HospitalInspections.org

Based on observation, interview and policy and procedure review, the hospital failed to maintain a clean and safe physical environment in room number (#) 4, a patient examination room, in the Emergency Department (ED).

This deficient practice has the potential to affect all patients admitted to room # 4 during an ED evaluation/admission.

Findings include:

Tour of ED Room # 4 with Director Patient Care Services, Employee # 1; Maintenance Director, EI # 2; and Housekeeping Director, EI # 3 beginning at 10:40 AM on 10/8/2014:

1). The white colored ceramic hopper (a clinical sink that flushes and has no covering) had some rust stains at the water level. A mildew appearing blackish-gray substance was observed around the inner rim.

2). The white colored ceramic sink had several light beige colored stains. According to the Housekeeping Director, EI # 3, these areas have been scrubbed multiple times, but staff were unable to remove these stains. EI # 3 says the sink will be scrubbed today.

3). Area Below Sink: A brown substance (unable to identify substance) is noted on the wall below the sink.

4). The external pipes that connect the sink to a metal box (located on the floor to the right of the sink) are coated with dust. According to the Maintenance Director, EI # 2, the box is probably a trap. The box is rusted. EI # 1, Director Patient Care Services, asked the Maintenance Director if the box could be painted and he said, "Yes."

5). There is an air conditioning unit in the window. The vents of the unit are dusty.

6). The window blinds (located above air condition unit) are dusty.

7). Two pieces of heavy plastic covering the space between the outer edges of the unit and the window sill contain accordion looking folds. Black colored dirt/grime and dust were noted in the folds (easily removed by hand). This was verified by the Housekeeping Director, EI # 3.

8). A coating of dust was observed on the top of the tile ridge (around the room) where the wall tile meets the sheet rock. The dust was easily removed with the surveyor's finger.

9). The large overhead lamp (attached to the ceiling) was dusty.

10). Four fluorescent lights were mounted on the ceiling. Dead bugs and debris were observed in the light covers.

11) Two wall vents were observed to be dusty.

12). A metal cabinet located to the left of the stretcher was rusted.

13). A dark black substance was observed on the stretcher in the spaces located at the base where the side rail connects to the stretcher bed and on the bottom of the stretcher (above the front wheel areas).

14). Paint on the ceiling and the walls was peeling.


"Standard Procedure for Cleaning"
Obtained from Housekeeping Director, EI # 3, on 10/8/2014 at 1:00 PM. The document is not dated.

All assigned areas will be cleaned according to the following seven step procedure:

1. Empty and clean wastepaper baskets...Sanitize with germicidal solution...

2. High dust using a chemically treated high dist mop head that attracts and holds dust particles.

3. Damp wipe using a germicidal solution for furniture, window sills, low vents, and other low ledges. Spot clean and disinfect walls, doors and door knobs...Clean interior of windows...with a glass cleaning solution.

4. Dust mop floors using a chemically treated mop that attracts and holds dust particles.

5. Clean restrooms using a germicidal solution...

6. Damp mop floor using a germicidal solutions.

7. Arrange furniture and inspect work."

Staff began cleaning room # 4 after the tour on 10/8/14. The room was inspected during the onsite visit on 10/8/14 at 1:20 PM. Housekeeping staff was cleaning the a/c unit, vents, and accordion style filler on each side of the unit. It was markedly cleaner, but still required further work. The light covers had been cleaned and no debris was noted. The stains in the sink were still present, but were lighter in color and less noticeable. The wall area below the sink was clean and the plumbing pipes were dust free. Staff was continuing to work in the room to address the issues.

During an interview on 10/8/14 at 1:35 PM, the Director of Patient Care Services, EI # 1, stated she will work with the Housekeeping Director to develop cleaning checklists for housekeeping staff and a checklist for supervisory review.

Based on observation, interview and policy and procedure review, the hospital failed to maintain a clean and safe physical environment in room number (#) 4, a patient examination room, in the Emergency Department (ED).

This deficient practice has the potential to affect all patients admitted to room # 4 during an ED evaluation/admission.

Findings include:

Tour of ED Room # 4 with Director Patient Care Services, Employee # 1; Maintenance Director, EI # 2; and Housekeeping Director, EI # 3 beginning at 10:40 AM on 10/8/2014:

1). The white colored ceramic hopper (a clinical sink that flushes and has no covering) had some rust stains at the water level. A mildew appearing blackish-gray substance was observed around the inner rim.

2). The white colored ceramic sink had several light beige colored stains. According to the Housekeeping Director, EI # 3, these areas have been scrubbed multiple times, but staff were unable to remove these stains. EI # 3 says the sink will be scrubbed today.

3). Area Below Sink: A brown substance (unable to identify substance) is noted on the wall below the sink.

4). The external pipes that connect the sink to a metal box (located on the floor to the right of the sink) are coated with dust. According to the Maintenance Director, EI # 2, the box is probably a trap. The box is rusted. EI # 1, Director Patient Care Services, asked the Maintenance Director if the box could be painted and he said, "Yes."

5). There is an air conditioning unit in the window. The vents of the unit are dusty.

6). The window blinds (located above air condition unit) are dusty.

7). Two pieces of heavy plastic covering the space between the outer edges of the unit and the window sill contain accordion looking folds. Black colored dirt/grime and dust were noted in the folds (easily removed by hand). This was verified by the Housekeeping Director, EI # 3.

8). A coating of dust was observed on the top of the tile ridge (around the room) where the wall tile meets the sheet rock. The dust was easily removed with the surveyor's finger.

9). The large overhead lamp (attached to the ceiling) was dusty.

10). Four fluorescent lights were mounted on the ceiling. Dead bugs and debris were observed in the light covers.

11) Two wall vents were observed to be dusty.

12). A metal cabinet located to the left of the stretcher was rusted.

13). A dark black substance was observed on the stretcher in the spaces located at the base where the side rail connects to the stretcher bed and on the bottom of the stretcher (above the front wheel areas).

14). Paint on the ceiling and the walls was peeling.


"Standard Procedure for Cleaning"
Obtained from Housekeeping Director, EI # 3, on 10/8/2014 at 1:00 PM. The document is not dated.

All assigned areas will be cleaned according to the following seven step procedure:

1. Empty and clean wastepaper baskets...Sanitize with germicidal solution...

2. High dust using a chemically treated high dist mop head that attracts and holds dust particles.

3. Damp wipe using a germicidal solution for furniture, window sills, low vents, and other low ledges. Spot clean and disinfect walls, doors and door knobs...Clean interior of windows...with a glass cleaning solution.

4. Dust mop floors using a chemically treated mop that attracts and holds dust particles.

5. Clean restrooms using a germicidal solution...

6. Damp mop floor using a germicidal solutions.

7. Arrange furniture and inspect work."

Staff began cleaning room # 4 after the tour on 10/8/14. The room was inspected during the onsite visit on 10/8/14 at 1:20 PM. Housekeeping staff was cleaning the a/c unit, vents, and accordion style filler on each side of the unit. It was markedly cleaner, but still required further work. The light covers had been cleaned and no debris was noted. The stains in the sink were still present, but were lighter in color and less noticeable. The wall area below the sink was clean and the plumbing pipes were dust free. Staff was continuing to work in the room to address the issues.

During an interview on 10/8/14 at 1:35 PM, the Director of Patient Care Services, EI # 1, stated she will work with the Housekeeping Director to develop cleaning checklists for housekeeping staff and a checklist for supervisory review.