A hospital has been using one of its public toilets as a sluice room due to lack of space, the first national audit of hygiene in acute hospitals has found.
The report of the audit, published yesterday, details a litany of failings by hospitals to meet required hygiene standards. It found many of the 54 hospitals inspected did not have hand-washing facilities that complied with current requirements.
"In a number of hospitals, some wards and departments were in desperate need of refurbishment; plasterwork was in a poor state of repair, paint was flaking on walls, skirting boards were badly damaged and there was evidence of damp penetration," the report said.
Inspectors also found a variety of cleaning equipment and materials in use across the country. In many hospitals, cleaning equipment was "outdated" or "inappropriate".
In most cases, materials to clean baths, showers and sinks after each patient's use were not readily available. The cleanliness of toilets and sinks was poor in many areas.
More than half of all bed frames were dusty or stained. In most areas, alcohol rubs were not available at the point of entry and exit to wards and departments.
Staff were observed offsite in uniforms, and theatre clothing was worn outside theatres.
Red cloths were provided by the catering department for use in kitchens in one hospital but this was the colour used by other staff in some hospitals for cleaning sanitary areas.
In some hospitals, the amount of technical support available in areas such as infection control, waste management, health and safety and cleaning services was limited, the report said.
More training was required in a number of areas, it said.
Furthermore, the authors said there was little evidence to confirm chemicals were being diluted correctly: "This can impact on the product effectiveness, cost and health and safety."
Overall, the audit found just 9 per cent of hospitals had a good standard of hygiene. In 43 per cent of hospitals, hygiene levels were fair and in almost half of all hospitals - 48 per cent of cases - hygiene standards were poor.
Hospitals were inspected during July and August and inspections were unannounced. The audit, conducted by UK company Desford Consultancy Limited, found levels of cleanliness varied between hospitals.
"In many cases, it was the attention to detail that was of concern. In some hospitals, space was at a premium and many wards and departments did not have adequate storage facilities."
The report said minor and major capital investment may be required in some hospitals to upgrade facilities to ensure they meet required hygiene standards.
Other findings included the fact that in many hospitals there was a lack of responsibility and accountability for waste management. Each hospital, it said, had developed its own approach to hygiene.
National standards are now being drawn up and the report recommends a senior manager at hospital-management-team level takes personal responsibility for the implementation of these standards.
A clean environment is key to reducing healthcare-associated infections, the report stressed.
The hospitals were inspected using guidelines drawn up by the Infection Control Nurses Association and each was given marks out of 100. The areas examined included the hospital environment, kitchens, handling of linen, waste management, safe handling of sharps, management of patient equipment and hand hygiene.
Hospitals were rated as having good hygiene levels if they scored 85 per cent or more overall. They were rated as fair if they achieved an overall score of 76 to 84 per cent, and poor if their overall score was 75 per cent or below.