Altnaglevin Hospital, Londonderry - 22 November 2011

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Picture 4: Ward 40 damaged frame of food service trolley There was a shortage of bed screens in Ward 40 and the ward sister informed the inspectors that it is difficult to find sufficient replacement curtains especially after patient discharge. Also the kitchen tray trolley was old, worn and very damaged; it should be replaced as it can not be effectively cleaned (Picture 4). In Wards 3, 8 and 40 the notice boards were finished in felt material which can not be effectively cleaned. Additional issue In Ward 40 the inspectors noted that the patient call bell was located at the opposite side to where the patient chairs were positioned, the cord of the call bell in use was not long enough to reach to the other side of the bed. 6.5 Information Cleaning schedules were available for nursing staff in all four wards, however they lacked detail in outlining staff roles and responsibilities for cleaning at ward level. Information posters on waste handling, linen segregation, NPSA colour coding of cleaning equipment and management of inoculation injury were not available consistently in all wards. In Ward 31 some of the posters in the clean utility room were old and torn. Information leaflets on MRSA and Clostridium-difficile were not available in Ward 8 or Ward 40, however the ward sister did say they could be printed from the internet as required. There were no hand hygiene posters at all of the hand washing sinks in either Ward 3 or 40 and Ward 40 did not have any advice leaflets on hand hygiene available. Not all the information posters which were displayed in Wards 3 and 40 were laminated and in Ward 40 some were attached to cupboards with adhesive tape. At the entrance to Ward 40, seven poster type pages had been attached to the door, some were not laminated, some were duplicated; the need for all these posters should be reviewed. Recommendations 1. The trust should ensure that the systems and processes in place for environmental cleaning, provide the necessary 16
assurance that cleaning is carried out effectively, and that all staff are aware of their responsibilities. 2. The healthcare environment should be repaired and maintained, and damaged fixtures and fittings replaced to maintain public confidence and to help reduce the risk of the spread of infection. 3. Work should continue on improving storage and maintaining clutter free environments. 4. Detailed nursing cleaning schedules should be developed. 5. The trust should ensure that all staff are aware of the importance of monitoring fridge temperatures. 6. An agreed set of core HealthCare Associated Infection (HCAI) public information leaflets should be available for patients, visitors, and staff. 17
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 Areas Inspected Ward 3 Ward
Page 7 and 8: Table 7 Hygiene Practices Ward 3 Wa
Page 9 and 10: 3.0 Inspections The DHSSPS has devi
Page 11 and 12: 5.0 Audit Tool The audit tool used
Page 13 and 14: 6.0 Environment STANDARD 2.0 GENERA
Page 15 and 16: also evidence of communal products
Page 17: Additional Issue In Ward 8 the lift
Page 21 and 22: potential airborne contamination. T
Page 23 and 24: The lift lobby in Ward 8 was being
Page 25 and 26: 9.0 Patient Equipment STANDARD 5.0
Page 27 and 28: 10.0 Hygiene Factors STANDARD 6.0 H
Page 29 and 30: Recommendations 13. The trust shoul
Page 31 and 32: Good practice was observed in effec
Page 33 and 34: 13.0 Summary of Recommendations 1.
Page 35 and 36: Reporting & Re-Audit Episode of Ins
Page 37 and 38: 16.0 Action Plan Reference number R
Page 39 and 40: Reference number damage Recommendat
Page 41 and 42: Reference number Recommendations 18

Altnaglevin Hospital, Londonderry - 22 November 2011

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