Bristol Royal Infirmary, Bristol

General Services Information

Hospital Questions

• How many single rooms are available to NHS patients at this hospital: 87

• Of these how many have an ensuite toilet: 57

• Of these how many have an ensuite toilet and shower or bath: 51

• Does this hospital operate an accident and emergency unit:

• How many specialist palliative care beds are available at this hospital: 0

• Does this hospital have a named private unit/service:

Trust Questions

• Does the Trust treat private patients:

Patient Safety

Trust Questions

• Is there a system for recording operations that resulted in a foreign body being left post surgery:

• What is the reporting system for a foreign body being left post surgery: incident reporting and investigation + monthly case note reviews

• Is there a system for recording operations that were cancelled due to missing notes:

• What is the reporting system for operations that were cancelled due to missing notes: incident reporting and investigation + monthly case note reviews

• Is there a system for recording operations that resulted in wrong site surgery taking place:

• What is the reporting system for operations that resulted in wrong site surgery taking place: incident reporting and investigation + monthly case note reviews

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in a foreign body being left post surgery: 1 retained cotton wool balls post delivery of baby

• During the period 01 April 2010 - 31 March 2011, how many operations were cancelled due to missing notes: 0

• During the period 01 April 2010 - 31 March 2011, how many operations resulted in wrong site surgery taking place: 0

• How many incident investigations using a full Root Cause Analysis did were carried out in 2010/11: 70 29 RCAs completed for incidents where RCA was not compulsory but thought to be helpful

• What percentage of patient safety incidents resulting in severe harm or death had a full RCA initiated/completed: 61-90% RCAs are reviewed in local clinical division first and then reported centrally when actions are agreed for next steps to prevent reoccurence

• What percentage of acute inpatients have a track and trigger warning system in place for the duration of the admission: 100%

• What percentage of patients are risk assessed for venous thromboembolism on admission: 91-99%

• Compliant with all relevant NPSA safety alerts issues in 2010/11 (you can find a full list of alerts issued at http://www.nrls.npsa.nhs.uk/resources/?p=3). :

• Alerts where not expected to be compliant by 1st December 2011 and when expected to be compliant. : SPN14 Right Patient Right Blood - competency for medical staff. Working on electronic questionnaire to be completed by medical staff. RRR001 Inpatient Falls - scoping of additional equipment for recovering patients from floor. Confirmation of funding required.

• Does the Trust have a policy for providing educational programmes on using and interpreting clinical indicators:

• Does the Trust have a designated member of staff who supports teams in locating and analysing safety and quality data? (support): support available centrally and within clinical divisions

• Is safety and quality data available on a central platform and actively disseminated to users:

Infection Control

Trust Questions

• Does the Trust employ an antibiotic pharmacist:

• Does the Trust operate a pre-admission assessment clinic or equivalent system where patients are screened and results returned in advance of the day of admission:

• Elective patient groups screened at the pre-op assessment clinic: All elective surgical and medical

• Are all oncology patients screened at the pre-op assessment clinic: YES

• Are all chemotherapy patients screened at the pre-op assessment clinic: YES

• Are all elective neurosurgery patients screened at the pre-op assessment clinic: Not Applicable

• Are all patients with past history of MRSA screened at the pre-op assessment clinic:

• What method of MRSA screening is used when screening at admission: Culture based in 24-48hrs

• On admission, does topical suppression take place immediately: Yes if the patient has previous history of MRSA or if the patient is to undergo emergency surgery

• Does the Trust have at least one accident and emergency unit:

• Are all patients admitted through A&E screened:

• Is screening done according to individual risk assessment:

• Does the Trust have a dedicated isolation ward:

• How many beds does it contain: 5 This is a 5 single bedded area that is used predominantly as a C diff cohort area

• Does the Trust have an isolation policy:

• Where medically appropriate, are patients with C Diff isolated in single rooms as a matter of priority:

• Does the Trust have a policy to guide the use of metronidazole and vancomycin for C.difficile infected patients:

• Does the Trust routinely isolate all patients with diarrhoea:

Stroke Medicine

Hospital Questions

• Does the hsopital have a specialist stroke unit:

• What type of stroke unit does the hospital have: combined acute and rehabilitation stroke unit

• Number of beds in the unit: 19

Trust Questions

• Does the Trust have a specialist stroke unit or units:

• Is the Trust part of a stroke care network:

• Details: Avon, Gloucestershire, Wiltshire and Somerset Stroke/Cardiac network

• How many emergency admissions with a primary diagnosis of stroke (ICD10 codes I60 - I64) did the Trust receive in the financial year (period 01 April 2010 - 31 March 2011): 600

• Of these, what was the number of patients given a Computerised Tomography (CT) scan within 24 hrs of admission: 494

• Is thrombolysis for stroke patients provided 24 hours per day and 7 days a week :

• Are there any formal arrangements with neighbouring hospitals for the emergency transfer of stroke patients who would benefit from thrombolytic treatment:

• These arrangements are with: North Bristol NHS Foundation Trust

Trauma & Orthopaedics

Trust Questions

• Does the Trust offer a trauma service:

• Does the Trust have a dedicated trauma list available 24 hours a day for the duration of the week, (Sunday to Sunday):

• Does the Trust offer an orthopaedics service:

• Do all the Trust's orthopaedic ward/team have a linked geriatric team with whom they have regular meetings at least once a week:

• Does the Trust run a pre-operative patient education session/class for patients to attend prior to Total Knee Replacement (TKR) and Total Hip Replacement (THR)? : These procedures are not undertaken electively at University Hospitals Bristol NHS Foundation Trust.

• Does the Trust have a standardised anaesthetic protocol for Total Knee Replacement (TKR) and Total Hip Replacement (THR) patients: Patients who require TKR and THR are transferred to North Bristol NHS Trust.

• Audited percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 0 These elective procedures are not undertaken at University Hospitals Bristol NHS Foundation Trust

• Estimated percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery: 0 These elective procedures are not undertaken at University Hospitals Bristol NHS Foundation Trust

• Not able to put a figure on the percentage of the Trusts total knee replacement (TKR) and total hip replacement (THR) patients walk within 24 hours of surgery:

• Does the Trust have a specialist orthopaedic physiotherapy service which is available 7 days a week:

• How many patients' discharge's delayed due to lack of physiotherapy services at weekends - audited figure was: 0 We estimate it is less than 5%

• How many patients' discharge's delayed due to lack of physiotherapy services at weekends - estimated figure: 0 We estimate it is less than 5%

• Not able to put a figure Patients' discharge delayed due to lack of physiotherapy services at weekends: We estimate it is less than 5%

• Are patients for total knee replacement (TKR) and total hip replacement (THR) admitted prior to the day of surgery: These procedures are not undertaken electively at University Hospitals Bristol NHS Foundation Trust.

• Are patient records routinely recorded using a specific multi-disciplinary team THR/TKR pathway document: We use a specific THR pathway document to record treatment for emergency patients.

• Is this data used to monitor compliance with the agreed pathway:

• Is criteria-based discharge used:

• Are patients routinely phoned in the first 48 hours after discharge to check on their progress:

Paediatrics

Hospital Questions

• Does the hospital have a paediatrics service:

Trust Questions

• Is the Trust's elective paediatric surgery carried out only by designated surgeons with at least six months training in a specialist unit:

• Do the Trust's anaesthetists with responsibility for paediatric anaesthesia participate in at least one paediatric list per week:

• Is a paediatrician on site (SpR or higher) 24 hours per day, 7 days per week:

• Are at least two registered children's nurses on duty 24hours per day in each children's ward:

• Is there a designated facility on site for parents or guardians to stay overnight:

Palliative Care

Trust Questions

• Does the Trust provide a palliative care service:

• How is specialist palliative care delivered at the hospital: A multi-disciplinary specialist palliative care team

• Does the hospital's specialist palliative team includes: A consultant in palliative medicine,A palliative care nurse,Other (please specify) OT, SW, access to psychological services, chaplain

• Is the Trust's specialist palliative care team available 24 hrs a day seven days a week:

• Are facilities provided to support relatives and carers who wish to stay with a patient in hospital: Not at all sites.

• Does the Trust routinely survey and evaluate the views of patients and bereaved relatives and carers regarding the delivery of care on the end of life programme:

Maternity Care

Maternity Sites

• St Michael's Hospital - Consultant Led

• How many women gave birth in the unit during the year? (not including home births): 5486

• How many babies were born in the unit during the year? (not including home births): 5574

• How many women were booked for a home birth: 200

• How many women had a home birth? (not including births at home by accident): 130

• Number of antenatal rooms: 8 Use postnatal beds as overspill as required

• Total antenatal beds: 8

• Number of assessment area rooms (for monitoring and / or induction): 7 Use postnatal beds as overspill as required

• Total assessment area beds: 7

• Number of delivery rooms: 13

• Total delivery beds: 14

• Number of postnatal rooms: 50

• Total postnatal beds: 50

• Number of rooms in obstetric high dependency unit: 0 Use CDS beds as required

• Total obstetric high dependency beds: 0

• Number of single rooms used for both delivery and postnatal care (labour, delivery, recovery and postnatal, or LDRP, rooms): 0

• Amenity rooms; Are women able to book a single room in advance of their birth:

• If women can pay for a single room what is the average cost per night (GBP): 62 £85 for ensuite room

• Does the maternity unit have a neonatal intensive care unit:

• Does the maternity unit have a neonatal high dependency unit:

• Does the maternity unit have a special care baby unit:

• Security measures - ankle bands for the baby:

• Security measures - cot alarms:

• Security measures - CCTV:

• Security measures - restricted access:

• Other security measures: Have regular baby abduction dry runs

• Pain relief available - bath or shower: Provided by unit

• Pain relief available - birthing pool: Provided by unit

• Pain relief available - birth ball: Provided by unit

• Pain relief available - Massage: Provided by women

• Pain relief available - Aromatherapy: Provided by women

• Pain relief available - TENS: Provided by unit

• Pain relief available - Epidural: Provided by unit

• Pain relief available - Mobile epidural: Not available

• Pain relief available - Entonox (gas and air): Provided by unit

• Pain relief available - Intramuscular injection: Provided by unit

• Total number of WTE midwives at the unit in your funded establishment, including vacant posts: 151.61

• Total number of WTE midwives at the unit as staff in post, including agency and bank staff: 151.61

• Does the unit have midwives available to provide one-to-one care available 24 hours a day, 7 days a week: On site

• Does the unit have midwives available for home births available 24 hours a day, 7 days a week: On call Have also team on site

• Does the unit have midwives trained and experienced in water birth available 24 hours a day, 7 days a week: On site

• Does the unit have a paediatrician available 24 hours a day, 7 days a week: On site

• Does the unit have an obstetrician available 24 hours a day, 7 days a week: On site

• Does the unit have an anaesthetist available 24 hours a day, 7 days a week: On site

• Does the unit have a dedicated obstetric anaesthetist available 24 hours a day, 7 days a week: On site

Trust Questions

• Do all women have a choice about where they receive their antenatal appointments (i.e. at hospital or local health centre): Low risk women have midwifery led care in the community. Women requiring consultant care have some hospital appointments. There are some Consultant clinics held in some community settings.

• Are NHS antenatal classes available (e.g. Parentcraft):

• Available during the daytime (until 5pm):

• Available in the evenings (after 5pm):

• Available at weekends (Saturday and/or Sunday):

• Available for women only groups:

• Available for other groups:

• Also available for: Women expecting twins. Also have tours of the hospital at weekends

• Are all women routinely offered ultrasound scans:

• Scan 1 available between: 8 -14

• Scan 2 available between: 18-21

Trust Statistics

Trust Questions

• You can view various measures relating to the Trust's performance by clicking the following link: University Hospitals Bristol NHS Foundation Trust