By Aileen Murphy

The Erne Hospital in Enniskillen has been labelled 'dirty' in a recent report.

A patient suspected of having MRSA still being nursed in an open ward, nursing staff treating patients without wearing gloves, and dirty blood-stained bathrooms form the basis of a critical report into services provided at three wards in the Hospital.

They are carried in a Report compiled by the consumers' watchdog body, the Western Health and Social Services Council, and concentrated on the levels of cleanliness and infection control at three wards in the Erne, namely the Maternity Ward, Ward Nine (Elderly Medical), and in Ward 10 (Medical).

The Council members' Report identifies a number of worrying observations and is extremely critical of the cleanliness of the Erne, and lack-lustre attempts to control infection, in the hospital.

In the Maternity Ward, cleaners were observed working without disposable gloves. Council members witnessed cleaners, "going into patients' toilets with no gloves on. Only one had gloves on but they were not of the disposable type. After use, these were put on top of a cleaning trolley. This raised the question if these same gloves were to be used for the next cleaning job."

One cleaner was further noted coming from a side ward carrying a urine sample without wearing gloves. Tested urine samples were also observed sitting in an open container in a bathroom under a notice asking for the samples to be disposed if.

Used needles in an open sharps box were noted in the treatment room, and unused needles in the Maternity Ward were deemed to be, 'very accessible' .

In Ward 9, Elderly Medical, hygiene was again called into question. Council members recorded that one toilet was completely without hand-washing facilities, while other toilets did not have adequate posters advising about correct hand-washing techniques.

Council Members were informed there were patients with the superbug disease, MRSA being treated in side wards; however, worryingly, they were also informed 'there was one suspected MRSA case waiting to be confirmed, and they observed this patient was still being nursed on the main ward.

In Ward 10, there was similar criticism of hospital employees, as Council members noted: "Not once during the survey period was any member of staff observed washing their hands or using a sanitizer."

While no staff member was observed wearing 'stoned' jewellery, a number were wearing wristwatches. And one junior doctor was recorded as having his tie tucked into his shirt at mid-chest and he had his shirt sleeves folded up to his elbows.

The Report continues: "Staff (on Ward 10) were wearing aprons but were not using gloves at any time although there were boxes of gloves throughout the ward. One nurse was observed working with a patient taking blood. She was not wearing an apron or gloves and was moving between patients. She was not observed hand-washing or using the sanitizer."

Cleaners who were questioned about their role in the hospital indicated they would welcome training in the area of infection control. The Report quotes the cleaners: "They said they did not have enough time to do proper cleaning to their satisfaction and they don't have enough cleaning materials. They are told to use soap and water,

"Cleaners said they have been told not to use chemicals and only to use micro-fibre cloth which is 'great for dusting' but 'useless for cleaning'."

Evidences of appalling levels of hygiene were noted in all three wards surveyed.

Members noted showers areas which were 'dirty and clogged'. Members pinpointed further breeding grounds for infection, with the Report recording: "At the start of the visit, a blood stained sticking plaster was observed on the floor of the shower/room. There was also blood on the floor. The plaster and staining was still there at the end of the visit," the Report notes.

Time and time again standards in the Erne are criticised, with phrases including: 'old and shabby curtains'; 'shower very mouldy'; 'plug-hole blocked and full of 'sludge'; 'cracked mirror and very rusty around the edges'.

The Report explains this survey was 'unannounced', so staff had been given only one hour's notice before the Council members arrived to make their inspection. As a result, members entering Ward 10 observed: "hectic cleaning activity and tidying of one bay", and noted, "the sweepings collected from this floor seemed to be rather a lot."

Compounding the problems observed, the Council members further commented on a lack of staff training regarding cleanliness and infection control, and stated.

"It is difficult to understand why the infection control nurses are all based at the Tyrone County Hospital and none is based at the Erne. The Erne Hospital is virtually operating as the acute hospital for the two areas, with most of the higher risk patients being admitted there."

The Erne was commended for a large notice referring to infection control in the main corridor; however, it was explained, this was high above double doors and 'is only visible if the person chances to look up."

In conclusion, the 'watchdog' body said: "Much is made of the role visitors have to make in helping staff to control infection. It is concerning, therefore that staff appear to have some way to go in giving a lead in the basics, such as hand washing."

Responding to the critical report from the Health Council, the Western Area Trust confirmed that the Western Health and Social Services Council (WHSSC) recently undertook an unannounced 'Bug Watch' survey at the Trust's Erne and Tyrone County Hospital sites.

'The Trust has now received a copy of the Report and has since met with the chief officer of the WHSSC to discuss its findings.

"The Trust's lead in the management of Infection Control, Alan Corry-Finn, the Director of Primary Care and Older People's services with the Trust, has since developed an action plan and will be keeping the WHSSC closely informed on this issue."

ting in an open container in a bathroom under a notice asking for the samples to be disposed if.

Used needles in an open sharps box were noted in the treatment room, and unused needles in the Maternity Ward were deemed to be, 'very accessible' .

In Ward 9, Elderly Medical, hygiene was again called into question. Council members recorded that one toilet was completely without hand-washing facilities, while other toilets did not have adequate posters advising about correct hand-washing techniques.

Council Members were informed there were patients with the superbug disease, MRSA being treated in side wards; however, worryingly, they were also informed 'there was one suspected MRSA case waiting to be confirmed, and they observed this patient was still being nursed on the main ward.

In Ward 10, there was similar criticism of hospital employees, as Council members noted: "Not once during the survey period was any member of staff observed washing their hands or using a sanitizer."

While no staff member was observed wearing 'stoned' jewellery, a number were wearing wristwatches. And one junior doctor was recorded as having his tie tucked into his shirt at mid-chest and he had his shirt sleeves folded up to his elbows.

The Report continues: "Staff (on Ward 10) were wearing aprons but were not using gloves at any time although there were boxes of gloves throughout the ward. One nurse was observed working with a patient taking blood. She was not wearing an apron or gloves and was moving between patients. She was not observed hand-washing or using the sanitizer."

Cleaners who were questioned about their role in the hospital indicated they would welcome training in the area of infection control. The Report quotes the cleaners: "They said they did not have enough time to do proper cleaning to their satisfaction and they don't have enough cleaning materials. They are told to use soap and water,

"Cleaners said they have been told not to use chemicals and only to use micro-fibre cloth which is 'great for dusting' but 'useless for cleaning'."

Evidences of appalling levels of hygiene were noted in all three wards surveyed.

Members noted showers areas which were 'dirty and clogged'. Members pinpointed further breeding grounds for infection, with the Report recording: "At the start of the visit, a blood stained sticking plaster was observed on the floor of the shower/room. There was also blood on the floor. The plaster and staining was still there at the end of the visit," the Report notes.

Time and time again standards in the Erne are criticised, with phrases including: 'old and shabby curtains'; 'shower very mouldy'; 'plug-hole blocked and full of 'sludge'; 'cracked mirror and very rusty around the edges'.

The Report explains this survey was 'unannounced', so staff had been given only one hour's notice before the Council members arrived to make their inspection.

As a result, members entering Ward 10 observed: "hectic cleaning activity and tidying of one bay", and noted, "the sweepings collected from this floor seemed to be rather a lot."

Compounding the problems observed, the Council members further commented on a lack of staff training regarding cleanliness and infection control, and stated.

"It is difficult to understand why the infection control nurses are all based at the Tyrone County Hospital and none is based at the Erne. The Erne Hospital is virtually operating as the acute hospital for the two areas, with most of the higher risk patients being admitted there."

The Erne was commended for a large notice referring to infection control in the main corridor; however, it was explained, this was high above double doors and 'is only visible if the person chances to look up."

In conclusion, the 'watchdog' body said: "Much is made of the role visitors have to make in helping staff to control infection. It is concerning, therefore that staff appear to have some way to go in giving a lead in the basics, such as hand washing."

Responding to the critical report from the Health Council, the Western Area Trust confirmed that the Western Health and Social Services Council (WHSSC) recently undertook an unannounced 'Bug Watch' survey at the Trust's Erne and Tyrone County Hospital sites.

'The Trust has now received a copy of the Report and has since met with the chief officer of the WHSSC to discuss its findings.

"The Trust's lead in the management of Infection Control, Alan Corry-Finn, the Director of Primary Care and Older People's services with the Trust, has since developed an action plan and will be keeping the WHSSC closely informed on this issue."