Problems of care in a private nursing home

• Published in: BMJ Vol. 301; no. 6748; pp. 371 - 372
• Main Authors: Pearson, J, Challis, L, Bowman, C E
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 18.08.1990; British Medical Association; BMJ Publishing Group LTD
• Subjects: Aged; Aged, 80 and over; Anticoagulants; Biological and medical sciences; England; Home nursing; Homes for the Aged - standards; Hospital beds; Humans; Medical sciences; Medical specialists; Middle Aged; Nurses; Nursing Care - standards; Nursing homes; Nursing Homes - standards; Observational research; Practice Observed; Pressure ulcer; Private Practice; Public health. Hygiene-occupational medicine; Quality of Health Care; Social policy; Staff authority; England; Human; Convalescence center; Epidemiology; Elderly; Public health organization; Public health
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.301.6748.371

To assess problems of care in a private nursing home an observational study was carried out over two months, during which a research nurse worked as a member of the staff in a home caring for 25 patients aged 62-90. During the second month a consultant physician visited the home weekly to hold case conferences and assess each patient's functional ability and drug regimen. Various problems in medical, nursing, and bureaucratic matters were identified--for example, staff failed to understand the appropriate response to various medical symptoms; no clear policy existed for managing pressure sores; and one patient's anticoagulant state could not be assessed when industrial action meant that transport to take him to hospital was not available--and several changes in drug treatments were recommended. The problems that were identified were mainly due to poor communication between the home and general practitioners and hospitals and to the lack of guidance policy on common issues that arise in long term care. Such a policy could be produced by health authority staff, general practitioners, and representatives of nursing homes.