The Healthcare Environment Inspectorate (HEI) yesterday published its report relating to an unannounced inspection visit to the Royal Infirmary of Edinburgh on 18 August 2011 and found that there were nine areas where specific action is needed.
The hospital has been warned that patient equipment was not being cleaned regularly and in accordance with a timetable according to the report. The inspectors found some bathrooms and commodes in Ward 205 in a dirty condition, and mention that some equipment marked as safe was not in fact clean.
One of the areas where improvement is needed relates to very basic hygiene requirements among nursing staff. Even after all the national publicity surrounding handwashing requirements and the prevention of infection, the inspectors noted some staff in ward 205 who did not wash their hands on entering the ward. The way in which alcohol hand gel is made available was also mentioned. The hospital provides the gel above a sink in the same place as soap, which the inspectors feel may confuse staff and visitors trying to ensure that they have washed their hands and decontaminated themselves properly. Another criticism in the report was the way in which staff deal with dirty bed linen , with one member of staff observed walking through a ward with dirty bedlinen without either an apron or gloves being worn.
A new NHS Lothian system for care of mattresses in the hospital has been introduced, but the inspectors found that there was little evidence of any checklist system to ensure that the bedspace occupied by a patient, including the mattress on the bed was clean and ready to be used. In ward 202 a bathroom was used to store mattresses and other equipment. As a result the bath and sink is hardly ever used. The inspectors found that the hospital should be taking steps to flush both regularly to decrease the risk of legionella.
Staff were also inspected and some were found to be wearing stained uniforms, or jewellery which is inappropriate or which did not comply with the national dress code.
The inspectorate will follow up with the hospital staff on all of the shortcomings found in the report within 16 weeks from the date of the inspection.
When the Western General Hospital in the city was inspected earlier this year there were eight points in the report where improvement was required, including a similar point about a lack of cleanliness of some patient equipment.
The full HEI inspection report and an improvement action plan developed by NHS Lothian to address the identified issues are available to view at:
www.healthcareimprovementscotland.org/HEI.aspx
HEI was set up to help reduce healthcare associated infection risk to patients through a rigorous inspection framework. The HEI inspection team examined NHS Lothian’s self-assessment information and then inspected the hospital to validate this information, meet patients and staff, and visit wards and departments to assess how clean the hospital was and whether or not it was meeting national standards.Speaking of the report, Susan Brimelow, HEI Chief Inspector, said “Our inspection found that five of the nine wards and departments inspected were clean and ward staff reported good communication links with the infection control team. However, we expect to find all wards and patient equipment is maintained and clean to reduce risks to patients. We also found other areas where improvement is required including ensuring senior charge nurses are able to influence and direct infection control in their wards. We fully expect the report’s requirement and recommendations, which have been agreed by senior staff at NHS Lothian, will be addressed and the necessary improvements made as a matter of priority.”
