strong (D-Dimer over 1000 with previous chest pain) that I had experienced a pulmonary embolism. As I was in no physical pain I wrongly believed that I would be in hospital for a few hours. I ended up being there for a week. I would have liked someone to explain that my stay would PROBABLY be quite lengthy. This would have alllowed my family to organise themselves (instead of waiting for me to come out) and provided at least some management of my expectations. Generally, in A&E and the wards, doctors were not willing (or able) to provide sufficient explanation of probable outcome. From what I was told later, it should have been fairly obvious what was going on and would have taken less than a minute to simply say "we're not sure yet, but we think that you have experienced a PE. If this is the case then there is a reasonable chance that you will be with us for a few days while we conduct a scan and provide appropriate blood thinning treatment." No commitment to diagnosis but at least giving me a realistic idea of what was likely.

Anything else?

My biggest concern was hand washing. As I entered the ward, I saw the graphs showing the rates of MRSA. Given the number of patients in a ward this suggests a significant risk to any given patient. I think the current availablity of touch-free sinks and good, clear signage at the entrance/exit to each ward is excellent. However, on a daily basis I saw far too many staff ignoring the sink and wandering past (presumably following a visit to a previous ward). This system needs monitoring and policing. I would recommend disciplinary action for staff who ignore the sink and a fine for visitors and patients. In particular, visitors should have a clear explanation as to why hand washing is so important as they enter the hospital. Staff (particularly the ones with stethoscopes around their necks) should know better! Just before I left the hospital I was informed that there had recently been a case of MRSA and I had to be swabbed. I currently await the results of my swab with fear both for myself and any others I come into contact with.

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Responses

Response from Macclesfield District General Hospital

We are really pleased to read your kind comments about our nursing and auxiliary staff. Staff at East Cheshire NHS Trust are committed to making every patient’s stay as comfortable as possible. It is great to read that our high standards did not slip even when working under pressure over holiday periods. We are really sorry that you feel you were not well informed about what would happen after you were first admitted to hospital. It is not always possible to diagnose a pulmonary embolism with only a D Dimer test. It is possible that in your case more information was needed before the medical team could decide on your diagnosis and treatment. Your comment has been passed on to the respiratory team, and they have agreed to use your feedback in junior doctor training to raise awareness of possible communication issues.

The Trust is committed to cleanliness and the control and prevention of infections, so we are very pleased that you were impressed with the hand washing sinks and signs at the entrance. There are extra sinks installed at nurses’ stations and many doctors and nurses use these sinks instead of the sinks at the ward entrance. We encourage visitors to wash their hands by playing reminder messages over the tannoy system. We continue to reinforce the messages to staff in training sessions, and all staff computers have a screen saver reminding them to wash their hands and demonstrating the best way to wash hands.

We would like to reassure you with regard to the MRSA swab. All patients who are swabbed are given a leaflet full of information about MRSA. We apologise if you did not receive one. If you would like a leaflet please contact the Customer Care Team on freephone 0800 161 3997 or email CustomerCare.Service@echeshire-tr.nwest.nhs.uk . About 30% of people carry Staphylococcus Aureus on their skin or in their nose. This is completely harmless and can be treated. The antibiotic resistant strains (MRSA) may be carried in the same way. If someone is carrying MRSA on their skin it does not necessarily pose a risk to anyone else they come into contact with outside the hospital. In order to reduce risks we swab patients who may have come into contact with MRSA so that if MRSA is found we can treat it if clinically necessary. We are now screening all patients who come in to hospital for a planned operation, in order to further reduce the risk. The graphs you saw include the number of patients who have been found to have MRSA on their skin. These patients will have been nursed in isolation as a further precaution. We display this information on the ward so that we can be open and honest. We are sorry that seeing these figures made you worried. If you would like to discuss this further please contact the Customer Care Team on freephone 0800 161 3997 or email CustomerCare.Service@echeshire-tr.nwest.nhs.uk