"Cleanliness is of a higher capacity ..."

About: Queen Alexandra Hospital

(as a relative),

What I liked

Cleanliness is of a higher capacity that the last time that I visited. The rooms are decorated to a good standard.

What could be improved

*Parking fees reduced for siblings (Direct Family) who have a Parent with a long term illness, requiring a stay of more than a month.

*Clear consise information between Consultants, Registrars and staff nurses so that care and treatment is cosistant, keeping the patient informed.

*Treatment for chemotherapy is regulary monitored so that it is given correctly, this could be achieved through logging all errors made and reviewing them, & improve training.

*More Nurses on the ward to take time to talk with the patients, 5 mins once a day is a small amount of time, 24hr is a long day, especially when the patient has no visiting relatives

*More comodes on wards like Haemotology, where diarrhoea is a constat side effect from treament, so that the patients dignity is preserved. When attached to two drip machines and tiredness from treatment has set in...getting to the toilet in a hurry becomes difficult!

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Response from Queen Alexandra Hospital

A supplementary menu is available to provide patient choice and nutritional wellbeing. Nurses on the unit assess this on a daily basis and are able to access the supplementary menu at short notice with dietician approval. Formal dietetic review is available for complex cases. The ward stocks a variety of supplementary drinks and build-up soups and can access high protein shakes. As a unit experienced in the management of acutely unwell and post chemotherapy patients these are incorporated as a matter of routine. Patients undergoing chemotherapy are monitored for weight loss, appetite, food and fluid intake. All patients are assessed weekly by the multidisciplinary team and treatment plans, progress and concerns are discussed and actioned as required. In addition, the Catering Department have confirmed that their satisfaction surveys do not support the comments made. Soft, high protein and high calorie foods are provided to anyone the ward staff feel require this type of food. With regard to ice cream, this is not normally served. However, it is provided on the specific request of a ward and kitchen staff are reminded not to send ice cream in the heated trolleys. The Catering Manager expressed his apologies if this has occurred.

Named next of kin / main carer may be assigned reduced parking permits. These are available on the ward and the criteria for issue is ' a close relative who is helping with on-going clinical care'. The ward has an information folder provided by the Macmillan Information Centre for families experiencing financial pressure. This enables access to advice and various grants. The Haematology Clinical Nurse Specialist acts as a key worker and patient advocate.

There is a high degree of unpredictability in the management of haematological conditions in terms of presentation, progression and response to treatment, including aggressive treatments. All ward patients are reviewed daily by nursing and ward based medical staff. There is a bi-weekly ward round with consultant input and a weekly multi-disciplinary team meeting. Immediate next of kin are involved in the decision making process in compliance with the patients wishes.

All chemotherapy drugs are prescribed and administered as per the Trust drug administration policy. Additional measures are in place with regards to high risk chemotherapy interventions and Portsmouth Hospitals Trust were the only Trust within the Cancer Network to pass the intrathecal standard in both the Cancer and Haematology Peer Reviews. Specialist pharmacy support is available and forms part of the core membership of the multi-disciplinary team.

Incidents and near misses are reported and reviewed by the ward sister and modern matron. Action plans are developed as required. Key messages form part of staff handover between each shift. The requisite number of staff are trained in the administration of chemotherapy and more nurses have recently been recruited. The unit has all single rooms to safely manage haematological conditions. The room design minimises the risk of isolation and visiting hours are negotiated to balance risk of infection against feelings of isolation. The recurrent nature of admissions means staff / patients and families generally develop a positive rapport.

The ward consists of 12 cubicles, 4 of which have en-suite toilet facilities. There are 3 commodes on the ward to serve the remaining 8 rooms and there are another 3 toilets.

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