Dirty beds threatening infection control success

6-Feb-2014

Scottish watchdog warns dirty patient equipment is putting patients at risk

Dirty beds are the biggest infection threat facing hospitals in Scotland, according to a new report by the Healthcare Environment Inspectorate.

The document said that, while there had been a noticeable overall improvement in cleanliness within healthcare facilities north of the border, this progress was being undermined by basic failings in relation to the decontamination of patient equipment.

In particular, beds, mattresses and commodes, as well as the management of needles, waste and linen, are areas for concern, together with continuing problems with hand hygiene compliance among NHS staff.

In the four years since the HEI was established there has been a strong decline in both serious breaches and more general criticism, against a backdrop of an increasingly-tough regime which has seen the introduction of unannounced inspections.

This isn\'t hard to deal with and every patient should expect a clean bed when they arrive in hospital

Susan Brimelow, chief ¬inspector of HEI, said: "Overall, the public should be assured by our findings, which show that NHS Scotland continues to make good progress in raising standards of hospital cleanliness, hygiene and infection control.

"NHS boards are clearly taking our inspections seriously and when we do raise concerns with NHS boards we see from their action plans and our own follow-up inspections that this results in clear action to raise standards.

"However, it is vital that improvements are not just made as a short-term action following our inspections - they need to be sustained over time."

Commenting on concerns over the cleanliness of patient equipment, she added: “Too often inspectors find that patient equipment is not clean. Good examples exist in other healthcare systems where dedicated patient equipment teams and equipment stores ensure patient equipment is clean and ready for use.

"We will continue to work with every NHS board to continue to raise the bar and ensure that, together, we provide a safe and clean environment for patients at all times, and the awareness of snap inspections."

The facts and figures of the inspectorate\'s four years in operation suggest broad improvement, with serious issues raised being 172 in year one and 210 in year two, but falling dramatically to 110 in year three. The most recent year, 2012-13, saw a further fall to 104, but with more unannounced inspections, which it was felt made the overall picture more encouraging.

Ms Brimelow said improvements were welcome but that there was no need for some of the adverse findings, such as poor cleanliness of bedframes and mattresses. However, she denied the problems were caused by restrictions on NHS budgets.

NHS boards are clearly taking our inspections seriously and when we do raise concerns with NHS boards we see from their action plans and our own follow-up inspections that this results in clear action to raise standards

She said: "I don\'t think this is anything to do with funding. These are basic standards which I think patients should expect.

"This isn\'t hard to deal with and every patient should expect a clean bed when they arrive in hospital. That is why we need to look nationally at other systems."

Commenting on the report, Health Secretary, Alex Neil, added: "NHS Scotland has a robust scrutiny regime in place and I am confident that this system is continuing to drive improvement. It is encouraging that we are continuing to make good progress in raising standards of cleanliness in hospitals.

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"However, I share the inspectorate\'s disappointment that there are recurring areas where improvement is still required."

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