Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) has introduced a Central Admission for inpatients, from 11 November, to ease the admission process and bed management system.
Deputy Superintendent of Nursing, JDWNRH, Tshering Dema, said JDWNRH is a 350 bedded hospital. The increase in different services and increase in the emergency and referral cases have led to a shortage of beds.
She said the emergency room has become very crowded and burdened because of overstay of patients. She said there is a high turnover rate in the emergency ward. “The ward should be ideally kept empty all the time. The health staff in the emergency ward will do emergency intervention and send the patients to ward but due to shortage of bed in the ward, the patients get stagnated in the emergency and this leads to pressure,” she said.
Recently, there were patients lying in emergency ward for two or three days and sometimes six days. The health staff in the emergency ward has to call up the ward boy to check whether there are empty beds in any of the wards.
These has led to many miscommunications between patients, doctors and nurses, and thus, creating inconveniences. The emergency ward was functioning as an acting bed management center since they were calling all the wards for any empty bed.
Similarly, Inpatient Department (IPD) also had issues. IPD were acting as an admission center. They were doing all the admission process of the patients, and instead of giving their 100 percent to the patients, almost 30 percent of their time is spent in processing their admission, said Tshering Dema.
She said the work which 20 nurses are doing can be done by just 2 nurses.
She also said due to the sheer increase in number patients admitted in the hospital, quite a number of patients were discharged without any records and observation notes of the patients anywhere.
In 2018, 1,476 patients were admitted in Inpatient Department in month. In 2017, the observation patients in maternity ward numbered 434, and 643 patients in 2018 and 439 surgical patient in 2018. Deputy Nursing Superintendent said there were no records of the patients.
Earlier, the nurses used to do the admission process of every patient in each of the 20 wards. “So if we have central admission, we can do away with all the work which leads to duplication, and nurses will focus on the patients and able to give good care,” said Deputy Nursing Superintendent, Tshering Dema.
Henceforth, health staff in emergency ward will inform the ward that they will need a certain number of beds, instead of calling in each and every ward about the empty beds.
Medical Superintendent of JDWNRH, Dr Gosar, said patients were admitted from everywhere before. Some to emergency and some to the wards, but now, with the central admission, patients will have to go to the counter and then get admitted.
At times, the doctors will not know whether there is bed available or not. This has caused a lot of inconvenience to the service and to the patient as well, he added.
“Now if there is no bed in the surgery ward, the patients will put to another ward wherever available,” said Dr Gosar.