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Care Opinion

Infection control concerns

Posted By bonanzaeq57

"Infection control concerns"

About: South West Acute Hospital / Emergency Care and Medicine Services

(as a service user),

I had a visit to A&E and was disappointed with the lack of infection control. Upon arrival, I positioned myself close to the exit of the waiting area, as far away from other patients as possible as I had my newborn baby with me and was conscious that I wanted to keep him as far away from potentially contagious harm as possible.

After waiting a couple of hours another patient came in and sat in the same row as us. This poor patient was very unwell and began to vomit on the floor of the waiting area. He was then called into triage and another lady in the waiting area let the reception know that there was sick on the floor that needed to be cleaned.

Shortly after a staff member came to clean the area with incontinence pads. I was shocked to see that they were cleaning this vomit with no mask, apron or even gloves on her as they wiped it up. To make matters worse, the vomit covered incontinence pads were then placed into the general waste bin in the waiting area rather than the bins which are for items containing bodily fluids.

Another staff member then arrived to ask if a cleaner was needed, to which the first nurse replied no, and that it was sorted. However, this area had not been disinfected and the smudges of the vomit could still be seen. As well as this, I think it is the duty of cleaners just to disinfect – not to handle bodily fluids. From what I could see from the waiting area no cleaner had been made aware that this happened and therefore wouldn’t have known to disinfect the area.

About half an hour later, a porter arrived at the waiting area with a bucket of some sort of cleaning product and began to clean the wheelchairs. I explained to this person what had happened and said that the area had not been disinfected. Hoping that they would maybe disinfect the area himself or else contact the necessary staff member to sort it out. However, instead they stared at me blankly before carrying on about their business (bizarre way to respond to a reasonable request from a patient).

I was then seen by the doctor and as I was leaving A&E through the waiting area I could see that the vomit was still smudged into the floor and had still not been disinfected. Disappointingly, there were a few elderly people now sitting in this infected area and had their handbags sitting on top of where the man had vomited. There was also a toddler crawling around the area within close proximity of where the vomit was.

I am aware that the clinical staff would have been very busy and I’m sure that they are lovely, however, in my opinion there is absolutely no excuse for not implementing basic infection control procedures. If it was felt that this was an appropriate way to clean a communal area, then I wouldn’t be confident that the same staff member felt the need to wash their hands before coming into contact with patients.

Another unrelated point that I feel the need to mention is that the breast-feeding room in the waiting area was locked for the entire 4 hours that I was there. It was not in use by anyone else, it was just locked. This would lead me to believe that this room has been given another use other than for actually breast feeding. Having been rushed to A&E, I was not wearing particularly breastfeeding friendly clothing and would have been very grateful for the use of this room rather than feeling quite exposed in a room full of strangers.

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Responses

Response from John Kerr, Emergency Nurse Practitioner SWAH ED, Acute Services Emergency Care, WHSCT 7 months ago
We are preparing to make a change
John Kerr
Emergency Nurse Practitioner SWAH ED, Acute Services Emergency Care,
WHSCT

assess and treat

Submitted on 12/09/2023 at 11:48
Published on Care Opinion at 11:51

Dear bonanzaeq57

Thank you for using care opinion to highlight a number of issues, in relation to a recent visit to our Emergency Department (ED). Upon reading, it appears our standards fell short of your expectations. I would like to address number of key points made by yourself.

Firstly it is not clear whether it is you or your baby was the patient. In line with the Royal College of Emergency Medicine, we have in place a separate assessment and waiting area for paediatrics, in order to reduce the risk of harm and exposure to both the child and the guardian. If your child was the patient, it appears that we have failed in our duty of care, and for that I would apologise.

As you rightly identified it is not the responsibility of the Domestic services to clean up bodily spills. Each case is risk assessed by the individual completing the task, and appropriate PPE worn accordingly. I will remind all staff about risk assessment process in clearing bodily fluids. On investigation within the waiting area, all bins are clearly identified with a label, for offensive waste usage. The bags within the bins, are black in colour with an orange stripe, the latter is not clearly identifiable. I agree this can be confusing. In respect of your complaint, it appears the staff member disposed of the incontinence pads appropriately.

On site, we have access to a domestic supervisor and I agree that this service should have been called upon to disinfect the affected area. I have made all staff aware of their duty in respect of infection control and the need to contact the appropriate service. My apologies if this caused offence.

I cannot comment on the porter service, and maybe someone from guest services will respond in due course.

Infection control training for all staff is mandatory every 2 years, with effective hand washing high on the agenda. I would like to assure you, that regular hand washing audits take place in the the department, by the infection control team.

Finally, in relation to the infant feed room being locked for the duration of your visit, I have fully investigated your concern. Unfortunately, due to storage constraints on the department during the Covid outbreak, the infant feed room was decommissioned, and used as PPE storage unit. As a department, in-line with Western Trust guidelines, we are still operating at a high level of alert and protection. This will continue to be used as a storage facility, unfortunately, until the level of alert has been reduced. I agree the sign of the door can be misleading, frustrating and confusing for all concerned. I have discussed with my line manager, who has alerted the estates department with a view to reviewing the signage on the room. I wish to note that a parenting room is available to use adjacent to the room in question.

I hope that this has answered some if not all of your points raised and does not distract you from using our facility when you are in need in the future.

I wish you well, kind regards

John Kerr

Emergency Nurse Practitioner ED

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Response from Michelle Scott, Patient Client Experience Lead, Primary Care and Older Person, Western Health and Social Care Trust 6 months ago
Michelle Scott
Patient Client Experience Lead, Primary Care and Older Person,
Western Health and Social Care Trust

I am the gatekeeper of Care Opinion and 10,000 voices quality improvement initiative for the Western Health and Social Care Trust

Submitted on 19/10/2023 at 14:55
Published on Care Opinion at 14:55

picture of Michelle Scott

Hello bonanzaeq57,

Thank you for taking the time to leave your story.

My name is Michelle Scott Patient Client Experience lead for the Western Trust.

Whilst I was happy to read that you witnessed a porter cleaning wheelchairs, I felt it necessary to seek a response in regards to the rest of your experience with portering services. I have liaised with the head porter of the hospital for his feedback. please see his response.

"Thank you for your feedback. I was disappointed to hear about the lack of engagement with the patient to offer assistance for that I am sorry and I will raise this at our next team meeting for reflection and learning. Portering staff complete infection control training and would know the procedure for reporting spills, again I am disappointed that this was not explained to the patient and reported to the necessary staff member"

I hope this response is useful and I would again like to thank you for leaving your story

kind regards

Michelle Scott

Patient Client Experience Lead

Ext 214486 (02871345171)

Mobile: 07833402847

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Response from John Kerr, Emergency Nurse Practitioner SWAH ED, Acute Services Emergency Care, WHSCT 5 months ago
We have made a change
John Kerr
Emergency Nurse Practitioner SWAH ED, Acute Services Emergency Care,
WHSCT

assess and treat

Submitted on 21/11/2023 at 10:08
Published on Care Opinion at 11:53

Hello bonanzaeq57,

Just an update regarding the infant feeding room, all the changes have been complete, the room has been painted and its original function is now fully operational.

Again I would like to thank you for bringing this to our attention and I am delighted changes were made to improve this service

kind regards

John

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