As with any public sector projects, budgets are always under scrutiny but finances are assessed on a best value basis with quality, service life and installed costs all brought into the equation.
Adaptability is also key, as few environments experience such a rapid pace of change as hospitals or have such a business critical need for electrical services to be available to meet current and future needs.
Finally, patient needs and welfare must also be high on the agenda, with the electrical specification meeting current and future clinical and care needs while managing the level of disruption and infection control risk associated with major refurbishment projects.
These were all considerations during the recent project to create a ‘Forget-Me-Not’ ward at Warrington Hospital, which saw the refurbishment of a former 24-bed elderly care ward into a custom-specified dementia unit that addresses patients’ physical, mental and emotional needs.
The project is part of a drive to tackle the increasing numbers of elderly patients with dementia being admitted to UK hospitals for additional conditions, which has resulted in the Government setting aside a £50m dementia care fund to spend on specialist care and facilities.
Warrington Hospital successfully bid for a £1m share of that £50m through the King’s Fund. Following a collaborative design and specification process involving a consultation group made up of patient/carer representatives, members of the estates team, clinical professionals and representatives from the Alzheimer’s Society the Forget-Me-Not unit was created.
Flexible nurse call
Amongst the practical elements of the electrical specification in the Forget-Me-Not unit, the nurse call system was critical. Not only does it ensure that patients can call for prompt assistance but also that a degree of flexibility is built into the new facilities.
Explains Lee Bushell from the hospital’s Estates Capital Projects team: “We had been upgrading the hospital to Courtney-Thorne’s 08 wireless nurse call system on a rolling programme of ward refurbishments since 2012, so we knew we could be confident that it would be reliable.”
“We also needed a system that was both flexible and scalable should we need to reconfigure or extend the unit in the future and the wireless system means that we can make changes without any re-wiring.”
The unit accommodates 17 patients across one seven-bed bay and two five-bed bays, each of which are served by their own nurses’ station. Each nurses’ station has a dedicated touch screen which displays and monitors calls from patient beds, the dining and social areas on the unit and the sensory garden which has been created to encourage patients to spend time outdoors. The source and urgency of each call is displayed with complete accuracy on the touch screen unit at the nurses’ station. The system also provides real-time call management information, enabling the hospital’s team to track call patterns and analyse response rates.
The ability for the nurse call system to record data from each patient call is not only critical for the dementia care team at Warrington Hospital; it is also embedded in the Health Technical Memorandum (HTM) relating to bedhead services, HTM 08-03. This which states that “It should be possible for the system to log all of the calls/events and provide detailed history reports when required.”
The 08 wireless nurse call system was designed, programmed and installed by Courtney-Thorne’s in-house team in an installation programme that lasted just three days. The system works using a combination of radio signals and, because it is wire-free, there is no need for cabling either at the time of installation or if there is a future need to reconfigure the layout. No physical works means no noise or dust, which could potentially increase the infection control risk.
John Polhill from Courtney-Thorne comments: “For most installations, overhead lamps would also be installed to alert nurses to calls in the corridor areas.
“In this specialist environment there is a nurse’s station for every bay within the unit and the increased staff/patient ratio meant that lamps were not required.
“However, the system has been configured to give complete adaptability, including the capacity for ‘silent’ nurse call through integration with nurses’ pagers. This enables the system to be set to silent with nurses being alerted to any calls made through the vibrate function on their pagers.”
The increased staff ratios that underpin high standards of care at Warrington’s Forget-Me-Not unit are supported by a custom-designed dementia environment. Every element of the layout and decoration has been designed to reduce patient anxiety and disorientation, while encouraging social interaction, independence and stimulation.
Colour plays a pivotal role, with colour coded doors and door frames to help patients identify different areas. Colour has also been used in the lighting installation to both stimulate and sooth patients during their stay.
In the corridor areas, ordinary warm white lighting in circular ceiling-mounted units is complemented by colour-changing LEDs around the edge of each unit, enabling staff to choose between standard operational lighting or coloured mood lighting.
The lighting installation also plays an important role in highlighting other design features within the unit that have been specified to calm and relax patients.
Picturegrams have been used throughout the unit to aid wayfinding, and a cartoon-style mural of the local area has been painted in the corridor to help patients tap into long-term memory. This area of the unit also includes a bus stop where patients can ‘wait for a bus home’ or sit and chat.
Spotlights have been installed to highlight these features of the design layout to attract patients to certain areas of the unit and ensure that frequented areas are well lit.
The lighting installation also includes soft lighting in the relaxation room where Causeway Electrical Services has also installed a wall mounted TV screen that has been recessed into a ‘retro-frame’ to make it look like an old-style television. The screen plays footage of local scenes from the 1950s and 1960s to tap into patients’ long term memory and help them feel comfortable in their surroundings.
In addition to the decorative touches designed specifically to address the emotional wellbeing of patients at Warrington’s Forget-Me-Not unit, Causeway Electrical Services also carried out a complete re-wire of the facilities to reconfigure services in-line with the new layout.
The unit was changing from a 24-bed ward to a 17-bed specialist care unit so new bed head electrical installations had to be installed including all bed head trunking, sockets and over-bed light for patient use, medical gases, cleaners sockets and sockets for medical use.