Shocking standards at ARI could lead to surge in deadly infections, warns expert

pennington hits out after damning report by inspectors reveals dirty toilets and poor cleanliness

By Stephen Christie

Published:

SMOKE FREE BUT NOT DIRT FREE: Aberdeen Royal Infirmary has been ordered to clean up its act by healthcare inspectors. Raymond Besant

Shocking standards of cleanliness at Aberdeen Royal Infirmary could lead to a surge in potentially deadly illnesses, a world leading scientist has warned.

Professor Hugh Pennington spoke after a damning report highlighted a number of concerns at the hospital, including “poor levels of cleanliness” and infection control.

Dirty toilet seats, stained shower trays, spillages on walls and dusty wards were just some of the failings found by health inspectors.

Prof Pennington, a bacteriologist based at Aberdeen University, said: “If things at ARI were not to improve dramatically and quickly there is a real risk of an increase in the rate of outbreaks of hospital-acquired infections.

“This is not rocket science – if a hospital follows the correct guidelines and procedures there is no reason why infection spread can’t be prevented.”

The Healthcare Environment Inspectorate (HEI) examined ARI’s accident and emergency department as well as wards 11, 14, 16 and 33 on October 13.

Inspectors found in one ward the ward manager did not know the current or historical rate of infection for the hospital superbug Clostridium difficile (C diff).

In the report, inspectors also raised concerns that basic infection control theory was not being applied in practice.

It said: “Inspectors observed patients who should be in isolation being treated in the middle of a general ward.”

During the inspection, a section of floor in ward 14 in an area caring for people with gastro-intestinal bleeding was being replaced while patients were in bed receiving treatment.

“This was creating dust and debris that was being trailed through the ward,” the report said. “It was clear to the inspection team that standard infection control procedures were not being implemented by all staff groups.”

There were also “numerous examples” of poor standards of cleaning in the hospital, inspectors found.

The report said: “Inspections on the ward revealed poor levels of cleanliness.

“Dust was found at both high level (curtain rails around beds) and low level (under beds and benches).

“Stains and spillages were found on walls and ceiling tiles. Bath/shower rooms were not clean, with shower trays stained and shelves left dusty.

“In addition, the underside of toilet seats were found to be dirty in some areas. Some areas could not be thoroughly cleaned as they were inappropriately used as storage space.”

One picture in the report showed a shower room being used to store commodes. Waste management at the hospital was also flagged up by inspectors.

“On one ward, it was found that inappropriate items were disposed of in the sharp bins and clinical waste bags,” they said.

“On another, there were no clinical waste bags and general refuse bags were in use throughout the ward. In another ward, only clinical waste bags were in use.

“Used blood transfusion bags were also found to be unsuitably stored in the sluice of one ward. On another, clear glass IV paracetamol bottles containing drug residue were found in an open cardboard box in the ward kitchen.”

Inspectors also found a lack of communication between managers and ward staff about controlling infections.

The report made nine requirements for NHS Grampian to improve procedures in relation to infection control and cleaning – including the “urgent review“ of cleaning duties – with a further six recommendations.

Prof Pennington said: “This is a very disappointing result for ARI and lessons don’t seem to have been learned, despite all the publicity on hospital bugs from politicians and health professionals.

“It’s very sad when increased publicity leads to poorer standards – this should be producing results if anything.

“People on infection control committees in hospitals should be regularly looking at documents or guidelines on hospital infections and their spread and make sure their own hospital does not get into that situation.

“One has to draw the conclusion that they have other things taking up their time rather than prevention of infection, which is quite wrong.”

Health Secretary Nicola Sturgeon called for urgent action to be taken at the hospital, which cares for patients across Tayside, Grampian and the Highlands.

She added: “I am disappointed that so much room for improvement has been identified at Aberdeen Royal Infirmary.

“Some of what the inspectorate has found is simply unacceptable.”

The health board said a “comprehensive action plan” involving clinical and non-clinical staff at all levels in the organisation and public representatives has now been drawn up.

A follow-up unannounced inspection on November 16 found that action was already being taken and many concerns had already been addressed.

NHS Grampian chief executive Richard Carey said: “We will work closely with the inspectorate in implementing their recommendations on improving our infection control measures, and report regularly to our board on progress. The public will quite rightly seek reassurance that the hospital is as safe as possible.

“We intend to provide that reassurance not through words but by our actions, so that when next an inspection is carried out the inspectorate will report full compliance.”