Staff at Woodend Hospital in Aberdeen were observed moving between patients without sanitising their hands by inspectors from Healthcare Improvement Scotland during an unannounced inspection in August.
The same groups of staff, which included occupational therapists, physiotherapists, domestic and estates staff, were also seen wearing the same pair of disposable single-use gloves when touching patients and moving between areas and frequently-touched surfaces.
Woodend Hospital provides substantial care for the elderly, and houses the Department of Medicine for the Elderly, which is a base for Aberdeen University geriatric medicine students.
Healthcare Improvement Scotland has issued a number of required improvements to the hospital, which NHS Grampian has said will be implemented.
The inspectors also found issues with detergents used by nursing staff, including some expired products and incorrect instructions for dilution.
At the time of the inspection there were no patients at the hospital with confirmed Covid-19.
Some patients were in isolation for other reasons, and inspectors flagged that all the doors in one isolation room had been left open.
The general patient environment in the hospital was reported to be clean, and patients were treated with dignity and respect by staff.
Medical and nursing staff were not reported to have the same issues with hand sanitising and re-use of PPE as other staff members.
Ten requirements have been issued to NHS Grampian, including that all staff comply with the World Health Organisation hand hygiene guidelines.
The health board has also been told to ensure PPE is used in line with the National Infection Prevention and Control Manual.
A spokesperson for NHS Grampian said the hospital has work to do in meeting best practice guidelines for infection prevention and control, and that it will implement changes.
"Treating older people with compassion, dignity, and respect is a core part of our values and as this report notes our patients at Woodend are well cared for in a clean environment,” they said.
"Inspectors noted our virtual visiting programme and the ways staff work hard to keep relatives informed about the care and treatment of their loved one. They also heard directly from staff about the ways they are supported by the organisation during the pandemic.
"However, as the requirements laid out in this report make clear, we still have work to do in meeting best practice for record keeping and infection prevention and control.
"While hand hygiene was performed well by nursing and medical staff, some other staff groups missed opportunities to sanitise their hands. Inspectors further noted some occasions where personal protective equipment (PPE) was not used correctly.
"We carry out regular hand hygiene audits and refresher training in the correct use of PPE is regularly available and advertised through our daily staff brief.
"We have accepted all the requirements of this report and have developed an action plan to see them implemented. This can be read in full on the Healthcare Improvement Scotland website."