Ward clean but web and blood in toilet

A newly published report by the Regulation and Quality Improvement Authority (RQIA) arising from the inspection makes 12 recommendations for improvements at the Londonderry hospital.

RQIA paid an unannounced visit at the hospital on June 6 as part of its programme of infection prevention and hygiene inspection and whilst most of the areas inspected where compliant with its standards some issues were noted.

For example, the inspection team found that staff at Ward 2 were often placed under pressure because whilst the ward is funded for 18 beds, it can hold up to thirty patients.

“This has implications for staffing and staff confirmed that agency and bank staff are required at times to provide adequate staffing levels. At present there can be 10 consultants with their associated specialties treating or assessing patients admitted to the ward.

“At the feedback trust representatives confirmed that meetings had been held by the senior management team to address ward pressures,” the inspectors noted.

Inspectors also identified a number of areas of notable practice including the implementation of High Impact Intervention care bundles; good knowledge displayed by staff; good hand hygiene decontamination and PPE practices; and good practices in relation to the isolation of patients.

The report states that Ward 2 was compliant over all and in the environment standard, the non-compliant scores mainly reflected issues related to the age, condition and general wear and tear of the building.

The two environmental areas non compliant with RQIA standards were the public toilets and the equipment store.

In relation to the public toilet the inspectors noted that “there were cobwebs at the light fitting, the air vent was dusty, there was a blood stain on a toilet roll dispenser and excess toilet rolls were stored in the cubicles.”

The report states: “The inspectors acknowledge that the public toilet at the main reception has a high throughput of visitors but it reflects a worn and tired environment and is in poor repair.

In reference to the equipment store the report says “wall damage was noted in the equipment store where there were holes in the wall, which had not been filled in when furniture had been removed, and wall tile damage was noted in the dirty utility room.”

Following the inspection the RQIA made a series of 12 recommendations to the Western Trust (WHSCT).

It was recommended that the Trust ensure staff are aware of their responsibilities in making sure environmental cleaning is carried out effectively.

The RQIA also thinks greater attention is required to ensure lime scale is removed from fixtures and fittings and that the Trust should work on the repair and maintenance of ward and public environments and that it should replace damaged fixtures and fittings.

The trust should also ensure that the linen store is dust free, linen skips are in good repair and reusable linen bags are fit for purpose.

Waste and sharps policy should be monitored and individual staff have a collective responsibility to ensure that equipment is easily cleaned and in a good state of repair.

Furthermore the Trust was told to ensure that washer disinfectors reach satisfactory cleaning standards and to review the condition and appropriateness of the hand washing sinks and consumables in Ward 2 with a view to replacement or replenishment.

A systematic approach should be used for cleaning fixtures and fittings and equipment used for the general cleaning of the ward and appropriate eye and face protection should be available to ensure staff are protected from risks associated with contact from blood, body fluids, chemicals or contaminated items.

The RQIA also recommended that the trust should ensure staff receive instructions and training on the correct dilution rates for the disinfectant in use and that staff should be made aware of National Patient Safety Agency (NPSA) colour coding guidelines.

The RQIA inspection thanked staff at the Altnagelvin Hospital for their assistance during the inspection.