Altnaglevin Hospital, Londonderry - 22 November 2011

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In Ward 40 at the entrance to the ward the bracket holding the alcohol dispenser was broken, not visible and was nearly empty. Also the brackets for holding the alcohol dispenser on the drugs trolleys were all broken. The inspectors were impressed with the new Infection Control stations located throughout the ward, however two of the alcohol dispensers were broken (Picture 5). Alcohol dispensers were not always available at the patients beds, at the point of care. Picture 5: Ward 40 Hand hygiene station Ward 3 and Ward 40 were fully compliant with regard to the availability of personal protective equipment (PPE). In Ward 31, disposable gloves and aprons and in Ward 8 disposable gloves, were available from a dispenser in the dirty utility room. The infection prevention and control staff confirmed at the feed back session that due to a risk of contamination, PPE should not be stored in this room. In all four wards inspectors founds instances of cleaning chemicals or disinfectants not being held under locked conditions in line with Control of Substances Hazardous to Health (COSHH) regulations. In Wards 3 and 40 nursing staff were not sure of the correct dilution rates for Actichlor Plus, and in Ward 31 detergent wipes were not available on patient testing equipment trolleys. In Ward 8 the bedpan washer was out of order, when questioned nursing staff gave varying answers on how to manually clean bed pans. Staff were also unsure of the correction solutions in use for general cleaning. The cleaning trolley in Ward 8 was old, worn and required cleaning. A red mop and bucket with dirty water was observed in the domestic store and an un-bagged dirty mop head was on the floor. The static mop in both Wards 8 and Ward 40 was dirty and clogged with dust. In Ward 40 there were no yellow mops or mop buckets available for cleaning in isolation areas. 26
Recommendations 13. The trust should ensure that consumables are clean and in a good state of repair. 14. Hand washing sinks in clinical areas should be accessible and comply with current guidelines. 15. The trust should ensure that all chemicals are stored under locked conditions in accordance with COSHH regulations. 16. Equipment used for the general cleaning of a ward should be available, clean, fit for purpose and stored appropriately. 17. Systems and processes should be in place to assure that staff knowledge and practice is kept up to date regarding the cleaning and disinfectant process. 27
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 and 18: Additional Issue In Ward 8 the lift
Page 19 and 20: assurance that cleaning is carried
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: 10.0 Hygiene Factors STANDARD 6.0 H
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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