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Based on observation, interview and record review, the hospital failed to maintain a safe and clean environment when the floors and walls were damaged.

These failures placed all patients, staff, and visitors in the Emergency Department (ED) at risk of injury and infection.

Findings:

During an observation and interview on 9/30/24 at 11:30 a.m. with the Director of the Emergency Department (Dir 3) and the Manager of the Emergency Department (Mgr 1), the hospital walls, floors, and furniture were observed. The baseboards were pulled away from the corner of the wall outside Pod D (different areas of the ED are designated as "Pods") creating a hole in the wall, and the corner moulding outside Pod D was pulled away from the corner, exposing the wall behind it. In Pod C, the wall had a hole approximately four inches by three inches, approximately two feet above the ground. Dir 3 stated the holes in the wall and the molding pulling away are a problem in the ED because equipment crashes into the walls and causes damage. Dir 3 stated this could be a patient safety and infection control risk, because the damaged walls can't be disinfected properly.

During an observation and interview on 10/1/24 at 9:30 a.m. with the Dir 3 and the Manager of Infection Prevention (MIP) in the ED, the MIP observed the baseboards, holes in walls, and where the moulding was pulling away from the corner. The MIP stated could be a source for the spread of infections.

During an interview on 10/2/24 at 10:50 a.m. with the Facilities Director (FD), the FD stated he does environmental rounds in the ED twice a year. The FD stated large holes in walls can be a life safety issue (someone could get hurt) because an arm could get stuck in a hole or a patient could be injured, and small holes are also a concern because they can be the source for spread of infection since they can't be cleaned. The FD stated he has observed children sitting on the floor in the ED playing with the cracks in the walls and the moulding where is had come separated from the wall. The FD stated the ED is on a list to have improvements made to the walls, baseboards, and moulding.

According to an article in Health Facilities Management, dated August 16, 2019, titled, "The Role of Maintenance in Infection Prevention," retrieved from https://www.hfmmagazine.com/articles/3728-how-maintenance-can-help-or-hurt-infection-prevention, the article indicated, " ... Because of their random nature, miscellaneous HAI (Hospital Acquired Infection) concerns can sometimes be the hardest to spot. Some things to look for include: Peeling paint or damaged wall surface. A wall surface that is not smooth is not cleanable and also is an infection prevention concern ...Damaged plastic laminate, upholstery, doors, and similar items. Plastic laminate casework (cabinets, moulding, etc) is frequently damaged, resulting in a surface that cannot be cleaned properly. The same applies to damaged upholstery, mattresses, and other surfaces. Damaged materials must be repaired or replaced to provide a cleanable surface ..."