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

dust in the isolation room would suggest that cleaning was not being
carried out effectively on a daily basis, while in Ward 4C patients and
relatives were not provided with relevant information leaflets. A review
of the notes in Ward 6A identified that both the care pathway and the
infection, prevention and control assessment had not been completed.
To improve practice and knowledge in the effective cleaning at ward
level further effort is required in all wards inspected, and notably Ward
5A which was minimally compliant in this section. In Ward 5A
registered nursing staff did not routinely clean patient equipment
between use however nursing auxiliary staff did. Some nursing staff
questioned were unaware of the dilution rates for the disinfectant in use
for routine cleaning, none knew the dilution rate for cleaning blood and
body spillages and the NPSA (National Patient Safety Agency) colour
coded system for cleaning.
In Ward 4C there was little evidence to demonstrate patient equipment
was cleaned between use as detergent wipes were exposed and dry in
their canisters. Individual bottles of constituted disinfectant bottles
were not dated, NPSA colour coding guidelines were not available for
nursing staff and staff were unaware of the need for a decontamination
certificate for equipment needing repaired, serviced or maintained.
Staff in Wards 6A and 7B were unable to outline the correct procedure
for cleaning blood and body fluid spillage as they did not know the
correct disinfectant dilution rate. Data sheets for the disinfectant in use
were not available in Ward 6A and not all nursing staff were aware of
the NPSA colour coding system.
Inspectors observed that the trust has in general implemented the
concept of ‘bare below the elbow’ for staff delivering care. However, in
Ward 4C two members of staff did not comply with the policy, two
members of medical staff wore wrist watches, two members of staff
wore unsecured clothing. In Ward 5A medical staff were observed with
stethoscopes hanging around their necks, a student nurse in Ward 6A
wore false nails. These were removed before the end of the
inspection.
Designated staff changing facilities were not available for nursing and
domestic staff to change into and out of their uniform at work.
Recommendations
19. The trust and individual staff have a collective responsibility
to ensure that hand hygiene is carried out in line with WHO
guidance and that all PPE is used appropriately.
20. The trust and individual staff have a collective responsibility
to ensure that staff knowledge is kept up to date with regard
to isolation, cleaning and decontamination of equipment.
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