Kids' ward 'at the end of the road'
A litany of hygiene concerns has been identified at Wellington Hospital - including waiting-room chairs declared an infection risk - with the children's ward among the worst areas.
An audit of Capital & Coast District Health Board found chairs in the hospital's waiting room and beds in the children's wards had "deteriorated" so badly that there were holes in the vinyl of both.
They were considered too ragged to clean to an acceptable infection control standard and have been flagged as a safety risk by the Ministry of Health.
Other dirty equipment included a birthing bath used at Kenepuru's maternity unit, and a thermometer used to test the water.
Ministry auditors spent 252 hours speaking to more than 90 staff and patients and sifting through medical records for the audit last September, which The Dominion Post obtained under the Official Information Act.
The health board was ordered to take 18 "corrective actions", with the children's ward singled out by ministry auditors as of particular concern.
The auditors said the ward was inadequate and they demanded to see improvements within three months.
Without a high-dependency unit, doctors placed child patients in order of illness severity. The mix of patients with respiratory and viral illnesses meant there was a high risk of cross infection, the auditors said.
And not all of the bed spaces had room for oxygen equipment vital for acutely sick kids.
Paediatric surgeon Brendon Bowkett, who has previously called for a separate children's hospital for the region, said the existing ward was totally insufficient. It did not even have air conditioning and since the rise in poverty-related diseases, including respiratory and skin infections, there was hardly room for the 5000 patients a year.
"This is the end of the road, basically. We need a new facility."
Auditors said the board was challenged by "fiscal constraints," particularly when it came to finding money for capital works - such as Kenepuru's new dialysis unit and youth mental health service.
The audit also revealed that a patient with the antibiotic-resistant superbug MRSA was allowed to mingle with other Wellington Hospital patients for 24 hours, despite a doctor documenting the risk and recommending isolation.
In 2009, Andrea Tabernacle, 30, died of multiple organ failure, toxic shock and leukaemia following a stem-cell transplant and after being infected with MRSA. A coronial investigation is under way after her mother, Rozalia Biczo, complained that Wellington Hospital staff did not do enough after she contracted the superbug.
District health board interim chief executive Debbie Chin said the board was pleased it had passed its certification audit, and would now be assessed on a three-yearly basis. The result showed it was serving 900,000 people in the central region well.
Furniture did not pose a "significant" infection risk, she said. It had already been scheduled for replacement in an internal review, and a health and safety officer would now assess all furniture every six months.
In the children's ward, there were enough outlets to provide oxygen therapy to children who needed it. Older facilities were built with fewer outlets, she said. A temporary spa bath was in use at Kenepuru Hospital until an alternative was put in place.
Medical and surgical patients had now been separated to reduce the risk of cross infection.
The incident with the MRSA patient was "regrettable and highly unusual", as monitoring for the superbug was constant.
WHAT THEY FOUND
Family violence screening was being carried out on only one out of every four children admitted, and not at all in the emergency department.
The journey through the hospital was confusing for some patients, with care plans not always followed. One cancer patient said it felt like they were being "kept in the dark". But auditors said there had been improvements in this area and "the care needs of the patients are predominantly met".
The emergency department, children's ward and main foyer could not be cleaned to the level required for proper hygiene to be maintained.
There were no safeguards on baths being used by sick children. "While there is an instruction notice to parents (to rinse and dry the bath) there is no process for ensuring the children's baths are cleaned between uses to an infection control standard".
Staff were friendly, respectful and competent, and staffing levels were good. The women's health service showed continuous improvement.
The Dominion Post