Martha’s Rule
The Norfolk and Norwich University Hospital has implemented Martha’s Rule for all inpatients, and patients attending the Emergency Department.
What is Martha’s Rule?
Martha’s Rule is a patient safety initiative designed to support the early detection of deterioration. It recognises that patients, and their significant others, including carers, have unique insight into a patient’s health, and are often able to pick up subtle changes in a patient’s condition that may mean they are getting worse. Martha’s Rule aims to ensure that these concerns are listened to and acted on.
As part of Martha’s Rule, we are committed to asking each patient at least daily if they feel they are getting better or worse. This is to monitor any unexpected changes in their condition. Where patients report feeling worse, these concerns are escalated and acted on by nursing and medical staff as indicated.
Martha’s Rule also provides a 24-hour telephone number which allows patients, or someone calling on their behalf, including relatives, carers, advocates or staff, to seek support when they feel that a patient is becoming more unwell.
When to make a Martha’s Rule call
You can use the Martha’s Rule telephone line if you are concerned that a patient is becoming more unwell.
Examples of changes you may have noticed could include:
- Changes in temperature – hot or cold to the touch
- Worsening pain
- Any changes to the skin (e.g. rash)
- Low energy, drowsy or sleepy
- Levels of hydration
- Changes in breathing
- New confusion
- Anything else that worries you
If you are concerned about any of these, or anything else that might indicate a patient is becoming more unwell, we encourage you to first speak with the nursing and medical teams caring for the patient. If you have already done this and feel your concerns have not been addressed, you can contact the Martha’s Rule service for further support.
How to make a Martha’s Rule call
- First, speak to the team caring for you or your loved one
- If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, you can access the Martha’s Rule service by calling: 01603 288249.
Your call will go through initially to the Recognise and Respond team who are a team of specialist nurses. They will ask you for the patient’s details. For adult inpatients they will respond to the call themselves. For patients in other specialist areas including paediatrics, neonates, maternity or the emergency department, they will pass your call onto the specialist team responsible for Martha’s Rule in that area who will call you back.
When we receive your call we will first need to know:
- The patient’s name
- The patient’s location
- Your relationship to the patient
- Your contact number
- Whether the patient you are calling about is currently pregnant
The team responsible for Martha’s Rule in the area where the patient is being cared for will then listen to the reasons for your call.
The service is available 24 hours a day, seven days a week.
Sometimes, if we are with another patient, we are unable to take your call immediately, but you can leave a voice message providing the same information above and a contact number and we will aim to get back to your as soon as possible.