Health procedures risk safety of patients, inquiry told

Nurses working in hospitals across NSW are struggling with inconsistent equipment, inadequate supply procedures and cumbersome approval processes that jeopardise the safety of their patients, an inquiry has been told.

Practitioners working for different local health districts voiced similar procedural concerns about the NSW health system at a Special Commission of Inquiry into the state’s healthcare on Monday.

Stroke team lead at Sydney’s Royal Prince Alfred Hospital Kylie Tastula said there was a lack of consistency between local health districts, agencies and facilities in relation to how stock and equipment are ordered. 

Inconsistencies could have fatal consequences for patients.

Patients transferred urgently between different hospitals in the same health district are often put on different arterial lines because of incompatible equipment, risking infection, Ms Tastula told the hearing. 

“It should be standardised across the state,” she said. 

Standardised equipment could also help in terms of staff being adaptable moving from site to site. 

Ms Tastula noted the lack of a delegated staff member for procuring critical equipment and supplies left nurses to carry the brunt of the workload. 

“Clinicians are the ones that keep an eye on the stock levels,” she said.

Ms Tastula proposed that ordering should be done by non-clinical staff who consult clinicians as appropriate.

But inconsistent and arduous approval requirements and processes for purchasing critical equipment and supplies often leaves hospitals without stock. 

There was no system of tracing the visibility of deliveries, orders and supply levels, she said. 

“I've lost count of how many times I’ve heard doctors asking for a device or a piece of equipment, only to be told the facility has run out.” 

Stock management, approvals and overseeing the costs lay with clinical staff without the available time to do so,  Ms Tastula said.

“I'm there to provide clinical care for a patient, not necessarily to do the negotiating of prices and things like that.”

NSW Nurses and Midwives Association president at Yass Hospital Paul Haines said there should be a staff member to oversee stock levels.

“A clinician will identify that an item in stock is low and they'll order it and another clinician a day or so later will also identify the same stock is low and order more and then another day later it might be ordered again because nobody actually has responsibility for ordering that stock,” he told the inquiry. 

“We don't know what anybody ordered and nobody knows who's actually accountable.” 

The Special Commission of Inquiry into Healthcare has been examining escalating costs and waste in the NSW health system and how to make better use of staff and funding.

The inquiry, led by Commissioner Richard Beasley SC, will resume this week.

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