Care of Children

Hawke's Bay Herald-Tribune, Volume 81, Issue 45, 16 November 1937, Page 6

Care of Children

hospital board discussion

Question Referred To Building Committee FACILITIES LACKING Following the recent spread of communicable diseases among child patients at th.6 Napier Hospital, the medical iuperintendent, Dr. James Foley, was agked at the instigation of Mr C. O. Morse, to Teport ,to the Hawke's Bay Ifospital Board on tlie planning and fccilities for tlie prevention of _ the spread of these diseases in the Shrimpton ward, to enable methods of improvejnent to be discnssed. Extracts from the report, presented to the board 's monthly meeting yesterday afternoon, are as follow: — "To-day, the correct method of hospital planning is in dispute. This appli.es particularly to the building of children 5s wards. What is ideal froin an architectnral point of view with due xegard to space and accommodation, may not be conducive to medical and nursing effieiency, and, in -the cass of Shtimpton Ward, it is only fair to ray that this ward was not originally intended as a children 's ward. "In children there -are always acute i commnni e'abl e diseases and one should devise ways and means to prevent their spread in the ward. "Tn some of the smaller hospitals of Grealf "Britain, the methods that are employed are either to admit first of all to an observation ward for a certain period, before allowing the patients into ihe general ward, or to adopt the other system of admitting to a cubicle. Provision. for Segregation.

"In a modera hospital, the children;s .ward is necessarily somewhat complicatecL Provision has to be made .for separaung male and female children, even with the younger patients. There is also segregation of the medical and surgical cases, and, paTtic-ularly, isolation of those suffering from communicable diseases. "Most of the sepaTation is effected by the nse of cubicles or side rooms _,with. as a rule, running water freely available. On admission to a cubicle tho patient is kept there until the incnbation period of certain diseases is passed, and when this period of isolation is over, patients who have not been discharged , may be transferred to the open ward. 4 'The problem of admitting a case-to tho children 's ward is that a patient may be harbcraring some nnhnown infection, apart from, the inf ection for which it is admitted. If the fact of exposure is elioited on admission, suitable measures for segregation can be undertaken, but, generally, it is difficult to obtain any history of exposnre, although systematically sought. Diphtheria, measles, chickenpox and whooping cough aTC easily introduced into any children 5s ward, but the greatest danger is the introduction of the common cold and the mixed germs of broncho-pneumonia amongst children already ill, because of serious clinical eonsequences. Zsolation on Admission. 4 ' Eegarding the question as to whether adequate provision is made for dealing with all cases admitted to the -Shrimpton ward, I would say that, for the last yeaT or so, we have been uolating all cases- on admission, until it is apparent that they are not harbouring any other communicable trouble. This applies particularly to medical cases which are more likely to be a source of inf ection than acute surgical ones. Y "As -for the planning of the ward. I would Bay that it is not ideal, insomuch as the sihk room for the disposal of nrine and faeces is across the main corridor of the hospital, while the bathroom and lavatories were built for adult patients. "Fortunately, a considerable improvemsnt has recently been made in. this ward by the building ef its own Idtchen, which previonsly it shared with the adjacent ward. 4 'There are six large side rooms in the Shrimpton ward ' which provide every facilility in the segregation oi cases, but because of the many doors — 11 in number — difELculty must be experienced by the visiting honffraries in keeping in contact with patients who are oceasionally moved to differentrooms.

Making Supervision Easier. "It is therefore a question as to whether it would be an improvemem; to cnbicilise'the ward by removing most of the large doors to these side rooms. This would still provide isolation and make supervision and nursing technique easier. "When the Shrimpton ward was first opened, the sister's room was a considerable away, being situated in the main corridor almost opposite the entrance to the adjacent ward, but, for obvious reasons, one of the side rooms in the ward has Been converted into an. offiee, and ensures better supervision of the'children. 5 ' Mr. Morse said tbe report confirmed a feeling lie had that all Was not quite right with the ward. The report gave much food for tliought and, having in mind the fact that the late Mr. "Wai-, ter Shrimpton had left a considerable sum of money for the establishment of a children5 s ward, the board should see that his wishes were carried out in the best possible roanner. There wa3 £2000 lying ready for the board's tise for that purpose. ' 4 Money is There. The chairman (Mr. Lassen): That's Ihe hrst I5vevheard of it. _Mr. Morse &ssured the chairman that )M mone£ was there tq make provisiop

for further children'^ services. He felt that the board should pay deference to the late Mr. Shrimpton's wish and make use of the money to establish a children's ward on the latest, most convenient, and efficient lines. The fact that most of the , wards in the hospital were overloaded did not allow of their proper functioning. When the lloyal Commission had gone into questions of the planning of the wards, they had come to the conclusion that the children's ward Jvas badly planned. The fact had not then been considered that tlie board was only sailing along temporarily with the Jhcilities at its command. The Koyal .Commission had also said that there was" no room for further extension, With this he did not agree, because all the wards had been planned to carry a top storey, which meant that thq existing accommodation oould be doubledi! The children's ward was not auitable, and he thought that the building committee should look into the bringing about df better conditions. No douht the recent spread of communicable disCase in the ward had been due to some extent to overcrnwding. He moved that ;the report be referred to th'e building conamittee. Mr, Lassen seconded the motion. More running water should be available for sterilisation. The lavatories and bathrooms in the ward had been built for adults and should he altered. Those were just some matters the committee could investigatel The motion was carried.