INMO launch “Ward Watch” which will be a new measure of hospital overcrowding

The Irish Nurses and Midwives Organisation (INMO) is, today, launching a new initiative called “WARD WATCH” which will be a new measure of hospital overcrowding.

The Ward Watch figure will count the number of additional patients, on beds, trolleys or chairs, on inpatient wards/units above the stated complement of that ward/unit.  This new Ward Watch count will, henceforth, be published daily in tandem with our long-standing Trolley Watch thus providing a hospital wide measure of overcrowding.

The INMO has decided to launch this new measure of hospital overcrowding as a direct result of continual feedback, from our members, that, in some hospitals, additional beds/trolleys were being placed on inpatient wards potentially compromising the care of all patients through increased risk of cross infection and/or poor staffing levels.  In addition, our members are concerned about the loss of dignity and privacy to patients arising from this recurring overcrowding.

This new Ward Watch initiative has been devised by the INMO and we have advised the Special Delivery Unit in the Department of Health of this new measure.

The INMO has been compiling this Ward Watch count, together with the Trolley Watch count, for a number of weeks, with information supplied by Bed Managers from all the acute hospitals.  In this context, if we consider the past four weeks, the following picture has emerged:

1. In this four week period, since 11th March 2013, there have been a total of 1347 patients, on beds/trolleys, placed on inpatient wards above the stated bed complement of that ward.

2. This means that there has been an average of 79 patients each day, placed in overcrowded, and inappropriate, environments on inpatient wards in hospitals across the country.

3. The following figures confirm that the placing of additional beds/trolleys, on inpatient wards, is a daily occurrence in the following hospitals:


2013 (Trolley + Ward)

2012 (Trolley Only)

Connolly Hospital, Blanchardstown



Tallaght Hospital



Mid-West Regional Hosp. Limerick



Midland Regional Hospital, Mullingar



Wexford General



In other hospitals i.e. Galway, Sligo and Tullamore the placing of additional bed/trolleys on wards, is a regular practice despite the fact that these hospitals have closed beds.

4. When one combines the Trolley Watch and Ward Watch figures, for this four week period, and compares them to the same four weeks in 2012 there is an overall increase of 19% in the number of patients placed in an inappropriate environment.

5. The comparative Trolley Watch figure for this 4 week period, in 2013, compared to 2012, shows a reduction of 7%.

The complete tables, for this four week period, are attached.

Speaking at today’s launch INMO President Claire Mahon said:

“This new initiative will give us a comprehensive picture of hospital wide overcrowding in this country.  It has been brought forward at the request of our members, in the frontline, who experience patients being placed in inappropriate locations on an ongoing basis.

These figures confirm that, particularly in five hospitals, patient care is being compromised as a direct result of inadequate bed capacity, leading to overcrowded wards.  This problem is compounded by poor staffing as a result of hospitals refusing to employ staff or because they cannot find the required number of nurses.

The problem is further exacerbated by the failure/refusal of these hospitals to declare they are in full capacity.  Frequently they do not initiate the necessary measures, including the cancellation of inpatient elective procedures, the postponement of day cases and additional consultant ward rounds, which would allow them to de-escalate and deal with their overcrowding pressures”.

Liam Doran, INMO General Secretary concluded:

“The INMO has published its Trolley Watch figures, every day, since late 2004.  It is now accepted as a true and accurate measure of ED overcrowding and the demands that are being placed upon emergency departments.

The reduction in the number of patients, on trolleys, in some hospitals is most welcome.  However, this new Ward Watch count confirms that, particularly in the hospitals named above, the reduction in trolley numbers is completely offset by the placing of additional patients, on inpatient wards.  This not only compromises their care but also the care of all patients on that ward.  The INMO remains fundamentally opposed to the placing of additional beds/trolleys, above the stated complement, on any inpatient ward/unit.

In March 2006 the former Minister for Health, Mary Harney, declared the A&E crisis a ‘National Emergency’.  Now just over 7 years later the trolley numbers are down by 9% but the combined ward/trolley count shows an increase of 19% indicating that the problem has spread to the wards and the shortage of beds continues.

The INMO is now calling upon the Minister for Health, Dr James Reilly TD, notwithstanding the pressures from the Troika, to increase bed capacity in every hospital regularly facing overcrowding.  While the overall reduction of 7% in Trolley Watch figures, since the same period in 2012, is welcome, this new measure confirms that serious capacity problems remain which must be addressed.

The INMO will now be seeking immediate discussions with the Special Delivery Unit and the hospitals who regularly overcrowd their inpatient wards. This will be to have them bring forward, and implement, all necessary measures, which must include additional beds, and staff, to address this grave and serious problem”.

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