Inappropriate use of PPE gloves and a failure by some staff to social distance have been spotted by inspectors who visited Forth Valley Royal Hospital.
Healthcare Improvement Scotland this week published its report relating to an unannounced inspection visit to FVRH on February 2.
The inspectors visited accident and emergency, A11/A12 (short stay medical ward), A31 (general medicine /infectious diseases ward), B21 (stroke ward), B23 (orthopaedic ward) and B31 (respiratory/general medicine ward).
The otherwise positive report highlighted a number of areas of good practice including: the person-centred team providing a range of resources to support patients and their relatives; staff wearing surgical face masks at all times and being aware of when they should be changed; nursing staff felt very well supported by the infection control team during the pandemic; and staff being kept up to date.
However, the inspectors singled out two issues they wanted addressed.
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In their report, the inspectors said: “Hand hygiene and the use of PPE by staff was variable. We saw examples of gloves being worn inappropriately by various disciplines of staff, therefore hand hygiene was not always carried out. PPE should only be used for individual care episodes or tasks and should be put on immediately before the tasks and removed immediately after.
“For example, we saw: a nurse wearing the same gloves between patient rooms; medical, domestic staff and health care assistants wearing gloves in a ward corridor; and a domestic wearing gloves to vacuum and going between patient areas.”
They said while the layout of bay areas allowed for good bed spacing and the ability to physically distance between patients, staff did not always observe physical distancing where it was possible, such as at the staff base and around the patient’s record trolleys or at break times.
“In many public communal areas, there were two-metre floor markings in place to prompt physical distancing. However, this was not in place for the public toilets or signs to state how many people should be in the area at any one time.
“There were a number of seating areas within the main concourse. Chairs had been spaced to promote physical distancing, however, there was also a number of fixed seating throughout the hospital corridors that did not have signage or markers to promote physical distancing.
“Staff break rooms were busy at times when we visited and staff were not always physical distancing during their break. We were told that senior managers are undertaking some work to improve physical distancing, including spacing out staff break times, looking at potential new areas or utilising areas differently.”
Speaking of the report, Ian Smith, Head of Quality of Care, Healthcare Improvement Scotland, said: “During this inspection, we found that the hospital provided a range of resources to support patients and their relatives. We also found that staff were kept up to date and were well supported during the pandemic.
“However, protective gloves should be appropriately worn by all staff. In addition, staff must observe physical distancing in clinical and non-clinical areas where possible.”
Measures agreed between the inspectors and the health board in an improvement action plan include: communication of appropriate use of PPE at morning meetings; support and education to ward staff where appropriate on the appropriate use of PPE; senior charge nurses are to monitor PPE use in ward settings; communication to domestic staff (SERCO) of the appropriate use of PPE; and services leads are to remind their staff on the appropriate use of PPE.
Additional rest areas are also to be provided for staff to ensure social distancing is maintained and volunteer COVID “champions” are to be recruited to promote social distancing in non-clinical areas. The importance of social distancing within clinical areas is also to be reiterated.
An NHS Forth Valley spokesperson said: "We welcome the findings of the recent Health Improvement Scotland inspection at Forth Valley Royal Hospital as it reflects the hard work carried out across the organisation to maintain a safe environment for patients and staff.
"The inspectors found that the hospital provided a range of resources to support patients and their relatives and that staff were kept up-to-date and well supported during the pandemic.
"Over the past few weeks a number of additional measures have been introduced to help staff maintain a two-metre distance during break times. These include converting a coffee shop, which is currently closed, into a staff seating area and providing outdoor marquees with heating and lighting which staff can use during their breaks. The restaurant hours have also been extended so breaks can be staggered throughout the day and a greater range of take away food and lunches are available. Work is also underway to identify a number of physical distancing champions from our existing staff to help and advise colleagues.
"We continue to closely monitor the use of PPE across the hospital and ensure any issues identified are quickly addressed."
The full inspection report is available to view by clicking here.
