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

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and some lights did not work. An issue also observed in Ward 5A treatment room. Damaged fly screens and radiator covers, displaced or damaged ceiling tiles, split covers on pull cords and rusted shelving in the chemical cupboard of the domestic store contributed to the minimally compliant score achieved in Ward 5A for this standard. The drugs’ fridge was old, worn and damaged, an issue also identified in Ward 6A. In Ward 6A, wiring was exposed on a hand held call bell, wall trunking in the bays and the sealant at some hand washing sinks were damaged. Some caps used to cover mirror screws were missing resulting in rusted screw heads. 6.4 Fixtures and Fittings The fixtures, fittings and equipment in all wards were generally fit for purpose however common issues were identified for action. In Wards 4C, 5A and 6A, shower rail fittings were available but there was no curtain to protect patient’s privacy and dignity. The lack of bedpan drip trays and chipped bedrails were noted in Wards 5A, 6A and 7B, bedpan holders were overstocked in Ward 7B. Vertical blinds and wooden chairs were damaged in Wards 6A and 7B and there was no sign on the treatment door alerting the storage of oxygen cylinders. Pillows in Ward 7B did not have plastic protective covering, inspectors observed stained pillows. In Ward 6A the leaflet rack in the waiting area was badly damaged and the fabric covers on the seating benches were badly stained. At the feedback trust representatives confirmed these would be replaced. Also observed were damaged toilet seats and worn plugholes, the blue storage containers in the treatment room were worn and damaged. A mattress spot checked in Ward 4C was damaged, the undercarriage of a bed was broken and privacy curtains were not dated. Privacy curtains in Ward 5A required changing. 6.5 Information With the exception of Ward 6A, the trust’s new nursing cleaning schedules outlining responsibility, equipment and frequency of cleaning were not in place for staff to reference and document. Due to on-going refurbishment of the domestic store in Ward 6A, domestic cleaning schedules had been removed. Hand washing posters in Ward 4C demonstrated a 6 step procedure instead of the recommended 7 step, information leaflets on MRSA, Clostridium difficile, general infections or hand hygiene were not available, MRSA leaflets were also not available in Ward 7B. 14
In Wards 4C and 5A National Patient Safety Agency (NPSA) guidelines were not clearly displayed for nursing staff to reference and in Ward 6A there was no poster available on the segregation of linen. In all wards inspectors observed posters and labels which were not laminated and posters attached to surfaces with adhesive tape. 6.6 Additional Issues • User friendly information on hand hygiene and environmental cleanliness audits and evidence on care bundle performance (Picture 3) were not displayed in all wards, for example Wards 6A and 7B. Staff in Ward 6A confirmed that the notice board for displaying the information had been removed for the ongoing refurbishment. Picture 3: Notice board displaying audits, information and mandatory training dates • In Ward 6A the original linen store had been spit into a smaller linen store and a domestic sluice room. The sluice room was still under construction therefore staff were using the domestic store in Ward 6B to store equipment, material and supplies and the nursing sluice to empty buckets. Recommendations 1. The trust should work to improve, monitor and ensure that environmental cleaning is carried out effectively, that patient equipment is fit for purpose and that the environment is in a good state of repair. 2. The senior management within trust should ensure that all staff are aware of their roles and responsibilities in environmental cleaning. 3. The trust should work on the repair and maintenance of ward and public environments and to replace damaged fixtures and fittings. 15
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 and 12: Level of Compliance Percentage scor
Page 13 and 14: educe the potential risk for the tr
Page 15: Picture 1: Tidy mail box storage Pi
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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