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Trial run tests procedures at Nightingale hospital

GHA staff carried out a patient transfer simulation on Tuesday, testing procedures for admitting patients from St Bernard’s Hospital to the Europa Nightingale Hospital.

The simulation started at 9am, ended at 1pm and was followed by a debriefing session.

The ‘patients’ comprised of 25 volunteers who had been training together last week. These volunteers were chosen as they had already spent time together recently. Masks were worn as per the protocol for transfers from St Bernard’s Hospital.

The ‘patients’ were not physically transferred from St Bernard’s Hospital, however, although the first call which starts the process was initiated from the hospital at 9.30am.

“This was all done internally here, ‘patients’ were not brought from St Bernard’s. We had our ‘patients’ kept in a separate room [until they were needed],” the acting matron for the Nightingale hospital, Sarah Smith, told the Chronicle.

“The simulation of the call from St Bernard’s started at 9.30am and we received our first five ‘patients’ at 10am.”

“We received the next lot of ‘patients’ within a half hour and then another lot in a half hour until we had the full 25 ‘patients’ in.”

The simulation needed to ascertain realistic timings in terms of putting them in an ambulance and bringing them up to the Nightingale facility should patients need to be moved from St Bernard’s to free up beds.

“Each fake patient was given the equivalent transfer information sheet that we would get from St Bernard’s and they had that with a set of vital signs written on the back,” said Mrs Smith.

“We had a nurse acting as a transfer nurse. When the patient is brought to us from St Bernard’s, she would arrive with the patient and give us the handover and the patient would be put into their allocated bed depending on their medical acuity and their frailty.”

“Then the nurses would do a set of observations. Those observations would be the ones that would be on the back of the charts so we can assess how stable or unwell they were.”

“We tried to make this as realistic as possible so we asked one of the volunteers to faint, and we asked one volunteer to be quite demanding in terms of being seen very quickly even though that was not appropriate for his medical condition,” she added.

In addition, they had one ‘patient’ admitted but their observations meant that they were not suitable to be nursed at the facility.

Under the simulation, this ‘patient’s’ condition had deteriorated on the way up to the Nightingale facility, thereby testing the response on arrival.

“This was picked up straight away, so then we looked at the process as to what would happen if that patient came,” Matron smith said.

“We went through the motions of referring that patient back to St Bernard’s and making sure that all ran smoothly transferring them straight back.”

Once a ‘patient’ was admitted by the GHA staff, it was assisted if the physios or occupational therapists were immediately required.

There were simulations regarding medications required by patients.

“We were also making sure that the plan we had in place for getting medication into the hospital was going to work efficiently and we did a trial run with that,” Mrs Smith said.

“That worked really well and we had the first lot of medication for the patients within an hour and a half.”

“Patients who needed medication would have it brought up with them from St Bernard’s but this is to make sure that we then have that additional stock for the rest of their admission.”

“And they could also be used for when they go home. They come up in blister packs ready so they could be used when they go home.”

Aside from Matron Smith, the Matron of the facility, Natasha Cerisola, was also present during the simulation, as was the GHA’s Dr Daniel Cassaglia, Head of Clinical Governance at St Bernard’s Dr Derek Burke, Director of Nursing Freddie Pitto, senior sisters, staff nurses, nursing assistants and porters.

Director of Public Health Dr Sohail Bhatti also paid a visit to the facility during the simulation.

Matrons Smith and Cerisola held a debrief with senior staff after the simulation to look at what went well and what areas they needed to perhaps reconsider.

“We will look at running mini simulations to just make sure any changes we made to that original standard operational procedure are going to work in reality,” said Mrs Smith.

“We did do an in-house trial that was run just by us internally last week. This is our proper big one with the changes that we made from that little one, and the plan is to run another one next week.”

“We are really happy with how it went today. The issues that we had last week and we changed made a massive difference.”

“We got feedback from the fake patients to make sure they were happy with the service they received and then generally felt that they were seen quickly, that the staff were polite and that they had been asked the relevant questions.”

“Generally, everybody felt that the exercise went well today. But, as with anything, there will also be points of potential for improvement and those things will be constantly looked at.”

Mrs Smith also noted how grateful the GHA was for the volunteers again for giving up their time to come in and make sure the facility had everything in place in case it needs to open.

“It was a really big team effort and it was great that we could use the entire multi-disciplinary team that would be involved with the transfer process so that is everybody from all the clinical side and the administration side,” she said.

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