Nurses at the region’s main hospital say they’ve been denied a meeting with management over persistent levels of overcrowding.
University Hospital Limerick has seen the worst levels of overcrowding in the country so far this year, with 4,782 waiting for bed.
Despite the summer being a generally quieter time in Irish hospitals, UHL has seen persistently high numbers of admissions since opening the new ED in May.
Mary Fogarty, industrial relations officer with INMO Mid West, says they’re extremely worried:
UL Hospitals Group meets regularly with the INMO and Siptu Nursing to discuss issues that arise in the ED. The next meeting of this Forum is scheduled for September 18th and we look forward to positive engagement with nursing representatives on that date.
The ED in University Hospital Limerick is the busiest in the country with over 64,000 attendances in 2016. The numbers presenting continues to increase year-on-year and of those presenting, the proportion requiring admission, including many frail elderly patients, has also increased.
Traditionally, average attendances at the ED have been approximately 150 over a 24-hour period from Mon – Fri and 120 per 24 hours at weekends.
In recent days activity has been very high with 193 attendances in the 24 hours up to midnight on Wednesday, August 16th; 199 attendances in the 24 hours up to midnight on Tuesday, August 15th and 193 attendances in the 24 hours up to midnight on Monday, August 14th.
In June 2017, the first full month since the opening of the new department, there was a 6.4% increase in ED attendances and a 13% increase in attendances by persons aged 75 and over. In the year-to-date, (January to July 2017) there has been a 2.4% increase in attendances in the ED and a 3.6% increase in attendances by the over 75s.
In addition to the increased volumes of patients attending, increased complexity and acuity is also a factor. The number of patients attending the ED requiring admission has increased by 9.3% in the year-to-date.
While traditionally, ED attendances were higher in winter months this has not been the case in recent years. There were 15,861 attendances in Q1 2017 and this rose to 17,069 in the second quarter.
UL Hospitals Group regrets that any patient has to face long waits in our ED during busy periods and a number of measures are taken to relieve pressure on the ED in line with our escalation plan.
Among the measures taken to relieve pressure on the ED are: the transfer of suitable patients from UHL to Ennis Hospital, Nenagh Hospital, St John’s Hospital and Croom Orthopaedic Hospital; the transfer of appropriate patients to community care settings; working closely with Community Intervention Teams to provide antibiotics and other basic care in a patient’s home or care facility; communication with GPs to ensure patients are referred to ED only where appropriate; extra ward rounds; and as a last resort, extra beds are put on wards.
UHL has 400 inpatient beds and this is recognised as not being sufficient for the needs of the MidWest Region. A bid to build an additional 96 bed block on the UHL site has been submitted to the Department of Health and approval has been granted for funding of the design stage of the build.
Plans to open a 17-bed short stay unit for medical patients in the old ED are well advanced and it is expected the unit will open in the near future.