The rate of vein inflammation among patients at Mater Dei Hospital has escalated after a nurses’ union directive came into force three months ago, The Sunday Times has learnt.
The condition, called phlebitis, was previously rare with just three cases a year but when contacted hospital CEO Joe Caruana said they were now witnessing four cases a month.
In September, The Sunday Times had reported that nurses were instructed to stop filling in the Visual Infusion Phlebitis (Vip) score chart – a daily nursing assessment put in place to minimise a patient’s risk of infection.
The Vip score is also a vital part of the hospital’s efforts to reduce the bloodstream infections caused by antibiotic-resistant superbug MRSA.
One of the most important interventions in any hospital is an intravenous drip. However, this requires an unavoidable break in the patient’s skin, which can serve as a direct shortcut for microbes between the skin and the blood.
Mr Caruana, together with the hospital’s board of directors, was concerned that whenever hospital staff traced back each case of phlebitis they discovered the Vip score chart would not have been filled in.
“Luckily, several nurses are putting patients’ safety first and not following the directive, but where it was not filled in we have witnessed a substantial increase,” he said.
The action is part of the Malta Union of Midwives and Nurses’ attempts to change the opening hours of the hospital’s salary section and make it more accessible to its members who needed to address inaccuracies in their pay cheque.
Mr Caruana explained that the dispute boiled down to a computer system, which although adequate for government departments, was inadequate to handle the numerous different rosters of hospital staff and accommodate the nurses’ demands.
He said there had been few developments in the past months but three weeks ago he had met MUMN officials and given them long-, medium- and short-term solutions to address the situation.
Based on this he was expecting the directives to be lifted, but the union, he said, refused insisting the Vip score was not the nurses’ responsibility.
With this attitude, the hospital’s board of directors believed that with these actions the union was rendering the role of a nurse to that of a care worker.
Mr Caruana is hoping the situation can be resolved at a conciliation meeting on Tuesday.
Attempts to contact MUMN proved futile by the time of going to print. When contacted last September an MUMN representative had shrugged off the impact of such a “minor” directive, which merely instructed members to drop the paperwork.
Nurses did not need charts to check patients, he had said, and they would still examine patients. If there was something wrong they would call a doctor.
However, Mr Caruana said this score chart was introduced in line with the UK’s Royal College of Nurses’ guidelines, where nurses examined the skin around the drip needle several times a day while carrying out routine patient checks. Nurses then filled in a chart with their assessment by ticking off boxes, a task that is usually completed in less than a minute.
The hospital believes this documentation is vital to maintain consistency of practice and ensure an effective handover from one nursing shift to the next. It is also essential for medico-legal reasons.