Six months after being ordered to clean up its act, NHS Lothian has been further criticised for poor cleanliness at Edinburgh Royal Infirmary.
The health board was given a warning following a visit by the Healthcare Environment Inspectorate six months ago.
But basic hygiene standards at the teaching hospital were described as ‘very poor’ in a follow-up report.
Inspectors found blood contamination on a bed rail and bed frame, the door to an isolation room left open, and half of the mattresses checked were contaminated and had to be removed.
They said that while there had been improvements since an inspection in May, further action was needed.
“We saw a large number of instances where medical students did not wash their hands before or after contact with the patients,” the report states.
NHS Lothian has been told to ensure that staff comply with standard infection control precautions relating specifically to hand hygiene and the management of any sharp instruments.
Fiona Cameron, head of infection prevention and control at NHS Lothian, said: "It is positive to note an improvement in the standard of environmental cleanliness.
"We are addressing the remaining requirements as a matter of priority.
"We have now received 200 new mattresses to support replacement across the site. We are also continuing to reinforce our hand hygiene non-compliance policy."