Serious concerns over safety at Galway hospital psychiatric unit

Serious concerns for the safety of psychiatric nursing staff at Galway University Hospital have been raised in an audit carried out last month by the Health Service Executive.

Among the concerns are that nursing staff can be working alone with patients; there are not enough panic alarms for staff; there is a delay in the activation of an emergency alarm; not all staff have had mandatory training in managing aggression and violence in patients because of “cost containment”; and not all new staff are given induction training.

The audit of health and safety at the 45-bed psychiatric unit in GUH was conducted by HSE senior management in May.

The report, seen by The Irish Times, has yet to be published. Some 14 areas were audited, including training, documentation, fire precautions and lone working. The areas found to "require attention" were, safety signs, lone working and the use of latex. Concerns were also raised about training.

On lone working, the audit finds: “The acting clinical nurse manager was not aware if all staff were aware of the lone working policy or if they adhere to it. Not all staff carry a panic alarm. Moreover there is not an alarm available to all staff or visiting professionals.

“The safety alarm system currently in use in the department is a concern. Every staff member should be aware of the delay from activation time to alarm time, which is reported to be eight seconds. If this can be reduced or eliminated it should be done so as soon as possible.”

Mandatory training

Not all staff have received mandatory training in health and safety. “Furthermore as a result of recent cost containment, not all staff have attended or been given the opportunity to attend mandatory training, eg in manual handling, management of aggression and violence.”

Potentials for harm are also highlighted, including pictures in the unit with glass in their frames and unlocked clinical rooms where sharps are stored.

The 2006 Department of Health regulations on staffing are quoted: "The registered proprietor shall ensure that the numbers of staff and skill mix are appropriate to the needs of residents [and] the size and layout of the approved centre."

There were concerns about safety on a continual basis, “particularly in the last few weeks” a spokesman for the Psychiatric Nurses Association said last night. “As recently as this morning we have been raising issues. The most serious items are staff shortages. On a regular basis there is just one member of staff in a ward, which is highly dangerous. We have been raising the fact the staffing floor in the department is being broken continually.

Patient safety

Denis Naughten

, Independent TD for Roscommon, which is served by the department, said there were “obvious and serious knock-on safety concerns for patients”.

A HSE spokeswoman said: "Following the Health and Safety Authority inspection in May, an action plan has been finalised. The majority of the issues have already been implemented and the remainder are being completed.

“Further training has commenced in the management of violence and aggression.”