Glasgow & West Scotland

Yorkhill inspection finds breast milk stored incorrectly

Baby's bottle Image copyright Thinkstock

An inspection into Glasgow's Royal Hospital for Sick Children has found that expressed breast milk was stored at the wrong temperature.

The Healthcare Environment Inspectorate (HEI) report stated that milk was kept in temperatures of up to 7C on four wards.

NHS guidelines recommend expressed milk be refrigerated at between 2C and 4C.

NHS Greater Glasgow and Clyde (NHS GGC) said it was addressing the issues raised as a priority.

Inspectors also found improvements were needed to ensure patient equipment was clean and ready for use.

In total, three requirements and one recommendation were issued to Greater Glasgow and Clyde health board following the unannounced visit to the hospital in December 2014.

These included an urgent requirement that refrigerated expressed breast milk be stored appropriately and that documentation should reflect best practice, to reduce the risk to patients.

Further recommendations

The inspectors also issued a requirement that patient risk assessments be documented in patient healthcare records, where a decision to leave isolation room doors open had been taken.

Inspectors had found that patients with suspected or known infections were isolated appropriately, but that on one ward all seven isolation room doors had been left open.

However, medical staff explained that there can be occasions when the door needs to remain open for safety reasons, such as being able to hear a patient if the relatives are not in the room with their child.

Image copyright HEI report
Image caption While the hospital was praised for "appropriate handling of clinical waste", contamination was found on the underside of patient trolleys

The HEI also issued an urgent requirement that the health board should ensure all patient equipment is clean and ready for use, to reduce the risk of cross-infection to patients, staff and visitors.

Inspectors found that the majority of wards and departments inspected were clean and that there was good compliance with standard infection control precautions, such as hand hygiene.

But while they reported that the majority of patient equipment inspected was clean, some items were dusty, including the undercarriages of five out of six incubators in the neonatal intensive care unit.

In addition, two out of five patient trolleys and beds in the Schiehallion Unit were found to be contaminated.

'Improvements needed'

HEI senior inspector Alastair McGown said: "This inspection found evidence that the Royal Hospital for Sick Children is working towards complying with the majority of standards to protect patients, staff and visitors from acquiring an infection.

"We observed good staff compliance with hand-hygiene practices and found a high standard of environmental cleanliness across the wards and departments inspected.

"However, we did find that improvements are needed to ensure patient equipment is clean and ready for use, and to ensure that expressed breast milk is stored appropriately."

He added: "This inspection resulted in three requirements and one recommendation. NHS Greater Glasgow and Clyde must address these areas as a matter of priority. We will follow up these concerns at future inspections."

A previous inspection at the hospital at Yorkhill in November 2011 also resulted in three recommendations.

The Royal Hospital for Sick Children will be moving to a new building at the site of the old Southern General in Glasgow in a phased move starting in the late spring.

Rosslyn Crocket, NHS GGC's nursing director, said: "This report clearly shows that our staff are working together to comply with healthcare associated infection (HAI) standards and this was commented on positively by patients and relatives.

"We are also pleased that the report highlights the range of infection control and hand hygiene posters, signs and guidance displayed throughout the hospital, and the good working relationship between ward and domestic staff."

But she added: "We are disappointed that the report makes three requirements and one recommendation, and we are already addressing these as a priority.

"Whilst we already carry out risk assessments prior to making any decision to leave isolation room doors open for particularly young and vulnerable patients, we have reinforced with staff the need to always document this in case notes."

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