The Gilbert Bain Hospital was given a clean bill of health following an unannounced inspection in August, with the investigation team finding only minor areas for improvement.
The Healthcare Environment Inspectorate team visited accident and emergency, maternity, the renal unit, Ronas ward, ward 1 (surgical) and ward 3 (medical), and found the hospital to be safe and clean with the environment well maintained.
The inspectors issued only three recommendations and two requirements – the latter were in the “minor” category and the hospital has nine months in which to implement them.
Compliance with a number of policies and procedures was good, including dress code and uniform policy, hand hygiene and sharps management. The hospital infection control manual was up to date and available online, as well as paper copies on wards.
Although there was good communication between staff groups, the first requirement was that NHS Shetland ensure effective communication between estates and ward staff. This will mean that ward and departmental staff are kept informed of ongoing maintenance issues that affect them.
The second requirement concerned communication with the public.Although healthcare information leaflets were available on wards and posters on hand washing were displayed throughout the hospital, none of the 10 patients spoken to by inspectors recalled receiving healthcare associated infection (HAI) information.
NHS Shetland was told to ensure HAI information is given to patients and visitors. A Coming to Hospital leaflet is currently being reviewed and will contain some HAI information.
The first of the three recommendations was that NHS Shetland should finalise its guidelines for antibiotic prescribing at the time of surgery as soon as possible.
In HEI’s previous inspection, the guidelines for administering antibiotics to adults undergoing surgery to prevent infection were being drafted. These guidelines were still in draft during this inspection. The NHS board said staff were using them, however.
The recommendation will ensure that staff are confident they have the most up-to-date guidance.
The second recommendation was that NHS Shetland should review its recording of catheter use to ensure good practice and ensure that they are changed every 72 hours, unless there is a clinical need not to.
The inspectors found the cleaning schedules were good in the hospital, but want formal arrangements to be put in place. At the time of inspection an informal communication book was used to pass information between different shifts about areas to be cleaned.
The third recommendation was for NHS Shetland to develop a formal process for communicating information between different shifts of domestic staff to ensure that cleaning schedules are fully implemented.
The inspectors were satisfied equipment for patient use, including drip stands, monitoring equipment and commodes, was clean.
They were also impressed that that there was good communication between different staff groups within the hospital.
NHS Shetland chief executive Ralph Roberts said: “I am pleased that we have received positive feedback from this inspection and that this provides independent confirmation of the infection control measures and good cleanliness and environment we have.
“This is to the credit of all our staff, patients and visitors for the actions they take to maintain the high standards we have at the Gilbert Bain Hospital. This also helps us to further improve our service and we will be responding quickly to the recommendations that have been made in this report.”