"Infection Prevention & Control Standards in Hospital."

About: University Hospital Wishaw / Accident & Emergency University Hospital Wishaw / Cardiology (Ward 4)

(as the patient),

I had an unexpected emergency admission to hospital in May 2020 and I spent 3 nights as an inpatient across 2 hospitals, ie Wishaw General and Hairmyers. I have to admit I was really scared going into any hospital but as I had suffered a heart attack I had absolutely no choice.

On the whole i noticed a bit of a step-up in relation to infection Prevention & Control practices in general but, in the short time I was an in-patient I witnessed several different events where the practices of medical staff would definitely have spread Covid-19 if it had been present in the wards.......and who knows really whether it was or not? 

The concerns relevant to Wishaw General are as follows:

No new patients were screened for Covid-19 on admission. I know this because I wasn’t and when I asked others they confirmed that they weren’t either. On admission to the A&E department I expressed my fear and I was told “Don’t worry, you’ll be fine, there’s no Covid in here” How do they know that if they weren’t checking new people coming in? To make sure I was as safe as possible I requested that I go into a side room.

There were clear notices up on walls in side rooms in A&E telling staff to remove PPE before leaving the room.......not once was this rule followed! And I’m not just talking about nurses, senior medical practitioners were just as bad! I find this very concerning. As a senior manager of a reputable Care at Home provider I teach Infection Prevention and Control procedures to Social Care staff and failure to follow Health Protection Scotland (HPS) guidelines on appropriate use, donning of and disposal of used PPE is considered a very serious risk to patient/client health and safety.........and then I find myself blatantly exposed to this same risk!

When in the Emergency Care Ward where visitors are not supposed to be allowed in I witnessed a relative of one patient being allowed in to set up their relative’s phone charger (I believe it was Grandparent/Grandchild) And not only this, but after the visitor was let in they discovered they had brought the wrong phone charger so went away and came back again with the correct one about 30 mins later! This in my opinion was irresponsible and totally unacceptable. I had been rushed into hospital by ambulance so had no opportunity to bring in any essentials I would need. My daughter drove 20 miles from her home to mine and then another 10 miles to Wishaw General to get me basic essentials and she had to hand these to a nurse at the main entrance ........ which is perfectly acceptable in the current climate; why I ask is a visitor allowed right into the ward with a phone charger? I actually overheard the patient asking their visitor how they managed to get in and they said they waved their work ID badge and no-one asked anything. I just hope that same visitor was not in contact with anyone Covid-19 positive as consideration for other patients in the ward was not evident........but then, where were the medical staff’s priorities either?

It’s all very well the DHSC putting out guidelines which are supposedly there to keep us all safe, but who is monitoring/policing any adherence (or otherwise) to these guidelines in any case? .... from what I have seen it looks like no-one is! It seems that as a patient I was the mercy of the standards and integrity of the person/s looking after me in the ward ..... scary!

As someone who takes Duty of Care very seriously I expect you not only to investigate my concerns but let me know what steps you will be putting in place to monitor practice! this is the very reason people like me, the general public, do not want to be anywhere near hospitals during the pandemic

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Responses

Response from Andy Pender, Senior Nurse, Emergency Medicine, University Hospital Wishaw, NHS Lanarkshire last month
Andy Pender
Senior Nurse, Emergency Medicine, University Hospital Wishaw,
NHS Lanarkshire
Submitted on 09/07/2020 at 11:01
Published on Care Opinion at 11:01


picture of Andy Pender

Dear Doods,

I am sorry to hear that you had an admission to the Hospital with a heart attack and understand the anxiety that you must have felt and especially during the corona virus pandemic.

I am also sorry that you have raised some concerns around staff not following infection control guidance and can provide you with a response to this.

In terms of the staff not complying with the removal of PPE after providing personal care, the PPE (water repellent face mask) that is being used within the department can be used for sessional use as recommended by Health Protection Scotland and would only be changed if became soiled or the health care practitioner felt it required to be changed. If staff are conducting basic nursing care then an apron and gloves should be worn and removed before exiting the room. If this did not happen then I would apologies. If an aerosol generated procedure is performed this would have been conducted within an isolation room and a higher level of PPE would then be worn and the PPE is removed inside the isolation room and the face fit mask removed on exiting the room. I would like to reassure you that we are monitoring the compliance of PPE use on a daily use in accordance with the Health Protection Scotland guidance. We will certainly share these concerns with all of the staff within the Emergency Department so that there is learning from your posting on care opinion.

The Senior Charge Nurse in her role and the staff have been monitoring the standard infection control precautions ( SICP ) compliance daily and weekly. This includes standards auditing of hand washing, PPE compliance, uniform policy and routine SICPs as per NHS Lanarkshire agreed monitoring programme. As the Senior Nurse I am visible on a daily basis within the clinical environment and am reassured that there is good compliance however I am disappointed to read your concerns and will raise this within the wider team.The Senior Charge Nurse in her role also monitors the overall environment to ensure infection prevention and control is paramount to maintain staff, patient and visitor safety.

Over and above the HEI monitoring programme and quality improvement work complete locally on the site there are regular unannounced Hospital Environmental Inspections visits within the Hospital and also from Health Improvement Scotland. The ED has had several of these unannounced inspections with positive reports in respect of compliance with infection prevention and control policies, processes and procedures. I hope this reassures you.

With regards to the relative you witnessed visiting a patient within the Emergency Care Unit (ECU), there are restrictions on visiting that have came from the Scottish Government, and there is NHS Lanarkshire Board guidance available for staff to manage this. I am unable to comment on other individual patients due to confidentiality and would be concerned if the visitor gained entry to the ward using her ID badge. Staff are aware that a risk assessment should be carried out prior to any visitor being allowed access to the ward, and I feel it is unlikely that the visitor came through the ward with no questions asked, and that an assessment had been done and this visit was deemed necessary for the patient and that visitor been identified as an essential visitor. I am sorry that your daughter was unable to visit and could only hand in essential items and glad that you agree and find that this is perfectly acceptable that this was the correct action based on your individual risk assessment and that the staff followed the visiting guide on the restrictions advised. We do appreciate how difficult this has been for families and loved ones and the staff have worked hard and continue to do so to make everyone a priority and make a decision based on their individual needs.

The Senior Charge Nurse has responsibility for the standards of care within each ward and all staff have a responsibility to follow and implement our infection prevention and control policy. This is monitored weekly through the standard infection control precaution programme and reported to the Senior Nurse and Chief Nurse at the hospital’s hygiene meeting. The staff have worked, and continue to work hard to protect all patients not only during this pandemic but also as part of their daily duties.

I hope that I have managed to address your concerns and reassure you that the team are monitoring standards on a daily basis and maintaining these standards to ensure we are keeping everyone safe. I would also apologise if you observed staff not following the HPS donning and doffing of PPE. Additional measures will be agreed with the Senior Charge Nurse to monitor this.

If there is anything that you feel I have not addressed then it may be helpful for you to speak with our patient affairs team by e mail on patientaffairs.wishaw@lanarkshire.scot.nhs.uk or via telephone 0n01698 361100 and ask for the patient affairs team.

Thank you for taking the time to post your experience on care opinion.

I hope that this finds you feeling better and recovering from your heart attack.

Best wishes

Andy

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