Room for improvement in Covid practices at BGH

A report published today by Healthcare Improvement Scotland, relating to an unannounced inspection visit to Borders General Hospital, stated two requirements for improvement in its Covid-19 practices.
The Borders General Hospital at Melrose.The Borders General Hospital at Melrose.
The Borders General Hospital at Melrose.

The inspection considered the factors that contribute to the risk of COVID-19 (or any other infections), and advised more secure storage of possibly-infected clinical waste and linen and “appropriate” wearing of PPE.

The inspection also found six areas of good practice within the hospital.

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Ian Smith, head of quality of care, Healthcare Improvement Scotland, said: “During this inspection, we found that the cleanliness of the environment was good and the majority of patient equipment was clean.

"In addition, Covid-19 information and guidance signage in the public areas was very good. Moreover, staff told us that they felt well supported during the pandemic.

“However, clinical waste and used or infectious linen must be stored securely and personal protective equipment must be worn appropriately by all staff.”

During the inspection, which took place between July 26 and 28, inspectors observed “staff of all disciplines not putting on and removing PPE correctly. This included staff not putting PPE on immediately before carrying out a task or removing it immediately after.”

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They also stated that in the corridors, “a number of clinical waste bins were unlocked and therefore clinical waste awaiting uplift was not stored securely”. This was raised on the first day of the inspection, but they were still unlocked on the second day.

Sarah Horan, director of nursing at NHS Borders said: “This inspection focused on Covid-19 and it is reassuring to know that staff are familiar with and are able to describe the systems we have in place to assess patients on admission for Covid-19.

"The past 18 months have seen constant change with new and updated processes being put in place in response to the pandemic, so there has been an awful lot for staff to learn and adopt as part of daily practice.

“I am also pleased that staff told the inspectors they felt well supported during the pandemic. The wellbeing of staff is of the highest priority for us and hearing this is encouraging. The pandemic is far from over, however, and we will continue to focus support on staff as they deal with significant ongoing challenges and pressures in a very busy healthcare system.

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“In some cases Inspectors observed staff wearing PPE when it was not required, and in a number of other instances it was either put on too early in advance of starting a procedure, or not taken off immediately after completing a procedure.

"This resulted in a requirement in relation to the appropriate use of personal protective equipment (PPE) and hand hygiene practices.

“We recognise that the practices observed by the inspectors could present an element of risk to patients and other staff and have addressed this through reminder communications and our regular programme of infection control spot checking procedures.

“Having to cease patient-centred visiting during the pandemic has been very difficult for everyone involved and it was reassuring that the inspectors found our processes in relation to reducing the risks to patients, staff and visitors to our wards to be robust.

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“I would like to thank the inspectors for their report. The feedback provided from inspections is always welcomed and we will use it to continually improve.

“I would also like to thank all our staff for their tireless and selfless work which continues during this incredibly challenging time. There were many areas of good practice acknowledged by the inspectors and this is a tribute to the hard work and dedication of our teams.”

At the time of the inspection, there was no outbreak of Covid-19 within the BGH, but this week a small outbreak was reported, and some patients had contracted the virus in the hospital.