A guide to your hospital stay The Pennine Acute Hospitals
Your feedback matters The Friends and Family Test To make our service as outstanding as possible, we ll be asking the following question to rate your experience: How likely are you to recommend our service to friends and family if they needed similar care or treatment? You ll receive this by either SMS or Automated Voice Message within 48 hours of leaving our department. This can also be answered on a postcard or online, to do so please speak to our staff. If you don t wish to take part, you can simply reply STOP when you receive the message.
A Guide to Your Hospital Stay Page: Welcome to The Pennine Acute Hospitals 3 Arrival 4 1. Car parking, bus services and help with travel costs 4 2. Visiting times 5 2.1 Children as visitors 5 Your stay on the ward 5 3. Staff caring for you: 5 3.1 Consultants and their teams 5 3.2 Nurses and support staff 6 3.3 Other members of the team 6 3.4 Student nurses / cadets / medical students 6 4. 4.1 4.2 5. Meal times: 8 5.1 Protected mealtimes 8 5.2 About the meals 9 5.3 Food allergies 9 5.4 Bringing in your own food 9 5.5 Restaurants, cafes and shops 9 Your safety, healthcare and security 10 6. Preventing infection 10 Consent for treatment: 11 memory / understanding) 11 8. 8.1 Information about your health 11 9. Security and respect 12 10. Privacy and dignity 12 11. Moving to another bed, ward or hospital 12 Other services / information 12 12. Alcohol Liaison Service 12 1
13. Breast feeding in hospital 13 14 Flowers 13 15. Interpretation and Translation Service (ITS) 13 16. Laundry 13 Mobile phones / photos / videos / bedside tv / radio 14 18. Post 14 19. Smoking 14 20. Spiritual Care Chaplaincy Service 15 Leaving hospital 15 21. Planning your discharge home: 15 21.1 Before discharge 16 21.2 On the day of discharge 16 21.3 21.4 21.5 22. 22.1 Your comments 18 22.2 The Friends and Family Test (FFT) 18 22.3 Patient Advice and Liaison Service (PALS) 18 22.4 Complaints 19 23. Getting involved with your hospital 19 24. Become a member have your say 19 25. Fundraising 20 26. The Pennine Acute Hospitals website 21 www.pat.nhs.uk Your Care: Information Cards 22 Infection control 23 Medicine matters 25 Nutrition matters 29 Continence matters 31 Falls prevention 33 Discharge 35 2
Welcome to The Pennine Acute Hospitals This handbook has been designed after consulting our patients and staff, to provide you with general information about our hospitals and any questions regarding any aspect of your hospital admission or care, then please ask a member of staff. The Pennine Acute Hospitals is a large acute trust comprising shortly, across Rochdale. We appreciate that this may be an anxious time for you and your family, but we will ensure that your experience will be safe and of the highest quality. speak to any member of your ward staff. With very best wishes, Sir David Dalton Chief Executive 3
Arrival 1. Car parking, bus services and help with travel costs Each of our hospital sites have a number of travel choices available on this, for each of our hospital sites is provided on the Trust website. The Trust has parking capacity available and we designate this by types of use. The Trust charges for parking and charges are displayed in parking areas, at payment machines and also on the Trust website. ; on the wards or departments, or by visiting car or extended visits, can buy a weekly ticket from the payment machines, hospital site. forms of support you may be able to claim a refund for fares to and from the hospital or other health costs. Further information is available on receipts for fares. All vehicles parked on Trust sites and in parking facilities are left at the owners risk and the Trust is not responsible for any loss or damage incurred. The Trust also takes no responsibility for the each site can be contacted and details are available on the Trust website. 4
2. Visiting times Visiting times vary in our hospitals as we work towards an open visiting healthcare needs. 2.1 Children as visitors Children are welcome to visit parents / carers / relatives in hospital, but any child under the age of 16 years must be accompanied by a responsible adult visitor. Your stay on the ward 3. Staff caring for you: mention some of our staff below although this will not cover the whole team. 3.1 Consultants and their teams The consultant leads a team of doctors who may all discuss your medical treatment with you. You will have access to members of the consultantled team including middle and junior doctors, on a daily basis and some meeting with your consultant, please ask a member of the ward staff wait, although we will try to arrange this as soon as possible. 5
3.2 Nurses and support staff On each ward there are experienced nurses who are responsible for the safe running of the ward you are staying on; they are known as ward managers. A team of trained nurses and healthcare support workers will also care for you during your hospital stay and one named nurse will be responsible for planning and co-ordinating your care. She / he will hand over your care when off duty to another trained nurse. The matrons have overall responsibility for several wards or areas and welcome comments on the care you are receiving. They will be happy to deal with any concerns you may have. 3.3 Other members of the team Whilst you are in hospital you may meet many other staff members such as physiotherapists, occupational therapists, dieticians, pharmacists, porters and voluntary staff. Remember everyone is here to support you and your family, so please ask if you need any information about the staff caring for you. 3.4 Student nurses / cadets / medical students nurses, medical students and other healthcare professionals, as part of a recognised teaching / development programme. You do not have to take part if you do not want to and your treatment will not be affected in any way. Please let your nurse or doctor know. 6
4.1 The Trust is committed to the campaign. All staff looking after you should introduce themselves and wear an identity introduce themselves to you or you cannot see their name / identity badge then please ask the member of staff to produce it. While you are a patient in hospital it will be necessary for you to wear unique patient number and the ward you are staying on. For your safety, your wrist-band will be checked for certain procedures, if you are not wearing one please ask the ward staff. 4.2 Staff uniforms Sister / Ward Staff Nurse Physiotherapist Housekeeper Occupational Therapist 7
Ward Clerk / Receptionist Specialist Nurse Healthcare Support Worker as head coverings. 5. Meal times: need any assistance, tell us when you arrive and we will ensure your meals are served on a red tray to help us identify patients who need assistance. Ward staff can then provide assistance or support from a trust volunteer. Tea, coffee and cold drinks are served during the day. Lunch Dinner 12 noon - 1.00pm 5.00pm - 6.00pm 5.1 Protected mealtimes introduced to cut down on ward activities, such as ward rounds, drug rounds, cleaning and therapy, so that you can eat your meal with as little interruption as possible. Family members are encouraged to come and help feed their loved ones at meal times. 8
5.2 About the meals You are able to choose your meals from an extensive daily menu. We offer breakfast and provide a hot meal, salad or sandwich for lunch and Special diets are provided for health, religious and/or cultural reasons. Special diets are also provided for patients who need a therapeutic diet for medical reasons. Please inform the ward staff upon arrival if you have any dietary requirements. 5.3 Food allergies It is important that you tell the ward staff if you are allergic to any foods. There is a ward booklet identifying any food items containing allergens and this is also available on the Trust intranet (ask a member of staff for help). 5.4 Bringing in your own food We hope that our services will cater for all your needs, although it is recognised that visitors may wish to bring food and drinks for you to ward with perishable food items please contact a member of the nursing team who will ensure the food items are stored correctly and labelled with your name and the date received. Food items brought in should be consumed on the same day only. 5.5 Restaurants, cafes and shops The Trust has restaurants and cafes on each of its hospital sites offering a wide range of hot and cold food, drinks and snacks. All hospitals have vending machines which allow 7 days a week 24 hours a day, hot and cold 9
Your safety, healthcare and security 6. Preventing infection All staff at the Trust are committed to reducing the risk of you getting an they may carry out the correct hand decontamination procedure to ask that the ward environment, furniture, nursing and medical equipment is or a nurse. using the alcohol hand rub, found at the entrance to all wards washing their hands with soap and water or use the alcohol hand rub between patients if visiting more than one patient helping you to keep your bedside area as clutter free as possible to assist with cleaning not visiting for 48 hours if they have had an episode of diarrhoea and or vomiting or feel unwell avoiding sitting on your bed during visiting times informing the ward manager if they see any member of staff not cleaning their hands. Public toilets are available on or close to every ward and will be clean at 10
suggestions, such as a doctor asking to examine your throat and you showing consent by opening your mouth. Sometimes staff will ask you to sign a form, depending on the potential risks of the examination or will provide you with information about the treatment or investigation which is being offered to you. Patients with cognitive impairment such as a learning disability or dementia, you may like to discuss their support and advise. Please ask a member of the ward staff to contact them and they will arrange to speak to you. way please let a member of staff know immediately. 8.1 Information about your health Any information we have about you is strictly directly involved in your care will have access How We Use Your Information, provides more details and can be found on the ward or the 11
9. Security and respect Patients are advised not to bring any valuables or large amounts of money with them whilst in hospital. If you do have some with you, please ask a family member or trusted friend to take them home for you. staff may store such valuables in a locked cabinet for you. The Trust will not tolerate aggressive behaviour, violence, physical or verbal abuse to anyone whilst on hospital premises. Any incident will be escalated to the Trust security team and may be reported to the police. 10. Privacy and dignity We aim to respect your privacy and dignity at all times and ask that you respect that of other patients. Wards are either single-sex or made up of male bays and female bays with separate washing and toilet facilities. However, in an emergency or in assessment areas, it may be necessary for you to be in a mixed-sex area for a short period of time. 11. Moving to another bed, ward or hospital be moved to another ward or transferred to another hospital during your inpatient stay. The reasons for any move during your stay will be clearly explained. Other services / information 12. Alcohol Liaison Service concerning alcohol ranging from wanting to reduce your intake to problems associated with dependency. Please ask a member of staff if 12
13. Breast feeding in hospital We support breast feeding across the hospital sites. Please ask a member of staff about available facilities. 14. Flowers Flowers can hinder us providing a clean and tidy environment for you and can increase the risk of infection. Therefore, some wards will not 15. Interpretation and Translation Service (ITS) provides language and sign interpreting services for over 84 languages. Our interpretation service is primarily delivered via telephone which is available 24 hours a day / 7 days a week. We also have a team of professional interpreters the ward staff if you need to use the service. 16. Laundry The hospital does not launder any personal items of clothing for you and you should arrange for your laundry to be taken home. 13
Visitors may use mobile phones in public areas of the hospital only and phones must always be switched off or be put in silent mode when visiting on the wards and in clinical areas. Patients may use mobile phones depending upon the ward conditions. Please ask a member of ward staff if this is appropriate. Please note that photos / videos are not allowed to be taken whilst in the ward and other clinical areas. Patient bedside tvs are available for most patients and are usually pay per view by credit/debit card. Full instructions are provided on-screen, telephone calls. All are available for a length of time to suit different hospital stays. Hospital radio is also available free of charge in many wards. 18. Post please ask a member of the ward staff. Cards and letters can be sent to you by clearly stating the ward you are on followed by the hospital address. 19. Smoking We aim to promote good health. Therefore smoking is not allowed anywhere in the hospital or in the hospital grounds, by staff, patients or visitors. This includes e-cigarettes. For help to stop smoking please call the free Smokefree National Helpline to speak to a trained, expert adviser on 0300 123 1044. 14
20. Spiritual Care Chaplaincy Service The Spiritual Care Chaplaincy Service is provided by a multi-faith team who visit the wards on a regular basis. The team form an integral part of our healthcare team. They provide support to patients with their clinical treatment and recovery and ensure that their recovery is not affected by concerns, fears or beliefs. Someone is always available to offer emotional support and/or religious care to patients and carers. This service is available 24 hours a day, 7 days a week for urgent needs and on the next working day for non- ask a member of the ward staff who will contact them. The hospital chapels, prayer and quiet rooms are available for anyone to use. There are regular services and prayer times that take place each week. Volunteers can take you to a chapel, prayer or quiet room in a wheelchair if needed. The team has a selection of holy books that you can borrow during your stay. Please ask a member of staff to contact us about your needs. Leaving hospital 21. Planning your discharge home: planning process should begin. Once the that you are making progress they will involve you in planning for your return home. 15
21.1 Before discharge Several things need to be arranged to ensure your safe return home and several staff may be involved in this process. Once your discharge date ask a relative, carer or friend to bring some suitable clothing and footwear in for you arrange transport with family, friends or private taxi. Ambulances by the staff involved in your discharge make sure you can get into your home ask any questions about any concerns or worries about your care after discharge. 21.2 On the day of discharge On the day of discharge you may be asked to wait in a discharge lounge. The discharge lounge provides a comfortable and safe environment for you while you wait, for example, for your medication and/or transport or family to collect you. Staff will still be available to support your needs. lounge. collect any valuables that have been stored with the ward staff ensure you have all your personal property with you to take home provide information and advice about any drugs or medications / been prescribed ensure any community / social services support required following discharge has been arranged for you at home provide details of who to contact if you have questions after your discharge. 16
21.3 Medication these for you. medication is on the bottles or packets effects will also be provided. any questions or concerns regarding your medications, please speak to a member of the ward staff. 21.4 Fit notes / claim forms Please ask a member of the ward staff about this; they will be able to for some claim forms, but the ward will provide you with this information. 21.5 Follow-up arrangements you leave the ward, or you will receive an appointment in the post. Patient experience and feedback 22. Patient experience: We welcome your views about our services and they are used to make improvements. There are many ways you can provide us with feedback about our services. You can pass on a compliment, make a comment or complaint about any aspect of your visit. We may also ask for your views in a survey, through a patient story, through a text message or as part of a patient group. 17
22.1 Your comments All wards and outpatient areas have comment cards and boxes in which to place the completed cards. These boxes are emptied by Volunteers each week and ward staff discuss the comments cards. The information patients and families provide is used to improve our services, helping to create a high quality patient experience which you will be happy to recommend to others. 22.2 The Friends and Family Test (FFT) which asks patients whether they would recommend the NHS service they have received to family and friends who need similar treatment or care. We would like to know how likely are you to recommend our service to friends and family if they needed similar care or treatment and the main reason for the score you have given. You can also put your comments onto the NHS Choices website 22.3 Patient Advice and Liaison Service (PALS) patients, their relatives, carers and friends, answer their questions and resolve concerns as quickly as possible. The service also provides information, guides people through the complexities of the NHS and provide information about the NHS complaints procedure and advice about making a formal complaint if this is necessary. They can also advise you about the role of independent advocacy services who can help you with a complaint and how to contact them. 18
22.4 Complaints The Trust has an open and honest approach in dealing with any concerns or if something has gone wrong. Clinical staff are always keen to resolve with any aspect of your care or your relative s care, please speak to your consultant or ward staff and they will be pleased to help you resolve any issues. f your concern cannot be dealt with locally, you can complain formally to the Trust. Formal written complaints are dealt with by the Complaints an investigation started within 3 working days. You can contact the or by 23. Getting involved with your hospital We have around 600 active volunteers. They are based across our hospital sites eg in our tea bars, at our information desks, on the like to apply to be a volunteer, please contact 24. Become a member have your say We are keen for our patients, local communities and members of staff to become members of our Trust as we aim for Foundation Trust status. This will help us to ensure we meet the needs of our patients and local long-term future of the trust. 19
be consulted on plans for future developments to meet the needs of the community help improve services within the hospital and the local health community help to raise funds to improve services in the hospital and the community volunteer in a variety of roles and settings attend health information events. We realise that members will want to be involved in different ways and it is entirely up to you how involved you choose to be, from just receiving you would like to become a Trust member please go online. 25. Fundraising The Pennine Acute Hospitals Charity supports the Trust to provide excellent patient care in great facilities, using the best equipment across four a donation or raising funds you can help us fund additional equipment, training and research which will enhance the care and facilities we are able to provide for our or department, or one of our appeals. Find out more about some of our fantastic appeals, upcoming events and how you can get involved, on To register your support or for more information contact the Fundraising. 20
26. The Pennine Acute Hospitals Website of these groups, whom we meet with on a regular basis to ask for their opinions and suggestions. The website now includes contact details and information for our hospital and community based services, latest news, job vacancies and links to the Trust s social media channels, including further information about the hospitals and the departments 21
Your Care : Information Cards 22
Infection Control Key steps for infection control As a patient or visitor, you can help by: 1. Not coming to hospital to visit a patient if you have been the last 48 hrs 2. Cleaning your hands with the alcohol based hand gel every time you enter or leave a ward or use the nearest sink to wash your hands with soap and water 3. Not sitting on patients beds 4. Washing your hands after using the toilet and before eating 23
Infection Control Key steps for infection control Staff will: 1. Clean their hands following the 5 moments of hand hygiene, using alcohol gel or soap and water 2. Be bare below the elbows in the patient environment 3. Always follow Aseptic Non Touch Technique (ANTT) and be annually assessed as competent 4. Use Personal Protective Equipment as single patient-use items 5. Assess each patient with diarrhoea for Clostridium 6. Clean all equipment daily with Chlor-Clean or Virusolve wipes or after use for patients with infections / diarrhoea 24
Medicine Matters Key steps for good medicine administration As a patient you can help by: 1. Bringing your current medicines and a list of them, into hospital with you 2. Taking your medicines as soon as the nurse has given them to you. If you need assistance please ask the nurse. If you wish to take your own medicines whilst in hospital discuss with the nurse, doctor or pharmacy staff 3. Ensuring the nurse asks you, every time you receive a 4. Asking questions about your medicines; if you need more information please ask your nurse, doctor or pharmacy staff 25
Medicine Matters Key steps for good medicine administration Staff will: 1. Check your name band to positively identify you 2. Systematically work through your drug chart / Electronic Prescribing Medicine Administration (EPMA) chart, checking all sections including symptomatic relief, once only medicines, all regular prescriptions and PRN medicines 3. Accurately document any missed / omitted or delayed doses on the back of the prescription chart / EPMA chart and enter relevant supporting information in the nursing /medical notes 4. Prepare medicines to be administered using a non-touch technique and perform hand hygiene at appropriate times. Take the prescription chart / EPMA record and medicines to your bedside 5. Ensure that you are supervised and assisted to swallow oral medications. Some fruit juices interact with medicines. It is usually best practice to swallow tablets with water 6. Sign the prescription chart / EPMA immediately after you have taken your medication (no medicines must be left around the patient bed areas) 26
Observations Key steps for observations (eg pulse, temperature, blood pressure, respiration) As a patient you can help by: 1. Informing the nursing staff how much you have had to drink 2. Informing the nursing staff if you feel thirsty or your urine looks dark and concentrated 3. Informing the nursing staff if you feel too hot, too cold, or shivery 4. Informing the nursing staff if you are feeling unwell 27
Observations Key steps for observations Staff will: 1. Complete and record observations on all patients at the time of admission 2. Complete a minimum of 8 hourly observations for all patients 3. Calculate an Early Warning Score (EWS) with every set of observations 4. Ensure that the frequency of observations is recorded on the observations care plan and reviewed as the patient s condition indicates 5. Escalate and increase the frequency of observations in response to abnormal observations in line with the Adult Standard for Patient Observation Practice Policy 6. Kidney Injury (AKI) or other appropriate cause for concern 28
Nutrition Matters Key steps for good nutritional care You and your family can help by telling your nurse: 1. If you have any food allergies or follow a special diet 2. If you have recently been struggling to eat either due to a poor appetite, or problems with chewing or swallowing 3. If you follow a special diet but are uncertain about what to eat whilst in hospital 4. What food and drinks you like and dislike 5. If you need help at mealtimes, for example opening packets or if you normally use special cutlery to help you to eat on your own 29
Nutrition Matters Key steps for good nutritional care Staff will: 1. Prepare patients and the surrounding environment at mealtimes and provide hand wipes or help, to wash your hands if you need this 2. to their needs 3. Assist patients who may need additional help at mealtimes, including offering feeding aids to allow patients to eat independently 4. Make use of food available at ward level if patients have missed meals or if they require an alternative to the meal supplied 5. Before discharge, provide the patient with information and communicate on-going concerns / treatment between health care settings 30
Continence Matters Key steps for good continence care As a patient you can help by: 1. Reducing caffeine intake 2. Ensure you drink 6 to 8 times a day 3. Let us know if you have any bladder or bowel problems 4. Make sure you understand your treatment programme and follow the advice given 5. When you leave hospital please make sure you know the contact number of your local Continence Service 31
Continence Matters Key steps for good continence care Staff will: 1. Ask all patients about bladder and bowel problems on assessment 2. problems, have a 3 day voiding and / or bowel chart completed 3. Ensure urine is tested from every patient with urinary symptoms to exclude any infection or abnormalities 4. Ensure a toileting programme is initiated for those patients who have memory problems 5. 6. Assess the need for continence pads when all alternative treatment and management strategies have been excluded. Use appropriate absorbency of pad (refer to voiding diary) 7. Ensure catheterisation is not used as a treatment for incontinence 8. Ensure that if the patient requires a urinary catheter, the rationale will be documented and reviewed every day, advice sought by nurse specialists / medical colleagues if required. An indwelling catheter core care plan should be commenced 9. Patients with indwelling catheter are given catheter care advice and emergency contact numbers. The catheter bag kinking and contamination 32
Falls Prevention Key steps for preventing in-patient falls As a patient you can help by: 1. Using your usual walking aids and wearing your glasses 2. Keeping your bed area tidy 3. Telling us or using your call bell if you need any assistance 4. slippers with rubber soles 33
Falls Prevention Key steps for preventing in-patient falls Staff will: 1. Ask about a history of previous falls and of fear of falling at the time of admission and at least every month for long stay patients 2. Test urine on admission 3. Avoid prescribing night sedation for patients who have not had it before 4. Ensure a call bell is within reach 5. Ensure appropriate footwear is available and in use 6. Assess whether there is a need for and provision of walking aids 7. Ensure a cognitive assessment - Mini Mental State Examination (MMSE) or Abbreviated Mental Test Score 8. Test those at risk for delirium (Confusion Assessment Method) 9. 10. Conduct a visual assessment 11. Take lying and standing blood pressure with a manual sphygmomanometer 12. Review medication for cardiovascular and central nervous system acting medications 13. Ensure they assess, based on observation, toileting arrangements and tailor care according to individual needs 34
Discharge Key steps for discharge As a patient you can help by: 1. Ensuring that you can get into your home the day of discharge 2. Where possible, asking a family member or friend to collect you on the day of discharge 3. Asking the nurse in charge or doctor for your estimated date of discharge 4. Ensuring that any potential delays to discharge from your soon as possible 35
Discharge Key steps for discharge Staff will: 1. Ensure that planning for discharge begins as early as possible following admission 2. On admission, provide all patients with the hospital discharge information regarding their admission and discharge 3. Provide an estimated date of discharge within 24 hours of admission to hospital 4. Identify, following an initial assessment, if further care needs may be required for discharge. If so, a referral (Section 2) will be sent to the hospital social work team (Single Point of Access) 5. assessments have been completed, they will send a further referral (section 5) to the hospital social work team (Single Point of Access), if needed 6. Complete a discharge checklist 36
Leaving hospital Before you leave, make sure you: have your discharge letter have your medicines and they have been explained to you know who to contact if you have any questions or concerns know when your next appointment is.
You can speak with: Have your say a member of ward staff looking after you a ward sister / manager or matron Spiritual Care Chaplaincy Service Patient Advice and Liaison Service (PALS) to any problems they encounter. They can also provide information about our services as well as listening to your feedback about the Trust. Contact our PALS on 0161 604 5897 or put your feedback on a card and put it in one of our feedback boxes. Alternatively you can email pals@pat.nhs.uk or visit our website at www.pat.nhs.uk. Published by Patient Matters Tel: 01253 766639 R0