Royal Victoria Hospital, Belfast - 17 July 2012 - Regulation and ...

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6.0 Environment STANDARD 2.0 GENERAL ENVIRONMENT Cleanliness and state of repair of public areas; cleanliness and state of repair of ward/department infrastructure; cleanliness and state of repair of patient bed area; cleanliness and state of repair of toilets, bathrooms and washrooms; cleanliness and state of repair of ward/department facilities; availability and cleanliness of isolation facilities; provision of information for staff, patients and visitors. Environment 4C 5A 6A 7B Reception N/A N/A 70 N/A Corridors, stairs lift 88 83 81 95 Public toilets 86 N/A 84 N/A Ward/department – general (communal) 90 72 79 80 Patient bed area 83 72 84 77 Bathroom/washroom 87 65 79 94 Toilet N/A N/A 87 79 Clinical room/treatment room 66 50 96 74 Clean utility room 85 59 76 80 Dirty utility room 86 71 75 73 Domestic store 73 64 81 79 Kitchen N/A 57 78 67 Equipment store 67 80 81 81 Isolation 76 86 79 73 General information 60 85 81 85 Total 80 70 81 80 The above table outlines the findings in relation to the general environment of the facilities inspected where none of the wards achieved compliance in this standard. The findings indicate that there were areas for improvement in all wards, notably Ward 5A, where clutter, the poor repair and cleaning of the fabric of the building, fixtures and fittings have contributed to the minimally compliant areas highlighted in red. The findings in respect of the general environment are detailed in the following sections. 6.1 Cleaning At the time of the inspection there was evidence in some areas to indicate compliance with regional specifications for cleaning. However, the inspectors observed that while cleaning mechanisms were in place to prevent the build up of dust, debris and bacteria and subsequently 10
educe the potential risk for the transmission of infection, they were not always implemented or adhered to. Ward 5A was minimally compliant for the majority of criteria within this standard with an overall minimally compliant score. A concentrated effort is required by staff in all wards to improve cleaning practice. In the main reception area, walls and flooring were stained, the edges of the stairs and ceiling air vents had a build up of dust, external windows were smeared, public telephones were dirty and had paper labels attached to the wall mounted frame. Dust was also noted on the plants, the wooden panelling housing the plants and on the window sill and in the radiator cover of the public toilet. Similar issues were noted in the public toilet of Ward 4C where the vinyl flooring was grubby, the air vent was dusty and the door was stained. In the corridors leading to Wards 4C, 5A and 7B green algae was present on some window panels and cobwebs were observed in the lobby outside Wards 6A and 5A. Greater attention to detail when cleaning window sills, external windows, stained flooring, corners and edges of flooring was required in the lobby of Ward 6A. Similarly, in Ward 5A, the lift doors and ceiling tiles were stained, sticky hand marks were noted on windows and sticky adhesive residue on the public telephone. In all wards inspected greater attention to detail was required when cleaning, to ensure dust, debris and stains are removed from all high and low horizontal surfaces, such as skirting, radiators, walls and flooring. The interior and exterior of high density shelving, windows, lights and vents, all fixtures and fittings, including sanitary, dirty utility and disposal areas required attention. Inspectors observed that adhesive tape was used to attach labels or posters to surfaces which in some instances had left a sticky residue, impeding the cleaning process. Lime scale was observed on taps. Particular care is required to ensure that lime scale is removed from taps and fittings as recent evidence has shown that lime scale may harbour biofilms and the build-up of lime scale can interfere with good cleaning and disinfection by masking and protecting pathogens. In Wards 6A and 7B shower chairs were stained, in Ward 5A, the inside and outside of the toilet bowl, the underneath of the toilet seat and the toilet brush and holder required cleaning. Wards 4C, 5A and 6A require further work to ensure that the inside/ outside of the drugs’ fridges and door touch points throughout the wards are clean. In Wards 4C, 5A and 7B temperature recordings were inconsistent and record sheets did not all provide evidence for 11
Page 1 and 2: RQIA Infection Prevention/Hygiene U
Page 3 and 4: 1.0 Inspection Summary An unannounc
Page 5 and 6: Table 1 Ward 4C 5A 6A 7B Environmen
Page 7 and 8: 2.0 Background Information to the I
Page 9 and 10: 4.0 Unannounced Inspection Process
Page 11: Level of Compliance Percentage scor
Page 15 and 16: Picture 1: Tidy mail box storage Pi
Page 17 and 18: In Wards 4C and 5A National Patient
Page 19 and 20: 7.0 Patient Linen STANDARD 3.0 PATI
Page 21 and 22: 8.0 Waste and Sharps STANDARD 4.0 W
Page 23 and 24: 13. The trust need to review staff
Page 25 and 26: Picture 5: Glucose monitor casing a
Page 27 and 28: tablets were decanted into an unlab
Page 29 and 30: dust in the isolation room would su
Page 31 and 32: 12.0 Key Personnel and Information
Page 33 and 34: 13.0 Summary of Recommendations 1.
Page 35 and 36: 14.0 Unannounced Inspection Flowcha
Page 37 and 38: 16.0 Action Plan Reference number R
Page 39 and 40: Reference number Recommendations De
Page 45: Reference number Recommendations De

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