Rocca Hospital: Missing Nurses, a Storage Area for Hazardous Waste, and Emergency Exits
<p><span style="line-height: 1.6em;">The City Audit also noted that the lack of maintenance of the beds affects patients’ quality of service and rehabilitation process. The watchdog recommended increasing the number of nurses since more than half of the hospitalized patients have some degree of nurse dependency. </span></p> <div> </div>
Kitchen in bad conditions, broken elevators, poor maintenance in beds and wheelchairs, and nursing staff shortages were some of the items that received comments by the General Audit of the City of Buenos Aires (AGCBA, for its acronym in Spanish) after analyzing the 2009 administration of the Rehabilitation Hospital Manuel Rocca. The health center, located in the neighborhood of Flores (Segurola 1949), "specializes in psychophysical and sensory modalities in rehabilitation hospitalization, surgery, day hospital and outpatient clinics."
The AGCBA said in its report published in May 2011, that the department of physical medicine and rehabilitation "has 80 beds of which 10 were in bad shape hampering the quality of the patient's stay and, consequently, the rehabilitation." The auditors could also see that "there was no preventive maintenance on beds and wheelchairs," so they recommended "hiring a maintenance service for better preservation and quality of care of the patient."
Division of Physical Medicine
The report notes that "the physiatric treatment of a patient "involves the process of comprehensive rehabilitation of disabling diseases in the acute, sub-acute, and chronic stages, including their social and professional integration. "Patients are admitted after being evaluated by an external physiatrist (and sometimes by court order) and are discharged "once the patient is able to continue with outpatient treatment."
When the audit team evaluated 48 of the 107 admissions made in 2009 they verified that "the length of hospitalization was a 23.89% above the average" (punctually hovered between 200 and 223 days). In this regard, the Hospital argued that "bed overcrowding due to a lack of discharges were due to social or legal problems."
Board of Nursing
When evaluating the distribution of nurses, the AGCBA verified "a staff of 89 agents, 13 less than the year 2009", a figure that between January 2009 and August 2010, the Department "did not have 19 agents for various reasons such as retirement, death, and prolonged medical leave. "
In turn, in the hospitalization area the auditors noted "a lack of 66 agents against 38 who met functions in the sector in 2009," adding that "60% of patients are hospitalized with spinal injuries, which are considered dependent or semi-dependent” and that "25% are totally dependent", which sequentially makes staff shortages a great deal worse.
The city watchdog indicated that this situation "creates the need for an adequate number of nursing staff and proper distribution" and used three nurses per bed as a parameter.
Physical Facilities
In the fieldwork, city auditors found that "the emergency fire stairs are missing in two pavilions" therefore making a "fast evacuation very difficult." To this, they add that the "local kitchen" is in very poor infrastructure and hygiene conditions" and that "the bathrooms do not have washrooms for people with disabilities or with pedestal lavatory, except those in the hospital sector, which at the time of the audit, were being installed".
Hazardous Waste
The report notes that "the hospital does not have a hazardous waste reservoir for containing both laboratory and radiology waste," even though "the rules state they should provide the necessary equipment to ensure security."