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Spanish Town Hospital - Outbreak reported in nursery

Published:Friday | November 6, 2015 | 12:00 AM
A section of Spanish Town Hospital
Entrance to the Spanish Town Hospital

Accident and Emergency Department

Handwashing guidelines are not being adhered to. Blood is taken without gloves and hands are not washed after removing gloves

- Cleaning materials are not labelled

- There is no documented cleaning schedule

- The cleaning methods do not conform to standards

- Job descriptions are to be prepared and given to all staff on recruitment

- Staff need to be made familiar with the mass-casualty plan, and the plan should be tested at least once per year

- Wheelchairs and stretchers are in short supply. Patients who are awaiting admission to the wards stay on the chairs and stretchers for extended periods

- Additional wheelchairs are needed in the department. A number of wheelchairs are defective, with no rubber on the wheels and no footrests

- Additional stretchers are needed in the department

- Sharps containers are inappropriate. Cardboard boxes and plastic bottles are used

- Patient bathrooms need to be upgraded. Seats and tank covers are missing in a few places. The staff toilet in the records department does not flush

- Orientation guidelines need to be prepared for clinical staff

- No logbooks are being used. Sheets of paper are used for triaging, and these are put in the patients' records. Therefore, no record remains in the department.

- A system is needed for the monitoring of the usage of drugs and supplies in order to prevent stock-outs


Neonatal Nursery

- On the day of the audit, a gram-negative organism outbreak was reported in the nursery and there was said to be an absence of the appropriate antibiotics required for the treatment of the babies

- The containers with the cleaning agents are not labelled

- The cleaning methods do not conform to standards, and schedules are not documented

- Makeshift sharps containers are being used. These present a risk to staff

- The storeroom has a number of non-functional pieces of equipment. These need to be removed so that the spare beds for the nursery can be stored there instead of in a space on the nursery ward

- Excess furniture in the clinical area hampers the proper cleaning of the floor

- Food and drugs are stored in the same refrigerator. This affects the cold-chain management of the drugs. A refrigerator is needed to store the food and drink belonging to staff

- Hand towels are in short supply, hence expensive gauze is being cut for hand-drying. This is penny wise and pound foolish


Operating Theatre Suite (Main)

- The tiles on the walls do not allow for adequate cleaning

- The operating room is crowded with boxes, supplies and unused equipment. These all hamper proper cleaning of the area

- The operating lights are dull in intensity

- There is 'fungus' growing between the panes of glass in the window of the operating room

- There is no documented cleaning schedule or documented evidence of monitoring of the cleaning activities

- The storage areas are without doors and are scattered in different areas of the operating suite

- The delineation of the access areas needs to be made clear. Infection control is being compromised

- The disposal of waste from the theatres requires an urgent review and reorganisation.

- Bins with dirty linen, etc., are left in the sluice room overnight and removed in the morning through the operating theatre

- The segregation of linen needs to be implemented. Soiled linen is put in the open bin with dry dirty linen and the correct colour-coded bags are necessary

- The expiry date is not affixed to the sterile packs. The date of sterilisation is used. This is not the policy

- The carbolic soap being used for hand-scrubbing needs to be removed if the antimicrobials are now to be used

- Material safety sheets for the disinfectants need to be made available to the staff

- Janitorial staff require training in the correct methods of cleaning and the materials and concentrations of chemicals to be used

- The mops being used are not of the required standard and the number of mops and buckets provided are inadequate

- The workload in the theatre is enough to warrant the assignment of a secretary or records officer