Healthcare Improvement Scotland arrived unannounced at the north-east’s flagship hospital last month, on a coronavirus-focused inspection.
In a report published this morning, the watchdog made three clear requirements of NHS Grampian to bring Covid safety up to the national level.
Those include ensuring testing is carried out following correct procedures, that the right cleaning materials are used to wash down equipment and that gloves are worn and removed as appropriate by staff to allow for regular handwashing.
But there were nine areas of good practice highlighted, which a health board spokeswoman said she hoped would “reassure the general public that the hospital is clean and safe.”
However, she admitted there “are always things we could do better”.
During the two day inspection on March 23 and 24, inspectors visited the emergency department and more than a dozen wards, used to treat patients with respiratory ailments, infections and kidney problems, as well the elderly and those in for all kinds of surgery.
Public and staff communal areas of the hospital were also looked at.
‘There are always things we could do better’ – inspectors find three failings at Aberdeen Royal Infirmary
And inspectors found patients on some wards were not being retested five days after their admission, in line with national guidance adopted by the north-east health board.
The team also found staff on some medium risk wards were using detergent wipes, rather than chlorine disinfectant products, to clean patient equipment – though on the whole, “the majority was visibly clean,”, inspectors said.
Outlining their concerns with hand hygiene, they wrote: “The majority of staff were compliant with hand hygiene and the use of PPE [personal protective equipment].
“However, we did observe some staff wearing gloves inappropriately which prevented them performing hand hygiene.
“PPE should only be used for individual care episodes or tasks and should be put on immediately before the tasks and removed immediately after.
“Also there were some minor issues with hand hygiene compliance during mealtime.”
Hopes good work highlighted will ‘reassure’ the public ARI is ‘clean and safe’.
However, the inspectors also highlighted nine areas of good work being done by hospital staff after a full year of the intense pressure of the pandemic.
Despite the very specific hygiene worries, the overall cleanliness of ARI, staff adherence to wearing surgical face masks at all times, and the routine cleaning of frequently touched surfaces was praised – as was the support laid on for staff, especially nurses.
NHS Grampian was also commended for placing staff to direct visitors upon entry to the hospital, having separate staff and patient entrances, and the work done with patients before their arrival – to ensure they made it to the right part of the health campus as quickly as possible to minimise transmission risk.
Action plan to address Covid report requirements
Bosses have already put together an action plan to address the concerns raised, with many of the steps outlined – including upping reminders and checks around testing, cleaning and hand hygiene – having been achieved in the last four weeks.
A spokeswoman for the health board said: “We welcome this report, which highlights how hard and how well staff are working across Aberdeen Royal Infirmary.
“Covid-19 has seen significant changes to the way we work; we hope this report reassures the general public that the hospital is clean and safe.
“Inspectors identified nine distinct examples of good practice during the inspection.
“These included separate entrances into the hospital for staff and the public, with staff on-hand to support visitors, a good standard of cleanliness, and the support available to nursing staff from hospital management and the infection prevention & control team.
“There are always things we could do better. This report contains three requirements and work is already underway to implement them.
“As part of the inspection process, we submitted a full action plan to Healthcare Improvement Scotland, and this is available to view here.”