Fleas, overcrowding and insufficient infection control at Hutt Hospital sounded alarms at the Ministry of Health.
During a routine inspection last year, auditors found that conditions in the hospital's maternity ward, mental health unit and children's ward were so concerning they were labelled "high risk" - and the hospital was given one month to starting fixing them.
Staffing shortages and a lack of bed space meant some areas were overcrowded and unsanitary, said a 2013 certification audit report released under the Official Information Act.
The ministry required the board to take 24 corrective actions after its audit in May last year. It was given between one and six months to address the issues.
Of high concern was the mental health unit Te Whare Ahuru, which is equipped for 26 patients. It was overcrowded and patients were forced to sleep in the telephone room, the lounge, or in beds on the general wards.
The children's ward was so crammed it was unsafe for sick children, without enough separation between patients and no room to isolate infectious kids.
In the maternity ward, a "risk register" showed problems dating back to 2009 had not been fixed. This included rips in the lino and carpet, and a recurring flea problem in the birthing area.
Staff shortages were also seen as a major issue, with an inadequate number of senior staff, and stressed nurses described as "bossy" by patients.
Despite the mental health unit being over capacity, staffing had not been increased.
In the children's ward, there were often only two nurses overnight looking after more than 20 patients.
The skill level in this ward was described as "inadequate", with too many junior nurses. This was also the case in the maternity ward, which was often short-staffed, and did not have enough senior midwives. On-call obstetricians often could not be contacted.
Hutt Valley District Health Board general manager of quality and risk Cate Tyrer said certification was a fundamental basis for improving quality.
The hospital had started a new risk-management system, which would see risks acted upon in a timely way.
The floor covering in the maternity unit had now been replaced, and a pest control regime implemented.
In response to concerns about staff shortages, she said "acute 24-hour hospitals will always have periods where demand fluctuates, and staffing needs to flex to accommodate this".
A TrendCare computer programme, which measured patient needs against nursing hours, had been introduced and was helping to balance nursing skills across the hospital.
Overcrowding issues in the paediatric unit referred to the configuration of beds, she said. At peak times, six beds would be put in a four-bed cubicle. A planned renovation before winter would allow for four beds per room.
Director of nursing for mental health Amber O'Callaghan said there was now a "full complement" of nursing staff in the mental health unit. She did not answer questions about overcrowding.
Similar concerns around infection risks at the children's ward at Wellington Hospital were raised by Ministry of Health auditors there last September.
At a Capital & Coast DHB meeting on Friday, infectious diseases specialist Tim Blackmore said both Wellington and Hutt hospitals were "just barely keeping up with demands" keeping children safe against infection.
The Ministry of Health did not respond to calls for comment.
- © Fairfax NZ News
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