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22 June 2015, 12:04 | Updated: 22 June 2015, 12:12
Birthing balls and a mattress in a hospital labour ward were contaminated with blood, inspectors have found.
A team from the Healthcare Environment Inspectorate also found that half the cot bed mattresses checked at Edinburgh Royal Infirmary were contaminated.
NHS Lothian has now been urged to make sure that "all patient equipment is clean and ready for use at all times''.
When inspectors made an unannounced visit to the hospital in April, they found that some of the reusable equipment inspected in some of the wards, and in the emergency department and labour ward, was ``dirty or contaminated''.
They said eight of the 29 mattresses checked were contaminated, including in both the emergency department and the labour ward, and three out of six cot mattresses checked were contaminated.
In the labour ward, three birthing balls, mattress covers and a mattress, as well as patient bed frames and stirrups, were contaminated with blood.
Inspectors also found that while hand hygiene was "generally good'' at the hospital this was not always the case in the emergency department.
The report revealed "poor hand hygiene practice among the ambulance staff, visiting medical staff (from other parts of the hospital) and nursing staff working there'', with staff seen "missing 18 out of 22 opportunities to perform hand hygiene following contact with the patient surroundings''.
To tackle the issue, NHS Lothian must ensure staff working in the emergency department comply with hand hygiene practices set out in Health Protection Scotland's National Infection Prevention and Control Manual.
Jacqui Macrae, head of quality of care at Healthcare Improvement Scotland, said: "Overall this was a good inspection and we found evidence that NHS Lothian is complying with the majority of standards to protect patients, staff and visitors from acquiring an infection. In particular, we saw staff following the majority of standard infection control precautions. We also found hand hygiene practice among staff groups was generally good in most wards we inspected.
"The exception was the emergency department where we found poor hand hygiene practice from staff. We expect NHS Lothian to address our requirements and recommendations at the earliest opportunity.''
Melanie Johnson, nurse director at NHS Lothian, said: "We welcome the report from the Healthcare Environment Inspectorate and we are pleased that some areas were singled out for individual praise, including good infection control management, combined with patient care and the general cleanliness of the hospital.
A total of 67 of the 70 patients interviewed by the inspection team also said they were pleased with the levels of cleaning in their wards.
"We recognise there are things that can be improved and they have been addressed as a matter of urgency, including the cleaning of patient equipment and ensuring that hand hygiene is improved by all staff in the emergency department.''