Health reporter Siobhan Ryan looks at the progress made by two nurses aiming to improve standards for elderly patients at two Sussex hospitals.

Practice development nurses Ruth Bailey and Caroline Davies have spent the last 16 months looking at ways to improve the environment and care of elderly patients at Brighton General Hospital and the Royal Sussex County Hospital.

The number of older patients on the wards of both hospitals is on the increase.

About 20 per cent of the patients staying at the hospitals are over the age of 60 and a large proportion of these are over 85 and making the long recovery from a stroke.

As people are living longer, there is a good chance more patients with similar problems are going to be making an appearance at both hospital over the next ten years.

For Ruth Bailey and Caroline Davies, the most important thing is making sure the patient's stay is as comfortable and stress free as possible.

The difficulties they face in achieving the goal are crumbling buildings and a shortage of nurses but, by introducing a number of simple measures, things are beginning to improve.

The nurses have been working closely with nursing staff on the wards and others involved in patient care, such as occupational therapists and physiotherapists, to develop projects aimed at improving conditions.

Mrs Davies said: "Staff have been asked to let us know where they felt they were going wrong and what could be done to improve matters.

"One of the areas where staff felt there was a need for improvement was in the care and treatment of people suffering from strokes."

The concerns raised led to the development of a stroke education programme.

The programme brings together people from all areas of a patient's care, such as their doctor, nurse and speech and language therapist.

Each individual is then encouraged to make it clear what they are doing and when so everyone knows what the pattern of care will be. The aim is to ensure the patient will have a smooth stay in hospital.

A new pilot scheme has also been launched to help cut down the number of falls people have while staying in hospital.

Mrs Davies said: "They can fall for all sorts of reasons, such as tripping over their dressing gowns, falling as they try to get out of chairs or slipping on the floor.

"What we have done is draw up a set of measures and checks for staff to warn them to look out for potential dangers.

"These include making sure call buttons are placed easily within reach from the bed, which means a patient doesn't have to lean over too far and risk falling out.

"It means warning staff to watch out for wires and cables coming from cleaning machines or make sure the polish used on ward floors is not slippery.

"It sounds obvious but sometimes just giving people a reminder can make all the difference and it already has.

"It is too soon to judge how successful the scheme has been but the wards involved have already reported a reduction in the number of falls."

The nurses are also looking at smaller, more immediate measures that have helped improve wards.

Mrs Bailey said: "It is sometimes the simplest things that can make all the difference.

"We were told that patients sometimes lost track of days and times while staying in hospital, so the simple solution was to bring in a large clock and a large calendar so they could see for themselves.

"We have also worked to bring in more volunteers to help out in the light of complaints that there were no facilities available on the ward for patients to buy things they needed, such as snacks or toiletries.

"We now have volunteers who are happy to go out and get supplies for patients, renew library books and even place a bet for them if necessary.

"They also have the time to talk to patients which nurses may not necessarily have the chance to do as often as they would like."

Both nurses work closely with other staff on the wards to learn what needs to be done and what help is required.

They admit the difficulties they face and that they have a long process ahead of them, which will include the eventual transfer of the service to the Royal Sussex.

Mrs Davies said: "We see ourselves as gophers in one sense. We find out what is needed on the ward and we go and find out how to get it and bring it back.

"There is still a way to go but we are starting to make a difference.

"The surroundings of an old building like Brighton General are not ideal and we don't have as many nurses as we would like but we need to make the best of the resources we have."

Both nurses, who operate through a job share scheme, say the reaction from staff and patients has been positive so far.

Mrs Bailey said: "The staff are now coming to us with ideas much more often and there is a real desire to see changes for the good. Patients are also happy."