Tuesday, 10 November 2009

Hospital Infection Control System Criticised

Susan Brimelow, Chief Inspector
Healthcare Environment Inspectorate

The Healthcare Environment Inspectorate, established in April, has made its first NHS board report. Results would probably be classed 'could do better' for Stirling Royal Infirmary, the hospital visited.

'Several areas of concern were noted in ward six, including dusty floors, the lack of a domestic waste bin in the patient toilets, cobwebs and a dirty toilet. The patient day room was being used to store equipment and the patient bathroom was being used as a staff toilet'.

I would be most concerned if I was responsible for ward six but it seeme there are no problems because the report states 'A panel of eight patients were happy with the hospital'.

The hospital was commended for using motion-activated recordings to prompt people entering wards to wash their hands.

I hope the facilities to wash hands are better than Ninewells Hospital in Dundee. They must be because, on my recent unexpected visits to Ninewells, at the main entrance a male voice roars 'please wash your hands before entering wards'. Great I thought, a massive improvement and much needed, as I walked what seemed a mile to find Ward 25. After long corridors, down stairs, more corridors I finally found the ward entrance door. Where was the basin to wash my hands? Inside I thought, so off I drifted through the door to report to the nurses station truly expecting a washbasin to be visible. Nothing. Oh, that's untrue - there were bottles of hand gel available on the ward corridors.

As some of my readers may know I contacted clostridium difficile a couple of years ago and I keep an eagle eye on the progress made in the prevention of this debilitating bug. Infections such as this are usually spread through poor hand washing, but I am now convinced the growth of this infection in recent times is due to people being falsely led to believe hand gels kill all infections. They do not. Only hot water and soap kills c.difficile and for surfaces bleach is recommended.

Ninewells will not be the only hospital to have hand-washing announcements but they have to provide washbasins, soap and paper towels for people both entering and leaving the hospital. The public ladies has been renovated recently and it's now half its size and reduced to three washbasins. There is usually quite a queue. Surely a washbasin or two situated inside each ward door wouldn't be too expensive to install - accompanied by the roar of the motion-activated male of course!

One good aspect of the new Healthcare Environment Inspectorate is that every acute hospital will receive at least one announced and one unannounced inspection within a three-year cycle. Why inspections have to be announced at all defeats me. Perhaps someone can explain the necessity.


JRB said...

Subrosa, for me the question is – Why do we need an external inspection agency?

Simply bring back the all powerful ‘matron’.
I can well remember the days when hospitals had a ‘matron’ who ruled with a rod of iron, and for whom cleanliness was next to godliness.
Cleaners were not contracted employees of some anonymous agency, but under the direct control of ‘matron’. The smell of Lysol hung thick in the air.
She may have struck fear in to all hospital staff, from student nurse to senior consultant, but cleanliness was never in question.

Clarinda said...

JRB - sadly Matron was of her time and cannot be brought back - NHS managementitis saw to that 20+ years ago.
I'm frequently embarrassed by the current grubby state of many hospitals compared to the Spartan state of hospital infrastucture and systems that I experienced throughout my training and professional experience up until the mid seventies.
In any case it was not just Matron, it was her Deputies, Assistants, Ward Sisters, Senior Staff Nurses, Clinical Nurse Tutors and an effective hospital based School of Nursing education system alongside a dedicated and robust permanent ward-based staff of domestic cleaners who all took personal responsibility and pride in their work. All of that was swept aside in the political impetus or excuse for modernisation(?) to put the tried and tested professional authority of doctors and nurses in a secondary position to 'management'.

I wonder how many nurses are loathe to request more 'elbow grease' from today's 'cleaners' in case they might be accused of bullying or harrassment?

Unless we encase patients and staff in silvered morph suits, dust will always be present as most of it is a physiological consequence of having skin!

Bring back soap and water for patients and surfaces as there is little point staff washing their hands while patients aren't washed or wash themselves on at least a thorough daily basis and open some windows to circulate fresh air!

No ad hoc clipboard wielding team of inspectors will make any real difference without the fundamental authority being given back to clinical Charge Nurses (not managers)to re-impose their personal authority to demand and obtain professional standards already demanded within their Code of Professional Practice and criteria of Registration and ultimately their legal 'Duty of Care'.

subrosa said...

Indeed John. Like Clarinda you're experience of hospitals will be greater than mine. Clarinda sees it from the staffing angle while we few it from a customer base.

subrosa said...

But will the tories do anything about it Clarinda?

I think I heard Nicola Sturgeon say some time ago she was bringing back matrons. Has it happened?

I must say outpatients at PRI was looking clean last week - just for the record.

Related Posts with Thumbnails