A report by the U.K. health regulator has identified serious shortcomings in the hygiene practices at a mobile MRI facility in South London, referring to clutter on the floor and no hand-washing by staff.
The unannounced inspection was carried out at InHealth MRI, Croydon University Hospital, on 9 November 2021. The service did not generally perform well for cleanliness, noted the report by the Care Quality Commission (CQC).
"In the scanner room and preparation area, we observed clutter on the floor which meant the floor could not be properly cleaned or kept dust-free. Cleaning equipment was also stored in the preparation area," the authors wrote.
The MRI unit at Croydon University Hospital scanned over 18,000 patients, including 759 babies and children, from September 2020 to August 2021. Courtesy of Chris Harris/Alamy Stock Photo.Furnishings and equipment were "not always well maintained and were an infection control risk." The seat in the changing cubicle in the mobile MRI unit was torn, and a large foam wedge had a tear exposing its foam innards.
"The design, maintenance and use of facilities, premises and equipment did not always keep people safe. Staff did not always assess risks to patients," the report continued. "Staff did not always respect patient's privacy and dignity. They did not always provide emotional support to patients, families and carers."
Other shortcomings
Some patients did not have access to the service when they needed it and sometimes had to wait for treatment. The service failed to take account of patients' individual needs, and leaders and teams did not always have plans to cope with unexpected events, the CQC inspectors stated.
"We observed staff donning fresh aprons and gloves between patients, however, staff were not observed using hand gel or washing their hands when donning and doffing personal protective equipment (PPE). This meant staff were not following COVID guidelines and standard infection control procedures," they wrote, adding that staff were bare below the elbow.
Also, staff did not follow the key protocol, which had not been reviewed since November 2019. This meant if a staff member was lone working, other staff would not be able to access the scanner in an emergency. No handover forms were used when equipment was given to engineers and physicists for servicing and testing, according to the authors.
"Staff did not always use the three-point demographic checks which meant staff were not handing over patients in line with the correct procedure," they noted. "Validating radiographers were required to print their name and sign, however on six (66%) of the records the radiographers had not printed their names."
Mitigating circumstances
At the time of the inspection, the hospital was undergoing a major refurbishment and the internal inpatient MRI scanner had quenched, meaning it was not in operation and under repair, the CQC found. Following the inspection, the provider confirmed the internal scanner became operational on 10 November 2021. All scans undertaken during the inspection were carried out in the mobile unit.
InHealth, a provider of fully managed MRI services, said that since the report was published on 18 January, it had been addressing each area highlighted and identifying any related actions, stated an article posted on 21 February by the MyLondon website.
"Our centre is currently undergoing a significant building programme. As part of InHealth's £4.5m investment at Croydon University Hospital, the newly refurbished centre will boast three state-of-the-art MRI scanners, new and improved patient waiting areas, high-quality equipment and staff facilities," a company spokesperson said.
According to MyLondon, a hospital spokesperson said: "The (National Health Service) trust works closely with our contracted provider for MRI services, InHealth, to improve the care offered to Croydon patients. The opening of a new department in March 2022 will continue this work and will support us in our ambition to provide excellent care for all."
