Safeguarding Adults: Learning in the acute

hospital settingAllison Cannon

Asst. Director of Quality

Lynn Beun, RGN

Do we learn

yes

No

Maybe

Protecting adults – practical steps taken by the Trust

Nursing Metrics

Safeguarding Committee

Comfort rounds

Sit and see Flagging

Pathways for patients with Learning

Disabilities

Training

AAR/RCA

Alerts by Age

3 4 4

810

36

0

5

10

15

20

25

30

35

40

1

31- 40 yrs

41-50 yrs

51-60 yrs

61-70 yrs

71-80 yrs

80+ yrs

Level of investigation

57

7 1

Level 1

Level 3

Level 4

30

21

11

2 1

0

5

10

15

20

25

30

35

1

Neglect

More than onecategory

Physical

Financial

Discriminatory

1820

8

14

5

0

5

10

15

20

25

1

Substantiated

Unsubstantiated

Inconclusive

Open

No further action

Feeding with oral syringes – abuse or acceptable?

Exercise: Patient story 1• Mrs A aged 86 years was admitted to hospital following a

fall. She had Parkinson’s disease and has difficulty eating and drinking. Her fluid balance chart (overleaf) shows that her oral intake is poor.

• Her daughter reports to you that she has witnessed a member of staff giving 10 mls of Fortisips on 4 occasions into her mouth using an oral-enteral syringe on four occasions.

• Q1. What pro-active safeguard steps could be taken to ensure Mrs. A. obtains adequate fluids and nutrition?

• Q2. Is oral syringe feeding acceptable practice or abuse? Discuss.

Mrs. A: Oral and IV fluid intake

0

500

1000

1500

2000

2500

3000

3500

01/05/2

012

03/05/2

012

05/05/2

012

07/05/2

012

09/05/2

012

11/05/2

012

13/05/2

012

IV fluids given in mls / 24hours

Oral Fluids Taken in mls /24 hours

Accident or Neglect?

Exercise: Patient Story 2• Mrs. B. aged 88. Admitted to hospital with abdominal

pain.• She went to the X-Ray department for a scan which had

to be taken lying on her front. She had to lie on a plastic cover on the scanner unit.

• Whilst turning Mrs. B. onto her front an injury occurred. The skin of her leg stuck to the plastic sheet. She experienced a lot of bleeding and damage to her leg.

• Q1. Is this an accident or is it neglect?• Q2. What questions would you want to ask to find out what had

happened?• Q3. How would you safeguard other patients?

Pressure damage

Changes to Practice

• Pocket guides for clinical staff• Reviewed policy • Feedback • Action plans • Hand held record • Staff learning• Handover – bedside handover.• Equipment checks