Hospital ordered to tighten infection control after inspectors find blood on surgeons boots

The Healthcare Environment Inspectorate (HEI) said standards need to improve in order to reduce the risk of infection among patients and medical staff.

Officers witnessed surgeons with blood-contaminated boots in a corridor following a surgical procedure and dirty mop poles were not being decontaminated between procedures.

HEI has issued seven requirements which it says must be addressed "as a matter of priority".

Jacqui Macrae, head of quality of care at HEI, said: "Overall, our inspectors found that NHS Borders demonstrated varying compliance with the standards to protect patients, staff and visitors from the risk of acquiring an infection.

"Further improvement is required in a number of areas, particularly in relation to staff following standard infection control precautions.

"For example, staff should ensure that all equipment used for cleaning the theatre environment is cleaned following each use and is stored appropriately."

Inspectors at the 273-bed hospital assessed staff adherence to standard infection control precautions (SICPs), which include hand washing, equipment cleaning and the management of blood and body fluid spillages.

They witnessed theatre staff failing to clean their hands between tasks and not removing their facemasks and gloves when leaving the theatre.

Health Protection Scotland states that all PPE (personal protection equipment) should be removed and disposed of immediately after use and hands should be decontaminated after the completion of individual tasks.

Inspectors noted that mop poles in each theatre were "significantly" contaminated with blood and body fluids and were not being stored appropriately.

They said in the report: "We observed that the method used to mop the floor was not consistent and resulted in blood being smeared around a greater area than was originally contaminated.

"Nursing staff cleaning the floor had not been trained on how to correctly use the microfibre cleaning system. We raised our concerns with the senior management team during our inspection."

Evelyn Rodger, director of nursing and midwifery at NHS Borders, said: "Feedback from the inspectors indicated a number of instances where policies and procedures were not being correctly followed, in particular in relation to cleaning methods.

"In these instances our standards fell below those expected by our patients and staff, and I would like to stress that staff from theatres and beyond took immediate action to address the issues that were pointed out to us during the inspection, which is acknowledged within the report.

"All inspections are a snapshot of a point in time, and provide learning opportunities for us. As an organisation we responded immediately to the findings.

"Cleaning methods and documentation have been reviewed and a new training programme has been completed through which every member of staff has been assessed on their knowledge, understanding and practical skills in relation to the correct cleaning methods.

"We are committed to ensuring that our patients receive the best possible care and are confident that our theatres reflect that commitment. Our focus is to ensure that the improvements made after this inspection are sustained."

NHS Borders medical director Dr Sheena MacDonald said: "The main risk of poor standards of cleanliness would be an infection in a patient's wound resulting from surgery.

"We investigate every single instance of infection and identify and take action in order to continuously improve."

Dr David Love, consultant in anaesthesia and critical care and associate medical director in clinical governance and quality at NHS Borders, said: "I accept this report as an important contribution to our operating theatres continuous quality improvement programme.

"Whilst being disappointed with the findings, changes were immediately made, both to practice and training, and our continued vigilance and monitoring will provide assurance of sustained improvement."