Queen Beatrix Medical Centre in St. Eustatius.
ST. EUSTATIUS–Medical care in St. Eustatius needs improvements in almost every area, as the shortcomings create considerable risks for the quality of care, the Health Inspectorate of the Ministry of Public Health, Welfare and Sport writes in a report.
The report, which was published in May, was drafted after health inspectors visited Queen Beatrix Medical Centre (QBMC) and St. Eustatius Health Care Foundation (SEHCF) November 20-23, 2018. The Health Inspectorate expects the healthcare provider to implement the necessary improvements within six months.
In 2012, the Inspectorate performed a baseline study on whether Statia’s healthcare provider complied with the preconditions for responsible care, including infection prevention, medication management and training policies for general practitioners.
The Inspectorate has guarded and promoted the quality and safety of care since October 2010. It sees to it that healthcare providers act professionally within the boundaries set by laws and regulations, respect their own norms and continue to make efforts to improve care.
During their visit, inspectors assessed on the basis of various standards whether the conditions for the provision of good care were met.
The Inspectorate stated that no incidents were reported in 2017 and that four complaints had been filed. It said the complaint regulation is working and the healthcare provider employs sufficient staff in relation to the number of patients. However, attracting a fourth general practitioner is posing a problem, the Inspectorate said in the report.
According to Inspectors, SEHCF could not prove it had ascertained that staff members were sufficiently knowledgeable and competent to perform their duties. Also, they were not schooled to obtain knowledge and skills to guarantee the (new) agreements in the quality system.
Where hygiene is concerned, inspectors found no recorded agreements on the prevention of infections and on cleaning, disinfection and sterilisation to make sure that at least the minimum standards of the Netherlands Association of General Practitioners NHG are being met.
The Inspectorate concluded that QBMC has insufficient means to work hygienically. At the nursing ward facilities for hand sanitisers were empty and there were no hands-free taps in various places, including the delivery room and the sterilisation room. There were no laundry facilities to wash nursing staff’s clothing, which was cleaned at home. In the ambulance, used gloves were deposited in a drawer, inspectors said in the report.
At several locations, inspectors found medical instruments that were not properly maintained, such as air-pressure meters, thermometers, cardiotocography and ultrasound devices, oxygen supply and centrifuges.
One of the ambulances includes a respirator for mechanical ventilation and intubation material, while no employee was certified to intubate patients, the Inspectorate said.
It was also stated that the healthcare provider had failed to properly store medical supplies. In the ambulance’s emergency kit and in the laboratory supplies were found that were past the expiration date and temperature-sensitive medication was not stored under the proper conditions.
According to inspectors, SEHCF was not aware whether employees were vaccinated against hepatitis B. Also, annual flu vaccinations were not offered to staff members.
Emergencies can be reported at two emergency telephone numbers, but these are not answered within 30 seconds, it emerged from random checks. However, general practitioners are able to reach their patients in Statia within 15 minutes under normal circumstances. Also, general practitioners are available 24/7, it is stated in the report. The midwife has insufficient possibilities for timely referrals in case of acute complications during deliveries.
SEHCF is the sole provider of curative care in Statia. It is governed by one director and a five-member supervisory board. The foundation is engaged in talks with the Auxiliary Home for the elderly about a merger. As per January 2019, SEHCF took over district and homecare from the public entity.
The Medical Centre consists of a nursing ward with 14 beds, an emergency room and a delivery room, a radiology department, a medical laboratory, a policlinic for general practitioners, a midwife and physiotherapists, and an ambulance department with two ambulances.
Besides general practitioner care, the Medical Centre offers possibilities for short-term admittance and deliveries. In 2017, QBMC registered 926 hospital days with an average bed occupation of 2.5. There were nine deliveries and 296 emergency consultations in that year.