NHS Highland has been ordered to improve the cleaning of theatre equipment at Raigmore Hospital in Inverness.
The Healthcare Environment Inspectorate (HEI) discovered contaminated equipment during unannounced inspections of the hospital in May.
Inspectors saw sections of theatre table mattresses placed on the floor after being washed and blood contamination on several tables that had been cleaned.
Two pieces of patient equipment were also found to be contaminated with blood, while others were either damaged or had tape or tape residue on them.
Damage was also found on some pressure-relieving mattresses and sections of theatre table mattress, while daily checklists were not up to date.
The inspection report said: "Damage, tape and tape residue on equipment means the surfaces cannot be cleaned effectively.
"NHS Highland must ensure that equipment used within the theatre department is free from damage, can be effectively cleaned and is appropriately stored."
Inspectors praised the hospital for the "good" standard of domestic cleanliness in the wards and main theatre department.
They also found good staff compliance with infection control precautions and hand hygiene.
But HEI said documentation of advice given by the infection prevention and control team at the hospital must be improved, and systems and processes used in the main theatre department should be implemented in all outlying theatres.
Interim director of quality assurance Claire Sweeney said: "In this inspection, which included wards and the theatre department, we found a number of areas of good practice.
"The standard of cleanliness in the wards and the theatre department was good and staff generally demonstrated good compliance with hand hygiene.
"However, we also identified some areas for improvement including that NHS Highland must ensure that all equipment in the theatres is in a good state of repair and can be cleaned.
"We expect NHS Highland to address these areas as a matter of priority and will continue to monitor the hospital."
Iona McGauran, lead nurse at Raigmore Hospital, said: "The inspection team highlighted a number of areas of good practice which included a good standard of cleanliness in the wards, departments and theatres, good staff compliance with infection prevention and control and the information displayed for patients.
"I am particularly pleased with the excellent feedback the inspection team received from our patients about their stay in hospital.
"Our theatre cleaning schedules have been updated and we are progressing some enhanced training in a number of areas including cleaning techniques in theatres."
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