Investigation Reveals Lack of Hand Hygiene in C. diff Outbreak in Scotland

The Scotsman is reporting that Ninewells Hospital in Dundee, Scotland, has been criticized for a significant lack of hand hygiene and properly cleaned and sterilized medical equipment that may have played a role in a recent outbreak of Clostridium difficile. Reporter Lyndsay Moss writes that inspectors, "found poor compliance with hand hygiene rules, soiled equipment marked as clean and overfilled dirty linen bags. The Healthcare Environment Inspectorate (HEI) also highlighted concerns about a patient with MRSA who was being treated on a ward with other patients without specific equipment dedicated for that person's use."

The report also says that concerns about the hospital had been raised in previous reports, and that the country's health secretary Nicola Sturgeon has called for improvements to be made "as a matter of urgency."

Moss reports further, "Five patients died at Ninewells during an outbreak of C difficile in 2009. The cases are being looked at as part of the public inquiry into C difficile deaths at the Vale of Leven hospital in Alexandria, Dunbartonshire ...The inspectors at Ninewells, who visited areas including A&E and wards for children and the elderly, highlighted a number of areas of concern.The report said that they were 'not assured that all senior charge nurses were confident in local infection control standards of practice and policy.' They saw some staff not wearing aprons and gloves when changing bed linen. They also witnessed poor hand hygiene, with medical staff wearing long sleeves and a lack of provision of alcohol hand gel in some wards. There were overfilled dirty linen bags in several wards. During an inspection of one ward, the senior charge nurse informed the inspectors of a patient with MRSA on the ward. They were told a risk assessment had taken place that had resulted in the patient not being allocated a side room. Instead, the patient was placed in the bed next to the clinical hand-wash sink in a six-bedded area to ensure easy access to handwashing facilities. But the inspection team found the alcohol hand-gel bottle at that particular sink was empty."