London’s Nightingale hospital recorded 144 safety incidents in 29 days – The Independent



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London’s Nightingale Hospital set up to support the capital at the peak of the coronavirus outbreak recorded 144 patient safety incidents during its 29 days treating 54 patients, it has emerged.

Dr Andrew Wragg, consultant cardiologist and director of quality and safety at Barts Health NHS Trust told a Royal Society of Medicine webinar there had also been two serious incidents at the field hospital while it was treating patients.

He said a study of the longer-term outcomes of its patients was still ongoing as 20 of the patients treated at the ExCel conference centre site were still in hospitals across London recovering from the virus.

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The Nightingale was built to house up to 4,000 Covid-19 patients and opened in April to cope with a predicted surge in patients needing critical care to help them breathe as a result of the virus attacking their lungs and causing pneumonia.

Although more than 2,000 staff volunteered and trained to work at the hospital only 700 staff were actually employed on shifts there as the hospital never had more than 35 patients at any one time.

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Johanna Cade, a nurse at Guys and St Thomas’ NHS trust and who worked at the Nightingale said: “We had quite high incident reporting at 144 incidents reported and I think that demonstrates that Nightingale really did well at building a no blame safety culture for resolution and learning. This system manifested itself and staff we’re really striving to make things better continually. We knew who to report to and how to escalate things.”

She showed data revealing the largest number of safety incidents involved medical devices, where there were 25 incidents which included the ventilators used to keep patients alive. Staffing issues and medication as well as pressure ulcers and communication incidents were also among the highest numbers.

She said the vast majority of incidents led to no harm of the patient, or only low harm with only a few categorised as causing moderate harm.

In one example she described how a patient’s blood sugar levels were mis-read on the paper notes used by the bedside staff in the first week of the hospital being open. She said this was investigated and led to changes in the way blood sugars were monitored and information reported.

There are more than two million safety incidents reported across the NHS every year but during the period the Nightingale was open it reported more incidents than any of the other hospitals run by the Barts Health Trust.

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Dr Wragg told the webinar: “Our very high levels of incident reporting are kind of a good evidence of that strong safety culture.

“We were safe. It was both personally and professionally, an incredible experience working there, mainly because of the amazing staff and colleagues who were very much focused on the responsibilities of what we had to do and deliver.

“We also recognised from day one that we just had to be a learning hospital. We were not a hospital to begin with, we had not tested any of our systems and processes. We really didn’t know whether we were going to be able to deliver a reasonable set of outcomes and that really meant whether our patients would have acceptable mortality from being looked after at our hospital, and we just had to learn very quickly.

“If there was a safety concern raised on the Monday, often by the Tuesday we would have the learning required around the issue fed into the training of new staff coming on board.

“You may argue that 54 [patients] doesn’t sound that many, but actually in conventional ICU terms that was still a significant ICU, and that was still a significant amount of critically ill patients that we cared for.”