"Infection Prevention & Control Standards in Hospital."

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