WDHB's head nurse welcomes care survey findings

Wanganui Hospital is making good progress in seeking to understand how falls, pressure injuries, incontinence and malnutrition affect our population and what it can do to minimise the risk for hospital patients and rest home residents.
Recently released results, from the 2011 National Care Prevalence Survey show, not one Wanganui Hospital patient who participated in last year’s day-long survey had any signs of breaks on their skin caused by pressure incurred during their hospital stay.
And if Whanganui District Health Board director of nursing, patient safety and quality Sandy Blake has her way, pressure injuries will soon be eliminated altogether.
“We know that by lying people on pressure reducing mattresses we’re able to save many from developing pressure ulcers,” Mrs Blake says. “So encouraging families to join together and buy their elderly and sick relatives a pressure-relieving mattress for their birthday or Christmas is something I feel we need to consider.
“It could be the best present you give someone you care for. Pressure-relieving mattresses can make a huge difference to rest home residents who it has been shown, are more likely to develop pressure ulcers.”
In terms of the malnutrition, incontinence, falls and the use of restraint measures also considered by the survey it appears results were mixed for Wanganui Hospital, the 15 rest homes and the community clients who took part in it.
The prevalence of incontinence in 2011 was found to be comparable with the 2010 results which showed incontinence is common across hospital, rest home and community settings, but highest in rest homes.
The report notes that due to incontinence often becoming an accepted burden for the elderly, few rest homes are diagnosing their clients and putting personalised interventions in place – something that both the hospital and rest homes need to do to encourage and help their patients remain continent or in some cases, regain their continence.
The survey report shows that malnutrition and malnourishment remain a concern with one in four clients in hospitals and rest homes found to be malnourished and about half the remaining clients at risk of becoming so.
On noting that 50 percent of those admitted to hospital and 85 percent of those admitted to rest homes are screened for malnourishment the report recommends that people’s weight and height needs to be monitored routinely during their time in both settings.
Mrs Blake says while it is upsetting to think of people being malnourished, unfortunately elderly people with long-term illnesses and the elderly are susceptible to malnutrition.
 “We know that the elderly lose their appetite and often refuse to eat nourishing food,” Mrs Blake says. “It’s an ongoing problem for staff working in the health and care sectors so I agree that regular monitoring is a good step towards trying to improve people’s eating habits.”
The survey report also noted that falls and the use of restraints are other areas that require close monitoring by the hospital and rest homes.
The cost and suffering incurred due to falls and falls-related injuries are substantial and often change a person’s quality of life forever, Mrs Blake says.
“While most falls and falls-related injuries occur among the elderly, the older they are and the more medical conditions they have, the more likely they are to fall.”
“The report tells us that during the last two years the incidence of clients who had a fall within the WDHB has stayed around the same with a slight increase from 23 percent to 29 percent in the hospital setting, a slight decrease from 13.5 percent to 12.5 percent in rest homes and an incidence of 9.4 percent in the community which this year was included in the survey for the first time.”
Included among the six recommendations around falls was advice that fall prevention must remain on the agenda of all care settings and at all levels – a recommendation fully supported by Mrs Blake.
In all 56 hospital patients, 334 rest home clients across 15 rest homes and 32 people cared for in the community agreed to participate in the survey giving an overall participation of 72 percent.