The Queen Elizabeth University Hospital and the Royal Hospital for Children have been positively recognised for progress in cleanliness and compliance with infection control measures following an unannounced visit from Healthcare Improvement Scotland (HIS).
The visit, which took place in November 2019, saw a group of external inspectors audit a number of areas and wards within the hospitals, and follows a previous visit in January 2019 which made a number of recommendations.
The report published today (Thursday 20 February 2020) demonstrates that key recommendations from the January 2019 visit have now been implemented, including the installation of negative pressure rooms, additional training and recruitment for domestic staff, removal of bladeless fans in high-risk areas, improvements to the cleaning schedule management and regular cleaning of ventilation panels.
The inspectors also visited the Institute of Neurosciences and identified some issues linked to the fabric and condition of the building. A plan is in development to invest in improved facilities for the Institute and new methods of working have allowed more time to be spent on cleaning than previously. A recruitment campaign is also being implemented to increase overall staffing levels.
The report further highlights an overall strong awareness and compliance among staff of standard infection control precautions, alongside a positive and consistent approach to infection control communication and management between infection control representatives, senior charge nurses and facilities teams.
As a result, all appropriate staff have an understanding of infection control measures and correct procedures in line with national guidelines which are consistently being followed to ensure the hospital environment meets agreed standards.
Patients surveyed on the wards also responded to inspectors with positive feedback, highlighting the cleanliness of wards and equipment.
Professor Marion Bain, Director of Infection Prevention and Control, NHS Greater Glasgow and Clyde, said: “Prevention and control of infection remains a top priority for NHSGGC. The latest inspection demonstrates the QEUH and the Royal Hospital for Children are meeting national requirements in relation to infection control and cleanliness standards. In particular, I would like to thank all staff involved as the progress made is a testament to their hard work.
“I am very pleased to receive this positive report, however, we are absolutely determined to ensure we continue to improve the service for the benefit of patients, and will continue to work with HIS to implement any further recommendations.”
The full report can be viewed here
ENDS
Recommendations from January 2019 visit, and corresponding observations from November 2019.
Leadership in prevention and control of infection
Recommendations from January 2019
Improvement in governance arrangements in estates and infection control required.
November 2019 inspection findings
- New accountability framework created outlining aims and objectives of infection prevention and control team, risk management, surveillance reporting and governance for reporting to board members.
- Regular meetings taking place to ensure NHSGGC complies with legislation, policy and guidance, best practice for management of the built environment.
- Restructure of facilities and estates teams and ongoing recruitment to provide more supervisory support for staff.
- Training conducted to ensure National Cleaning Services Specification is effectively delivered.
Infection control policies, procedures, and guidance
Recommendations from January 2019
Functioning negative pressure rooms must be made available.
Action taken
Inspection observed negative pressure rooms have now been installed and are operational and training had been provided to staff. Pressures within the rooms were routinely recorded and any deviance outside the correct pressure range identified, appropriate measures are taken.
All appropriate staff informed of roles and responsibilities in running of water alongside accurate record keeping to be implemented.
Action taken
All staff surveyed clearly aware of role responsibilities and regular flushing carried out at least once a week. Accurate records evidenced work being carried out.
NHS Greater Glasgow and Clyde must ensure all clinical areas across comply with the current national guidance in relation to the use of bladeless fans.
Action taken
No bladeless fans in use in high-risk areas and additional local risk assessment policy in place for use of cooling fans.
NHS Greater Glasgow and Clyde must ensure that information on the expressed breast milk recording charts is in line with national guidance. This will ensure that the storage of expressed breast milk is managed in a way that reduces the risk to patients.
Action taken
Majority of wards visited using appropriate charts to record storage temperature. All wards recordings within accepted temperature range.
Decontamination
Recommendations from January 2019
NHS Greater Glasgow and Clyde must develop a strategy that ensures the environment in the emergency department is clean and patient equipment is clean and ready for use. This will ensure infection prevention and control can be maintained.
Action taken
Noticeable improvement in the standard of environmental cleaning in the emergency department and initial assessment unit. The domestic resource in the department has been increased throughout the day and also to provide 24-hour cover.
NHS Greater Glasgow and Clyde must ensure that domestic supervisors sign off domestic cleaning schedules as complete with evidence and satisfaction that the domestic cleaning has been complete is detailed within the cleaning schedule.
Action taken
- Cleaning schedules for patient rooms and equipment within rooms identified.
- Completed schedules provide senior charge nurses with assurance equipment is clean.
NHS Greater Glasgow and Clyde must ensure domestic staff have the necessary equipment to perform their cleaning duties to keep the environment clean and safe.
Action taken
All staff surveyed highlighted good knowledge of equipment stores and cleaning duties.
NHS Greater Glasgow and Clyde must provide staff with suitable and functioning domestic services rooms to minimise the risk of cross contamination from the disposal of soiled water after the cleaning regime.
Action taken
In the majority of areas inspected, storage areas and domestic services rooms were clean, uncluttered, well organised and equipment was stored appropriately to allow effective cleaning of the environment.
NHS Greater Glasgow and Clyde’s senior management must ensure all staff are aware of the correct method for cleaning hand wash basins, and the correct cleaning products are used to clean all sanitary fittings in line with current national guidance.
Action taken
During inspection, all domestic staff we spoke with told were able to explain the correct process and product for cleaning hand wash basins.
NHS Greater Glasgow and Clyde must ensure that the built environment is effectively monitored to ensure it is maintained to allow effective cleaning to ensure effective infection prevention and control.
Action taken
- NHSGGC has worked with domestic cleaning provider to ensure compliance for Langland building. New programme of training in place, and nurses in charge reportedly satisfied with current level of domestic cleaning.
- Staff told inspectors domestic service is now more receptive to departments needs and that there are systems in place to ensure that the domestic staff can access all areas that require cleaning.
- Extra staff recruited to ensure flexibility of domestic cover.
NHS Greater Glasgow and Clyde must ensure the estates reporting system is reliable and effective and acted on. Staff should also be informed of timescales for completion.
Action taken
Improved communication between ward staff and estates team. Majority of estates jobs completed within reasonable timeframe. Outstanding jobs discussed at daily huddle.
Additional dedicated responsibilities for certain areas in hospital given to facilities managers. Escalation plans in place for staff to raise issues regarding work not done within timeframe.
NHS Greater Glasgow and Clyde must ensure ventilation panels are clean and free from dust.
Action taken
Vents dust free and cleaned as part of programme of works.
Last Updated: 26 June 2020