Unfortunately not everything in health and social care settings go the way that they should.
In July 2011 a criminal investigation began at Stepping Hill Hospital in Stockport. It was first sparked by a nurse who noticed that several patients on the ward she was working on, had unexpected low blood sugar levels. By the 21st July 2011 it had been discovered that 5 patients, all with underlying health problems, had been killed. It had been suggested that a number of saline ampoules and drips had been contaminated with insulin which lowered patients’ blood sugar levels. This is very dangerous and can lead to death.
When something as severe as this occurs, the hospital must respond quickly and must prioritise.
When the nurse first discovered that this was going on, she should have informed the nurse in charge of the ward. She should also back up her statements with any possible evidence. If I was the head nurse, it would concern me firstly, how many patients had been affected and secondly, why had it taken so long for anybody to notice? The reason why the nurse should tell the head nurse is because there is a policy that states she should. “[All staff] Are responsible for adhering to locally agreed standards of behaviour with regards to issues such as dress code, time-keeping and reporting arrangements;” http://www.stockport.nhs.uk/WebDocs/Disciplinary%20Policy_Procedure.pdf
The first thing the head nurse should do is then inform the police straight away. This is because it is a criminal matter and the hospital need to work with police and detectives to determine the person/s behind the poisonings. The NHS policy states: “Certain cases of gross misconduct may be so serious that they justify separate criminal investigation. Whilst the Trust will fully cooperate with criminal investigations, internal procedures will remain separate to the criminal investigation and independent of it. A decision to involve the Police in any investigation which relates to this procedure will be acted upon only after the appropriate Director and/or Chief Executive have been advised of the circumstances and given authorisation to proceed.” http://www.stockport.nhs.uk/WebDocs/Disciplinary%20Policy_Procedure.pdf
The next thing that should be done is to reassure patients and their visitors but also to reassure staff too, that the situation is under control and is being closely monitored. It is important to do this because it could cause even more chaos in an already critical situation and if I was in charge then this could concern me. Patients who are sick need to be at complete rest, stress could cause their condition to become worse. Relatives also need reassuring so that they continue to visit and don’t quiz staff who are already bogged down with the extra work load. They also need reassuring so that they don’t try to transfer the patients into neighbouring hospitals forcing the other hospitals to have a bed block. Staff need reassuring so that they can continue with their job as effectively as ever and that their care remains the top priority.
At the same time, all medicines stocked on site should be checked to see if they have been contaminated. This should be done to ensure that no more harm can be done to the patients in the hospital. If I was in charge it would concern me as to how the medicine had become contaminated and what the scale of the problem was.
All staff should be paired up when administering medicines to patients. This should be done to reduce the risk of it happening again as staff will report any suspicious behaviour. This is and should remain standard practice and it would concern me that this wasn’t being followed in the first place.
Security should be increased around the hospital, particularly on the affected wards. This is to try and deter the person from doing it again. It is also to reassure everyone in the hospital that processes are being done to safeguard everyone in the hospital and its visitors.