Doctors are not always able to keep track of where seriously ill patients are located at one of the busiest emergency units in the country because of the number of people being treated.
The situation was revealed in a confidential audit of Beaumont Hospital, which warned that unless action is taken, patients’ lives could be lost.
Among the conclusions of the document, obtained by trade newspaper The Medical Independent, drawn up last July at the request of James Reilly, the health minister, are that patients are effectively going missing while waiting for care and others are waiting hours for help.
The Department of Health report says that after a patient is admitted “the exact whereabouts of these patients is only known and monitored by one nurse”.
It said their location “can constantly change, which means no one clearly knows where individual patients are”.
The report’s authors described the situation as a “significant risk to patients”, that “has to be addressed as a matter of urgency”.
While an update point from Beaumont’s management said this issue has been addressed since the report was written, the document also noted confusion over the length of time patients were waiting on trolleys.
At the time of the review, it said there was “no clear system of monitoring the waiting times for patients”, with tracking being based on the area their trolley or chair was placed instead of the amount of time they had been waiting for help.
“Consequently, there was no easy way to determine who had been waiting for more than six hours, where they were waiting or what point [in their treatment] they had reached,” it said.
It further warned that people who guidelines insist should be seen quickly, are waiting hours or even days.
The report said triage — used to stabilise someone before they can be assessed for further care — of the most seriously-ill people should take place within 15 minutes, but “often takes longer, up to 40 minutes”.
It said patients waiting on a trolley or chair for a bed — which could take “up to two days” — were often kept “in the corridor or annex”.
Beaumont was chosen for assessment because it has “consistently demonstrated the highest number of patients waiting on trolleys in the country”.
The Irish Nurses and Midwives Organisation said there were 24 people waiting on trolleys at Beaumont yesterday, the second highest in the country — after CUH which had 32.
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