Bowel Management Patient Safety Alert (SPINE 01/19)

Roedd y cais yn llwyddiannus.

Dear Dorset HealthCare University NHS Foundation Trust,

MY COLLEAGUES AND MYSELF ARE SENDING A DISCRETE AND SEPARATE FOI REQUEST TO EVERY NHS TRUST (BUT ARE ENSURING THAT NO DUPLICATE REQUEST IS MADE TO ANY ONE TRUST).

WE WOULD REQUEST THAT FOI OFFICERS SEND (VIA THE WHATDOTHEYKNOW WEBSITE PORTAL) A SIMILARLY DISCRETE AND SEPARATE RESPONSE FOR EACH INDIVIDUAL TRUST.

I work for the Spinal Injuries Association (SIA), the leading national user-led charity supporting spinal cord injured people and their families. Being a user led organisation SIA understand the challenges of living with a spinal cord injury (SCI). We strive to support all people living with SCI to access the services and support they need to stay healthy and live full, fulfilling and active lives.

Part of my role is to assist the Head of Public Affairs with FOI requests, such as the one that follows. As a request under the Freedom of Information Act, please provide the following information about the recent NHS Improvement (NHSI) Patient Safety Alert “Resources to support safer bowel care for patients at risk of autonomic dysreflexia 25 July 2018”, Alert reference number: NHS/PSA/RE/2018/005

Q1. Does the Trust have a formal written policy for digital rectal examination, digital rectal stimulation and the digital removal of faeces in spinal cord injured and other patients with neurogenic bowel dysfunction?

(a) Yes
(b) No

Q2. Following recommendation of this patient safety alert, did the Trust “review your local clinical policy and guidance relating to bowel assessment and management”?

(a) Yes – produced a new policy
(b) Yes - revised an existing policy
(c) Yes – retained existing policy
(d) No – did not review an existing policy
(e) No – no bowel assessment and management policy in place

Q3. Is your policy based on the policy template that the Spinal Injuries Association circulated to your trust in August 2018?

(a) Yes
(b) No
(c) No bowel assessment and management policy in place

Q4. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention – Digital removal faeces?

(a) Yes
(b) No

Q5. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Digital rectal stimulation?

(a) Yes
(b) No

Q6. If admitted to the Trust will a person with neurogenic bowel dysfunction receive the following bowel care intervention –Trans anal irrigation?

(a) Yes
(b) No

Q7. Are staff available seven days a week to undertake these bowel care interventions?

(a) Yes
(b) No

Q8. Has the Trust “reviewed your local education and training provision for interventional bowel management” as recommended in the Patient Safety Alert?

(a) Yes
(b) No

Q9. As requested by the Patient Safety Alert, has the trust developed “an action plan to ensure patients have adequate and timely access to staff who are trained appropriately to carry out these procedures, including in the evening and at weekends”?

(a) Yes
(b) No

Q10. Has the Trust “shared your reviewed local guidance, advice on how to identify staff who can provide Digital Removal of Faeces, and the key messages in this alert with medical, nursing and other relevant clinical staff”?

(a) Yes
(b) No

Q11. Does the Trust have a policy that allows for the personal care assistants/carers of spinal cord injured patients to assist with this element of the patient's care?

(a) Yes
(b) No

Q12. As recommended in the Patient Safety Alert, have you identified “an appropriate clinical leader to co-ordinate implementation of this alert”?

(a) Yes (please answer Q13, but ignore Q14)
(b) No (please answer Q14, but ignore Q13)

Q13. What are the contact details for the “appropriate clinical leader”(ie name, position, telephone and email)?

Q14. Why has your Trust not appointed an “appropriate clinical leader”?

(a) Alert implemented without appointment of a clinical leader
(b) Took no action following Patient Safety Alert, as policy already in place
(c) Took no action. No existing policy in place
(d) Other

Q15. Are your newly registered nurses able to demonstrate the nursing procedures as required in Annexe B, section 6.5 of the Nursing and Midwifery Council’s document ‘Future Nurse: Standards of Proficiency for Registered Nurses’?

(a) Yes
(b) No

Technical Note – Relevant annexe reads:-

“Annexe B
6: Use evidenced based, best practice approaches for meeting needs for care and support with bladder and bowel health
6.5: Administer enema, suppositories and undertake manual evacuation when appropriate.”

If you have any queries or require clarification on any of these questions, please contact the Spinal Injuries Association at [email address]

Yours faithfully,

Andrew Smart

FOI.ENQUIRIES (DORSET HEALTHCARE UNIVERSITY NHS FOUNDATION TRUST),

9 Atodiad

Dear Andrew,

 

Thank you for your request for information under the Freedom of
Information Act 2000.

I can confirm that our response is:

Request:

Dear Dorset HealthCare University NHS Foundation Trust,

 

MY COLLEAGUES AND MYSELF ARE SENDING A DISCRETE AND SEPARATE FOI REQUEST
TO EVERY NHS TRUST (BUT ARE ENSURING THAT NO DUPLICATE REQUEST IS MADE TO
ANY ONE TRUST).     

 

WE WOULD REQUEST THAT FOI OFFICERS SEND (VIA THE WHATDOTHEYKNOW WEBSITE
PORTAL) A SIMILARLY DISCRETE AND SEPARATE RESPONSE FOR EACH INDIVIDUAL
TRUST.

 

I work for the Spinal Injuries Association (SIA), the leading national
user-led charity supporting spinal cord injured people and their
families.  Being a user led organisation SIA understand the challenges of
living with a spinal cord injury (SCI).  We strive to support all people
living with SCI to access the services and support they need to stay
healthy and live full, fulfilling and active lives.

 

Part of my role is to assist the Head of Public Affairs with FOI requests,
such as the one that follows.  As a request under the Freedom of
Information Act, please provide the following information about the recent
NHS Improvement (NHSI) Patient Safety Alert “Resources to support safer
bowel care for patients at risk of autonomic dysreflexia 25 July 2018”,
Alert reference number: NHS/PSA/RE/2018/005

 

Q1.   Does the Trust have a formal written policy for digital rectal
examination, digital rectal stimulation and the digital removal of faeces
in spinal cord injured and other patients with neurogenic bowel
dysfunction?

 

(a) Yes

(b) No

 

Q2.  Following recommendation of this patient safety alert, did the Trust
“review your local clinical policy and guidance relating to bowel
assessment and management”?

 

(a) Yes – produced a new policy

(b) Yes - revised an existing policy

(c)  Yes – retained existing policy

(d)  No – did not review an existing policy

(e)  No – no bowel assessment and management policy in place

 

Q3.   Is your policy based on the policy template that the Spinal Injuries
Association circulated to your trust in August 2018?

 

(a) Yes

(b) No

(c) No bowel assessment and management policy in place

 

Q4. If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention – Digital
removal faeces?

 

(a) Yes

(b) No

 

Q5. If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention –Digital rectal
stimulation?

 

(a) Yes

(b) No

 

Q6. If admitted to the Trust will a person with neurogenic bowel
dysfunction receive the following bowel care intervention –Trans anal
irrigation?

 

(a) Yes

(b) No

 

Q7. Are staff available seven days a week to undertake these bowel care
interventions?

 

(a) Yes

(b) No

 

Q8. Has the Trust “reviewed your local education and training provision
for interventional bowel management” as recommended in the Patient Safety
Alert?

 

(a) Yes

(b) No

 

Q9. As requested by the Patient Safety Alert, has the trust developed “an
action plan to ensure patients have adequate and timely access to staff
who are trained appropriately to carry out these procedures, including in
the evening and at weekends”?

 

(a) Yes

(b) No

 

Q10. Has the Trust “shared your reviewed local guidance, advice on how to
identify staff who can provide Digital Removal of Faeces, and the key
messages in this alert with medical, nursing and other relevant clinical
staff”?

 

(a) Yes

(b) No

 

Q11. Does the Trust have a policy that allows for the personal care
assistants/carers of spinal cord injured patients to assist with this
element of the patient's care? 

 

(a) Yes

(b) No       

 

Q12. As recommended in the Patient Safety Alert, have you identified “an
appropriate clinical leader to co-ordinate implementation of this alert”?

 

(a) Yes   (please answer Q13, but ignore Q14)

(b) No   (please answer Q14, but ignore Q13)

 

Q13.  What are the contact details for the “appropriate clinical
leader”(ie name, position, telephone and email)?

 

Q14.  Why has your Trust not appointed an “appropriate clinical leader”?

 

(a)  Alert implemented without appointment of a clinical leader

(b)  Took no action following Patient Safety Alert, as policy already in
place

(c)  Took no action.  No existing policy in place

(d)  Other

 

Q15. Are your newly registered nurses able to demonstrate the nursing
procedures as required in Annexe B, section 6.5 of the Nursing and
Midwifery Council’s document ‘Future Nurse: Standards of Proficiency for
Registered Nurses’?

 

(a) Yes

(b) No

 

Technical Note – Relevant annexe reads:-

 

“Annexe B 

6: Use evidenced based, best practice approaches for meeting needs for
care and support with bladder and bowel health

6.5: Administer enema, suppositories and undertake manual evacuation when
appropriate.”

 

Response:

The Trust has now had the opportunity to fully consider your request and
has attached a document that contains all of the information that we are
able to provide in this case.

The information supplied to you in this communication, continues to be
protected by the Copyright, Designs and Patents Act 1988. You are free to
use it for your own purposes, including any non-commercial research you
are doing and for the purposes of news reporting.

If you wish to re-use the information supplied, in whole or in part, for
any other purpose e.g. commercial publications, please write to me stating
what information you wish to re-use, the purpose(s) you wish to re-use the
information for. We will respond within 20 working days of receiving your
request with any conditions and charges that relate to the re-use of the
information in accordance with the Re-use of Public Section Information
Regulations 2005.

If you wish to discuss any of the above, please contact me, quoting the
reference above.

If you are unhappy with the way in which we have handled your request,
please contact myself in the first instance. If you wish to make a formal
complaint, you should write to our Complaints Manager at Dorset HealthCare
University NHS Foundation Trust, Trust HQ, Sentinel House, 4-6 Nuffield
Road, Poole, Dorset BH17 0RB

If you are not content with the outcome of your complaint or the internal
review, you may apply directly to the Information Commissioner for a
decision. Generally, the Information Commissioner will only make a
decision once you have exhausted the complaints and/or internal review
process provided by us. The Information Commissioner can be contacted at:
The Information Commissioner’s Office, Wycliffe House, Water Lane,
Wilmslow, Cheshire, SK9 5AF.

Kind regards

 

  Mark DOBBS
Sentinel
House Freedom of Information Officer

4-6 Business & Performance 
Nuffield
Road Normal working Hrs:

Poole Mon & Tues 0715-1505

Dorset Weds & Thurs 0715-1215
( Tel: 01202 277017
BH17 0RB
        Mob: xxxxx xxxxxx

* Email: [1][email address]

8 Web: [2]www.dorsethealthcare.nhs.uk

 

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