Decision Report 201608189

Summary

Mrs C complained about the care and treatment provided to her daughter by staff at the Victoria Hospital. Mrs C complained that when they arrived at the hospital, the nurse was unwelcoming and did not acknowledge how ill her daughter was. Mrs C also said that throughout the admission, nursing staff did not carry out appropriate observations. Mrs C went on to complain that when her daughter was assessed by medical staff, she was not thoroughly examined and a diagnosis of viral infection was made without full consideration of her symptoms and condition.

We took independent advice from a paediatric nurse and a paediatrician. We found that nursing staff did not provide Mrs C's daughter with appropriate nursing care, with failings identified in taking observations, record-keeping, and using the Children's Early Warning Score chart (CEWS chart - a set of patient observations to assist in the early detection and treatment of serious cases and support staff in making clinical assessments). We found that national guidance on children with fever was not appropriately followed by nursing staff. We also found that, whilst the examinations carried out by clinical staff were appropriate, they did not give enough consideration to the possibility of a serious illness. We upheld both aspects of Mrs C's complaint.

Recommendations

What we asked the organisation to do in this case:

• Apologise to Mrs C for failing to provide her daughter with appropriate nursing care and clinical treatment. The apology should comply with the SPSO guidelines on making an apology, available at www.spso.org.uk/leaflets-and-guidance.

What we said should change to put things right in future:

• Paediatric nursing staff should be knowledgeable and proficient in undertaking nursing assessments, observations, and using CEWS, and be able to act quickly on these observations.
• Parents/guardians should be given written information on warning symptoms and how further healthcare can be accessed if a child who had suffered from fever symptoms is discharged without diagnosis.
• Clinical staff should give consideration to the possibility that a child that has symptoms of a viral infection may have a more serious illness, and should be aware of the National Institute for Health and Care Excellence Fever guidelines.

We have asked the organisation to provide us with evidence that they have implemented the recommendations we have made on this case by the deadline we set.