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Caithness General Hospital Reducing Infection Risks

15th August 2010

Staff at Caithness General Hospital have made good progess in their efforts to reduce the risk of infection among patients, visitors and staff, according to a report published today.

The Healthcare Environment Inspectorate report, published today, states that NHS Highland is complying with the majority of measures to reduce infection rates. Inspectors found that the overall standard of cleanliness was high, the infection control nurse was well-informed and that communication with staff was good.

The inspectors did, however, identify areas for improvement:
Ensure all medical staff receive regular training in antimicrobial prescribing
Implement a stock rotation system and a system to monitor items used in emergency care
Review cleaning schedule and ensure a consistent approach to recording cleaning across the hospital.

Health Secretary Nicola Sturgeon said:"I have made tackling hospital infections my top priority so I am pleased to learn that Caithness General Hospital has implemented measures to reduce the risk of infection.

"There are, however, areas for improvement and I know that NHS Highland has put in place an improvement plan to address these concerns. The health board will now work with the inspectorate to reinforce public confidence."

The Healthcare Environment Inspectorate operates independently of the Scottish Government and the NHS boards it inspects. It carries out both planned and unannounced inspections of hospitals. For administrative purposes, it is based within NHS Quality Improvement Scotland.

The inspection at Caithness General Hospital took place on July 8 and 9.

The Healthcare Environment Inspectorate (HEI) today (Monday) published its report relating to an inspection visit to Caithness General Hospital on Thursday 8th and Friday 9th July.

HEI has been set up to help reduce healthcare associated infection risk to patients through a rigorous inspection framework. The HEI inspection team examined NHS Highland's self-assessment information and then inspected the hospital to validate this information, meet patients and staff, and visit wards and departments.

During the visit, the inspection team also assessed the hospital's physical environment for issues related to healthcare associated infection. The findings from the visit are set out below, and cover 4 requirements (which are linked to compliance with NHS Quality Improvement Scotland healthcare associated infection standards) that NHS Highland is fully expected to address, plus 4 recommendations for improvement.

The full HEI inspection report and an improvement action plan developed by NHS Highland to address the identified issues are available to view at http://www.nhsqis.org/nhsqis/7870.html

Speaking of the report, Susan Brimelow, HEI Chief Inspector, said: "We found that NHS Highland is complying with the majority of NHS QIS HAI standards to protect patients, staff and visitors from the risk of acquiring an infection within Caithness General Hospital. The overall standard of cleanliness within the hospital is good and the majority of the wards inspected were visibly clean. Environmental audits are being carried out, action plans produced and senior charge nurses have a good awareness of the audit results for their ward area. However, we did find that further improvement is required in some areas including the standard of cleanliness within the maternity ward and the sharing of feedback from public representatives involved across NHS Highland's public involvement programme."

Requirements

1. NHS Highland is required to identify a final timescale to establish formal operational arrangements for the infection control manager across the NHS board area to ensure full compliance with Health Department Letter (2005)8.

This will ensure that the infection control manager has overall responsibility for infection prevention and control.

2. NHS Highland is required to ensure that there is effective two-way communication between the infection control manager and the infection control team at Caithness General Hospital. This will ensure that there is effective communication in relation to infection prevention and control.

3. NHS Highland is required to review its procedure for the dissemination of patient information. This will ensure that patients are receiving appropriate information regarding infection prevention and control and healthcare associated infections.

4. NHS Highland is required to identify a timescale to implement its education strategy to ensure that the policy is inclusive of all staff and includes provision for mandatory update training for all staff in the prevention and control of infection.

This will ensure that all staff regularly receive the necessary update knowledge and skills essential to deliver the highest possible quality of patient care in relation to infection prevention and control.

Recommendations

1. It is recommended that NHS Highland continues to progress the results of the antimicrobial training review to ensure that all medical staff working at Caithness General Hospital receive regular training in antimicrobial prescribing.

2. It is recommended that NHS Highland implement an effective stock rotation system in the maternity unit. In addition, that a system is put in place to monitor the items used on the emergency care stations.

3. It is recommended that NHS Highland reviews the cleaning schedule documentation in place to ensure that there is a consistent approach to the recording of cleaning across the hospital site.

4. It is recommended that NHS Highland has an effective system in place to allow public representatives and local engagement structures to feedback and share relevant information.