To make a complaint to the hospital?

[Questionablmouse]

My dad was taken into hospital last week with a suspected heart block that was causing confusion and low heart rate. They found out he'd had a minor heart attack and put him on blood thinners. I got a call last night at 7pm saying he was confused and they were worried about hospital delirium but would monitor him.

He went to the toilet by himself at 8am this morning and fell, banging his head. He's had a CT scan which shows some bleeding and he's in quite a bad way.

Aibu in thinking that considering he was confused and on blood thinners he should have has something with him he he couldn't just wander around the ward? I feel like making a complaint because he should have been safe in hospital and now there's a chance he might not come home at all.

Ask to see his falls risk assessment.

To an extent, yes. Was he in a normal bed or did he have the sides up to prevent him from getting out unaided? Falls can happen quite a lot in hospital - partly because the unfamiliar environment can be disorientating, but also because hospitals simply don't have the staff to monitor patients that closely so the alternative is to keep them restrained in bed, either with barriers or by actually restraining the patient. Not many patients or their families are prepared to allow that. It's certainly worth asking if a risk assessment process was carried out and followed.

Of course not! Concentrate on your dad,

Really unhelpful response.

Sending a hug to the OP.

Complaining / bringing concerns to the attention of hospitals etc in these circumstances can help highlight failings and inform better care for both the OPs Dad moving forward, and future patients, at least one would hope.

Most hospitals have a PALS office on site, so a visit there doesn't have to interfere with the OPs focus on her Dad.

Elderly vulnerable people in hospital shouldn't end up worse than when they went in because of poor care.

I agree with all of this.

Yes I would and have not this exact situation but a complaint was put in, I basically did it with the hope of things would hopefully be looked into and it would help try and prevent a similar thing, I know there’s a culture for some people of never complain about the NHS but how is it suppose to get better?

Like ppl say ask to see his falls and mobility assessments and ask the nurse in charge of him how it happened, did he ring the call buzzer, were there any staff in the bay at the time he got up, 8am is a very busy time so staff may have been with other patients.if he is confused and at risk of falling this should all be documented and assessed to reduce the risk. Bed rails and barriers are not used to stop people getting out of bed, they pose more of a risk with patients climbing over them. Was he on telemetry heart monitoring, speak to the staff nurse first and contact pals, I hope he's OK, it's such a worry being in hospital but it's virtually impossible to stop falls unless it's 1 to 1 nursing.

That's what I mean - in our hospital people who may try to 'escape' the bed (particularly when they're confused) even with barriers up are physically restrained and it's not nice. It's avoided as much as possible but of course the flip side of that is increased risk. It's hard to know without knowing how mobile he was.

There is a balance. Every single complaint takes up hours and hours of NHS time, often by the doctors themselves. They are obliged to go through a full complaint procedure even if it is abundantly clear there are no grounds. As an example, one of my relatives recently handled a fairly basic and totally unfounded complaint. In the time they committed to that, they should have seen 18 patients. That's 18 people who lost out an appointment because some moron picked a fight with the NHS. Not all complaints are moronic, some are entirely valid and, yes they should not be allowed to get away with failing. But everyone, including the OP, needs to sit back, do their due diligence and work out the value of a complaint before leaping in.

you can't prevent all falls in hospital. A lot of whether a complaint seems reasonable will depend on the details including any falls risk assessment, the pattern of injury (is it possible that the CT changes actually precipitated the fall rather than were caused by it?) and exactly what the scenario was when he fell. Hope you get some answers and he recovers well. (Edit to say... also it's worth asking what their internal response to the fall has been and how closely they've followed their 'falls' policy.... if no incident form has been documented (which is really unlikely) then that suggests a more dysfunctional system, but if they've taken it seriously after the event then that would be more reassuring)

How do you physically restrain patients, and they fully assessed, on a dols, it's assault unless you can prove all alternatives are unsuitable , staff are trained in safe restraint, it's in the patients best interests and all staff at higher level , poa and family are involved in their care and are in agreement.

Ask the hospital what investigation they are doing around your dad's fall already.

I'm really sorry this has happened to your dad.

How are they being physically, restrained?
I used to be a mental health nurse and we did sometimes have to restrain patients ,but we had training in how to do it safely, and yearly updates ,
You can't just randomly decide to restrain a patient there are certain procedures to be followed

My Dad was recently in hospital and told not to get out of bed without help, but 1. refused to use a bed pan and 2. couldn't wait as long as the ward staff felt was necessary, so he was getting up against advice.

Everything about being in hospital is awful currently IME.

We are not in the UK. Here they put hand and wrist restraints on patients if they are at high risk of falls due to 'escaping' the bed. However they also ask family to stay in the hospital with the patient (including overnight) to avoid this. If the family cannot, the nurses will restrain the patients if they feel it's necessary for their own safety. We don't use wards in our hospital, the beds are in private rooms with private bathrooms, two per room at worst case scenario, so the nurses simply cannot monitor all the patients closely enough to stop them going to the toilet unless restrictions of some kind (such as guard rails) are used.

This. Circumstances like these would man that unless a family member stays with the patient they would be restrained with wrist and ankle bands in our (state run) hospital.

They should be looking into it as a Patient Safety incident and you can ask how he was assessed as a falls risk as part of that. Unfortunately some patients do not heed advice and overestimate their ability but staff should be more aware and a note about his mobility needs placed on the board above his bed.

the NHS has many flaws, but at least we don't routinely handcuff old people to their beds just for convenience (which as well as being barbaric, particularly if you're already a bit confused, comes with some pretty impressive medical risks).

Jesus, where exactly?

You're not in the UK and your responses would all be illegal in the UK so I am not sure how your posts are helping the OP.

We're in Spain. It's not done out of cruelty. It is for safety and no, it's not pleasant and we would always prefer family members to stay in order to avoid it. However as we all know, disorientated patients can put themselves in danger and this is seen as the lesser evil. They aren't quite police hancuffs. They are padded bands with enough movement to be able to drink and eat, shift position. Still not nice but again, neither is a bleed on the brain from falling off the toilet.

A friend of mine died in hospital last week. He had Covid. He also hated hospitals with a passion so between that and the confusion caused by his illness and treatment he kept trying to pull out his IVs and get up to leave. He didn't have anyone who could stay with him all the time so he was restrained.

But I am wondering how these sort of circumstances would be managed in the UK if it's illegal. On a practical level we know patients aren't always accurate with their self-presentation for things like fall risk assessments so how do you manage when you also are under-resourced and over-full?

It's not the case that we go around randomly handcuffing people. In August we had an English man in who had ALS. He was very unstable and his wife either couldn't understand the system or didn't want to stay the night so she just left him alone in his private room every night. At night he kept trying to get up and fell, so the staff used the guard rails on the bed. He kept trying to climb over them, fell and broke some ribs. In the end I had to have some very harsh words and force the wife to stay the night to prevent him getting up or he would have been restrained by necessity. What else could you do?

That is cruel and causes harm. The argument used to justify it reveals a very poor understanding of what "safety" means.

I'm not sure. I think the prevailing view is that it's the preferable alternative to wards - particularly mixed wards. If we want to be able to have private rooms and bathrooms we have to accept that patients can't be monitored by staff 24 hours. In theory in a ward nurses can see what's going on better and intervene quickly.

If he can normally mobilise independently, it's likely that he would not have been classed as a high falls risk. Most places I have worked will only do 1:1 if the patient is a high risk of falling due to mobility along with confusion. Even if he had been 1:1, that doesn't completely eliminate the risk of a fall. Staff are trained not to catch someone falling, but to assist them with a controlled fall if they are able to do so.

I'm really sorry this has happened to your dad, and it must be such a stressful time for you. In an ideal world, there would be enough staff to continuously observe confused patients, but unfortunately the NHS is not fit to cope. I wouldn't put in a complaint, but I would ask if they had the correct risk assessments put in place and how they would prevent this from happening again.