August 18, 2008

Checks Still Not Find Hospitals Clean Enough ; ‘Serious Concern on Threat of Infections’

By Madeleine Brindley Health Editor

FRESH concerns about cleanliness in some of Wales' largest hospitals have been raised by a health service watchdog.

The results of a series of unannounced spot checks at hospitals in Cardiff and North Wales will shake public confidence in the NHS' ability to prevent deadly hospital superbugs.

The Healthcare Inspectorate Wales raised serious concerns about the potential for infection at the nation's flagship hospital, the University Hospital of Wales.

And its two reports highlighted a number of areas where cleaning was described as "sub-optimal".

Despite the recent renewed focus on hand hygiene in the NHS, HIW also found instances where patients and staff were unable to wash their hands and empty hand gel dispensers.

The latest findings come less than a year after HIW and the Wales Audit Office criticised the NHS for failing to take the most basic steps, including hand washing, to prevent infections.

The spot checks, which were carried out in hospitals run by the newly-merged North Wales NHS Trust and Cardiff and Vale NHS Trust in June and July, found:

"Sub-optimal" cleanliness on a colorectal surgery ward at Ysbyty Glan Clwyd and a special medical ward at Wrexham Maelor Hospital which treats patients vulnerable to infection;

Dirty toilets, bed pans and commodes in use in Ysbyty Glan Clwyd;

Dusty high-level surfaces, radiators and light fittings in Cardiff and Vale NHS Trust hospitals;

Risk of infection from patients using communal toiletries;

I Empty hand gel dispensers at the University Hospital of Wales;

I Patient washbowls stored underneath beds on the medical rehabilitation and urology wards at UHW;

Staff in UHW and Llandough Hospital were found to be over- reliant on gloves, rather than washing their hands between patient contacts, and

There were no hand washing facilities in bathrooms on the elderly care ward at Llandough Hospital.

Health Minister Edwina Hart last night told both trusts they have until the end of the month to address the findings.

HIW started making unannounced spot checks of hospitals in Wales in 2006 amid growing public concerns about cleanliness and healthcare-acquired infections, such as MRSA and Clostridium difficile.

Although levels of healthcare-acquired infections are lower in Wales than England, it remains an area of significant concern to the public.

A spokesman for the Welsh Assembly Government said: "Trusts have been warned that unannounced spot checks will continue across Wales.

"The reports recognise that the trusts are working to improve cleanliness, reduce infection and de-clutter wards but say more needs to be done.

"The Health Minister expects the two trusts to consider the reports carefully and take appropriate action to address concerns.

"Our work to expand the role of hospital ward sisters and charge nurses to give them more power will help to improve ward cleanliness help to reduce infections."

Conservative Shadow Welsh Health Minister Jonathan Morgan said: "This is clearly going to shock the public once again at a time when public confidence in the ability of the NHS to keep hospitals clean is at an all-time low.

"The biggest concern people have is not the nature of treatment and recovery. It is whether a hospital is clean.

"This is basic levels of cleanliness that are falling down."

Mr Morgan, who has been touring hospitals in North Wales with party leader Nick Bourne, said he supported Health Minister Edwina Hart's tough stance and added that he feared some hospitals had become too big and unwieldy.

He said: "In North Wales, I visited community hospitals smaller than UHW but with a better team ethic because nurses had worked there for a long time.

"There was a real sense of teamwork and ownership. If you are working in a very large hospital, being moved from ward to ward, where is that ownership? Where is that teamwork?

"I suppose it is very easy for staff to ensure that cleanliness is someone else's problem."

Carol Lamyman-Jones, director of the Board of Community Health Councils in Wales, said: "CHCs across Wales were already aware of the issues raised in the HIW report. The public can be assured that we will continue our programme of visits and monitoring to ensure standards are improved."

Sue Gregory, Cardiff and Vale NHS Trust's nursing director, said: "We do everything possible to ensure hygiene and cleanliness are top priorities. This plays a significant role in our patient safety initiative which is well publicised amongst all staff. The trust welcomes the report by Healthcare Inspectorate Wales and accepts its findings. The trust is now considering those issues highlighted in the report and we are working together with our staff to ensure further enhanced standards in hygiene and cleanliness are implemented."

A spokesman for North Wales NHS Trust said: "Immediate action has been taken to improve cleanliness in those areas where problems were identified and staff are being reminded of the need to be thorough in their work.

"More rigorous local spot checks are also being introduced to ensure that the improved standards are maintained."

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