Inspectors slam hospital ward over hand hygiene

They said they had witnessed staff failing to wash or decontaminate their hands properly on ward 21, a general medical ward.

They also warned dusting and cleaning on the ward had to be brought up to the standard of other wards and said risk assessment procedures for major refurbishment on ward 21 had "failed to function".

The criticisms came in a report on St John's by the Healthcare Environment Inspectorate, which was set up last year in a bid to reduce the risk of patients contracting healthcare associated infections (HAI).

Yesterday's report, which followed an announced visit to the hospital over two days in August, highlighted good practice in the newly-opened ward 25, which was designed to make cleaning easier and provide a clean environment.

It said good hand hygiene practice was observed among staff across most of the hospital, but it said: "However, in ward 21 the inspection team observed several staff groups not washing or decontaminating their hands appropriately while moving between bed bays and when entering and leaving the ward."

On cleaning, the report said ten out of the 11 areas inspected in the hospital had good standards of cleanliness, but it said: "Cleaning in ward 21 needs to be brought up to the standard of other wards. In particular, with regard to high and low level dusting, the cleaning of window sills, panes and ledges, cupboard interiors, dirty/dusty floor corners, and equipment for storing food."

The report also highlighted refurbishment work at the hospital and said: "During the inspection, it was evident that the risk assessment processes to plan and manage refurbishment work in ward 21 had failed to function."

The inspection team's concerns included work being undertaken on the ward without sufficient protective measures in place, inadequate implementation of control measures and inadequate communication between the ward manager, facilities and the infection control team.

The report also highlighted a problem over access to hand-wash sinks on ward 21.

"In three of the four six-bed bays, there is only one sink. When the patient in the bed nearest the sink is sitting at their bedside table this sink becomes completely inaccessible leaving no available clinical hand washing facilities in the bay."

Tom Waterson, Unison branch chairman for Lothian Health, said: "I think we need some further investigation of why one area has fallen down so badly. There must be good procedures in place for every other area to pass."

Jackie Sansbury, chief operating officer of acute services for NHS Lothian, said: "We have been very clear that good hand hygiene is an absolute priority in a ward environment. We have already put further measures in place to improve and audit hand hygiene and results show it has improved.

"We are pleased with the positive feedback from the Health Environment Inspectorate team report which confirms that St John's is performing well and that overall the standards of cleanliness is good."

Health Secretary Nicola Sturgeon, who visited St John's in June to see improvements in infection control, said: "There really is no excuse for staff failing to comply with hand hygiene procedures given it is recognised as one of the most effective ways of preventing the spread of infections in our hospitals.

"I know NHS Lothian will work with the inspectorate to ensure that all the issues raised are addressed as soon as possible and an action plan is already in place."