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COVID-19
Why were potentially exposed nurses allowed to work in non-Covid wards at Waitakere Hospital? Melanie Reid reports
Urgent questions are now being asked about nursing protocols at Waitakere Hospital after 57 employees were removed as Covid-19 hazards.
The nurses now ask why there were no established protocols to prevent staff working with Covid-19 patients from also working with other patients, and why management did not accept the health and safety recommendations in that regard.
The 57 staff had been in contact with three nurses who had already tested positive for Covid-19.
“That’s a lot of staff, a lot of families and a lot of bubbles,” says Kerri Nuku of the New Zealand Nurses Organization. “The patients are also very angry because the system they trusted to take care of them has disappointed them.”
Newsroom understands that those who withdrew from Waitakere are being considered probable cases, meaning they have returned an initial negative test but are treated as likely positive due to their exposure history and clinical symptoms.
The Waitakere nursing list apparently allowed nursing staff to move between infected and uninfected patients in different wards.
Nuku says that when the first Covid-19 positive patients arrived in Waitakere, a health and safety representative on behalf of the staff told management that to eliminate the risk of infection to other parts of the hospital, they should not move staff to work between wings of the hospital to avoid cross contamination.
“Management disagreed, and staff had to work between Wings A and B.”
Nuku points to the Occupational Safety and Health Act, saying that this requires elimination of the risk when possible, and where not possible, the risk is minimized.
“It is our opinion that, if the employer had taken the concerns seriously, then the risk would have been eliminated in accordance with the requirements of the Law,” she says.
According to Nuku’s risk management protocols and policies, they are the responsibility of DHB.
Newsroom has asked Waitemata DHB to respond and explain what guidelines and directives were provided at the hospital regarding the registration of nurses.
Around 8:30 on Sunday night, the Northern Regional Health Coordination Center, representing the DHBs of Waitemata, Auckland, Manukau and Northland counties, issued a statement from its clinical group supporting the staffing plan from Waitemata. He said he supported staff working in the Covid-19 and non-Covid-19 hospital areas as long as standard precautions were used, such as the proper use of personal protective equipment, hand washing and daily self-monitoring to detect any effect.
Concern has been expressed about the adequacy of the use of PPE at Waitakere Hospital, and one nurse said she “believed she was a beggar” that the protective equipment could fail.
It is unclear whether nurses’ use of PPE in Waitakere was considered adequate protection against infection, allowing them to be included in other wards as part of normal duties.
However, new research published in the Journal of the American Medical Association suggests that “current recommendations for personal protective equipment may not completely prevent exposures in emergency department settings.”
Dr. Andrew Brant, Deputy Director General of Waitematā DHB, said the staff made all personal protective equipment available at all times, but the appropriate use of PPE was being audited for all Covid-19 patients.
The dire situation in Waitakere was revealed on Friday, May 1 after Newsroom questioned hospital management about a nurse who had tested positive.
Hospital staff expressed concern that the hospital appeared to have allowed a flexible nurse to contact Covid-19 patients and then work with patients who were not infected with the virus.
In a Facebook post, a nurse revealed that her flexible nursing colleagues were being assigned to different departments every day and said she was alarmed that they could spread Covid-19 while asymptomatic.
Newsroom also understands that staff are concerned that the hospital administration is too far removed from daily operations to adequately respond to their inquiries and concerns.
The Waitakere infection began when 21 older residents of CHT St Margaret’s Hospital and Rest Home in Te Atatu were admitted to Waitakere or North Shore Hospitals as Covid-19 and precautions left the facility understaffed. Since then, three residents have died and seven are understood to be still being treated.
The three deaths were from one woman in her 90s and two women in her 70s. A total of 34 cases had emerged in the St Margaret group by Thursday April 30, according to the Health Ministry, and 13 had recovered. Of those remaining in Waitakere, some senior patents have been transferred to North Shore Hospital in recent days. North Shore and Waitakere Hospitals are managed by the Waitemata District Board of Health.
A young and seriously ill Covid-19 patient was also transferred from Waitakere to Room 11 of Covid-19 dedicated to North Shore, formerly the infectious disease ward.
Another patient from St Margaret’s group at North Shore Hospital, who previously tested negative, has now tested positive.
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