Child patients sharing EDs with adults

Child patients attending emergency departments in many hospitals around the country are forced to share facilities with adult emergency patients, meaning that children often have little privacy and have to view violent and drunken behaviour at close hand.

This is despite the fact that a new HSE charter on children's hospital care stipulates that child patients should be separated from adults in ED services.

A recent audit of general hospitals outside Dublin that treat both adult and child patients, however, has found that only six out of 17 hospitals have separate waiting areas in emergency departments for adults and children. The report found poor ED facilities for children in many of the hospitals.

Also, in six of the 17 hospitals audited, children have to share ED assessment rooms, as there are no separate assessment areas for children presenting as emergencies.

The report, seen by states that in University Hospital Galway, for example, 12,000 paediatric emergency cases per year are seen in two cubicles separated by a curtain.

There are approximately eight chairs adjacent to these cubicles and patients, by force of necessity, are treated while sitting on chairs.

"Medical patients wait on those chairs, but unfortunately, surgical patients wait in the main wait area with adults until they are called for review. Neither the wait area nor treatment beds within the small room are aurally private. The treatment beds can be visually private via a curtain, but children being treated on chairs in the wait areas are are not visually private," the report comments on the facilities at UHG.

The facilities are equally poor in Limerick Regional Hospital, according to the report, where there is also no separation of child ED patients from their adult counterparts when they are waiting or are being assessed.

The report says non-segregation of child patients from adults is a major issue in Limerick and this situation is 'untenable'. 'With such a busy throughput, many children are exposed visually to very ill or even drunk adults' and 'no-one can stand over this.'

At Sligo Hospital, the report notes that a major area of concern is the sub-optimal ED for children, with a common adult-child waiting area.

The six out of the 17 hospitals treating adult and child patients which provide separate ED waiting areas for children, according to the report, are: Kerry; Mercy, Cork; Our Lady of Lourdes, Drogheda; Portiuncula, Ballinasloe; Portlaoise and Clonmel.

Those that do not have separate waiting areas are: Cavan; Cork University Hospital; Letterkenny; Limerick Regional; Mayo; Mullingar; St Luke's, Kilkenny; Sligo; University Hospital, Galway; Waterford Regional and Wexford.

The hospitals which do not provide separate ED assessment rooms for children,according to the survey, are: Cork University Hospital; Letterkenny; Limerick; St Luke's, Kilkenny; University Hospital, Galway and Wexford.

Some hospitals have separate ED areas for medical patients but not for surgical patients.

The report says that in University Hospital Galway, child medical patients have a separate wait areas and assessment areas but surgical patients do not. Waterford Regional has only partially a partially separate paediatric ED wait area while in Kilkenny, medical patients have separate wait and assessment areas but surgical patients do not.

The assessment of paediatric hospital facilities was carried out by the HSE's clinical programmes for paediatrics an neonatology.

The HSE has drawn up a draft charter on the rights of child patients in paediatric health services, and is currently seeking feedback on it. The deadline for submissions is January 31.

The charter states, among other things, that child patients should have audio and visual separation from adults in emergency department services and should have the right to private communication with staff.

The charter says the privacy of children and young people should be secured at all times in healthcare.

Feedback on the charter can be sent to the HSE at

The full draft charter is available to download here

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Revamp needed for kids' hospital care


[Posted: Tue 08/01/2013]


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