.1309 There was minor floor damage in the catheter lab. Floors shall be maintained in good repair. Repair the floor damage.
0.0
16.
.1313 Hot water throughout facility measured 70-126F. The NICU reached 121F. In Building 210, the X-ray rooms reached 124F, and Wound Care reached 126F. Post delivery and the Dialysis treatment only reached 70F. Hot water at hand washing and bathing facilities shall measure 105-116F. Adjust hot water throughout facility to be 105-116F. Repeat violation.
3.0
19.
.1314 A water dispenser in the Labor and Delivery area had black residue. One ice chute in the catheter lab was soiled. Multi-use utensils for service of ice and water shall be maintained cleaned. Clean the ice and water dispensers.
1.0
General Comments
Due to COVID 19, Please follow CDC guidelines regarding social distancing, quarantine, and disinfecting.
A copy of this report was sent via email to bbisset@wakemed.org
Ms. Bisset signed a paper copy, a photo of which was attached to this file.
.1309) Tile dirty in nourishment room on third floor. Walls and ceilings shall be clean and in good repair. All other walls and ceilings clean and in good repair. No points deducted.
0.0
10.
.1312) No paper towels in medicine room handsink 3F, nourishment med room D on 5th floor. Second floor handsink in ICU missing paper towels, dialysis room no soap at handsink. Handwashing facilities shall be supplied with soap and disposable towels or hand-drying devices.
1.5
16.
.1313) Hot water throughout at 86-126F. Hot water in 5th floor C soiled utility only at 86F. Hot water in one sleep study room at 123F. Wound center hot water at 118-124F. Hot water shall be provided at temperatures between 105 degrees Fahrenheit and 116 degrees Fahrenheit at handwashing and bathing facilities. Adjust hot water so it is between 105F and 116F.
1.5
20.
.1314) Ice machine in nursing station nourishment room on fifth floor had some minor black residue buildup. Ice machines shall be protected and clean. Clean these ice machines more frequently. All other ice machines clean. No points deducted.
Some holes observed near handwashing sink in ED Bay C from old soap dispensers. Door laminate damaged on patient bathroom door in pre-op phase 2. Grout missing in tiles of ED lobby bathrooms. Room #7 in sleep center has scuffed walls. Floors, walls and ceilings shall be maintained in good repair.
1.0
4.
Lights are burnt out above shower and toilet in patient rooms w378, w382 and w383. Ensure adequate lighting in these areas. No points taken
0.0
8.
Staff bathroom sink in 1 East is slow to drain and hot water faucet is broken. Lavatories shall be maintained in good repair. Repair this sink.
1.0
12.
Hand towels missing at handwashing sink in Xray 3 bathroom. Ensure bathrooms are stocked. No points taken
0.0
13.
Sinks throughout facility were observed to have incorrect temperatures. Areas where water was measured in excess of 116F were: patient restrooms in pre-op, imaging, wound care, pixus room A and B, 2nd floor, 3rd floor, 5th and 6th floors (medicine rooms, nurses stations, nourishment rooms, soiled laundry rooms, patient rooms w378, w382, w383, w387, w276). The outpatient lab also had water in excess of 116F. Check handwashing sinks in these areas to ensure water temperature is tempered between 100F and 116F. Areas where water temperatures were measured too low were nourishment room E on 2nd floor, cath lab, morgue, and imaging bathroom.
1.0
28.
Dust and debris build-up observed on floors in supply and equipment storage rooms on ground floor. Keep storage areas clean
0.5
32.
Chair in room 209 has a small rip. Plastic cot covers in room 240 and 234 are discolored or showing signs of wear. The ED family waiting area couch has a small rip. Furnishings shall be kept in good repair. Aside from these minor observations, all other furnishings were clean and in good repair. No points taken
0.0
33.
Soiled linens observed in sleep center rooms 8 and 9. Change linens when soiled.
1.0
General Comments
Facility grade cards are located at the main entrance, emergency entrance, women's pavilion entrance, imaging, lab, wound center, sleep lab, rehab and pulmonary function testing. There are 9 total
FLOORS IN SOILED AND CLEAN STORAGE ROOMS, NUTRITION, PIXUS, RESTROOMS, ICU, VENDING, NEEDING TO BE CLEANED UNDER, BESIDE, AND IN BACK OF EQUIPMENT, SHELVES, ETC
0.0
3.
WALL AREAS OBSERVED IN STORAGES ROOMS, DIRTY AND CLEAN LINEN, PIXUS, PACU WALL RAILING WITH CLEANING NEEDED; CEILINGS AND LIGHT FIXTURES NEED CLEANING AT VENT GRATE LOCATIONS WHERE DUST AND LINT OBSERVED; A FEW LOCATION WITH TORN WALL PAPER, ANCHORS WITH ITEMS MISSING STILL IN WALL, AND HOLES, AND RUB MARKS WHERE LAUNDRY BASKETS, CARTS ETC HAVE DAMAGED
1.0
5.
DECON, ICU, 2 WEST, 2 EAST, STORAGE, MAIN HALLS, ED, L&D NEEDING VENT GRATES CLEANED. LINT AND DUST OBSERVED ON FIXTURES
1.0
8.
HAND SINKS EVERYWHERE IN FACILITY TODAY, ED, ICU, NEWBORN, L&D, GENERAL PUBLIC WITH HAND SINK FAUCET BASES SOILED WITH BUILD UP. MENS PUBLIC RESTROOMS SOILED URINAL AND TOILET BASES; FLUSHRIM SINK WITH EXTENSIVE BUILD UP COATING BOWL/SINK BASIN; TUB IN POST PARTUM NEEDS CLEANING; SHELVES ABOVE HAND SINKS, AS WELL AS CABINET AREAS ABOVE HAND SINKS NEED CLEANING
1.0
28.
SOILED LINEN CARTS, LIDS, ROLLING CARTS, CABINETS, MED CARTS, STORAGE BINS, NEED CLEANING, TAPE REMOVED, ETC
0.5
32.
L&D ROOM BED, POST PARTUM BED WITH RESIDUE UNDER MATTERSS, JOINTS, SEAMS, ETC. EFFECTIVE CLEANING NEEDED; IV POLES IN 1 E STORAGE, SPECIAL NEEDS NURSERY NEEDS CLEANING - TAPE RESIDUE AND BROWN RESIDUE; COMPUTER MONITORS WITH DUST ON BACKS AND CORDS;
1.0
35.
SEVERAL AREA HAND SINKS OBSERVED WITH DISPOSABLE BASINS AT HAND SINK, NEW BORN NUERSERY USING HAND SINK FOR PURPOSED OTHER THAN HAND WASHING.
0.5
36.
REFRERATOR INTERIORS IN NUTRITION ROOMS ALONG WITH MICROWAVES NEED THRORUGH CLEANING INTERIOS AND EXTERIORS, DOOR GASKETS, ETC. 3 WEST MICROWAVE AREA DUSTY, UNIT ITSELF EXTENSIVE DUST BUILD UP ON TOP.
1.0
General Comments
FOR HAND SINKS IN THE SPECIAL NEEDS NURSERY, IF THERE IS GOING TO BE WAHSING OF TUBES, BREAST PUMP PARTS, NIPPLES, ETC, THERE NEEDS TO BE NO WAY THE SINK CAN BE LOOKED AT AS HAND WASHING. FURTHER, THE ACTIVITIES SHOULD NEVER BE DONE IN THE SAME AREA, AS THESE INFANTS NEED EVERY FIGHTING CHANCE TO AVOID ANY POTENTIAL CROSS CONTAMINATION. REMOVE TOWEL AND SOAP DISPENSERS IF THAT SINK IS TO BE USED FOR CELANING.
There is some damage under the room handsink in room 131, the veneer in the base of the cabinet is cracked and along the front of the cabinet, the veneer is missing; repair or replace damaged veener. In room 128, the enamel around the sink drain is cracked and some rust damage is visible, repair/re-enamel the sink or replace.
1.0
32.
Comment: Several rooms on the 1st and 2nd floors had chairs with worn arm rests, repair or replace worn arm rests/chairs as needed.
Repair walls in patient rooms that have been scraped by equipment/beds. Repair water stains/check for current leaks in the ceiling in maternity room#24 and W380.
1.0
8.
Repair peeling paint on floor tile in shower in room 228. Repair rusting toilet supports as needed in patient rooms. Repair water damage below handwash sink in room 218. Do not block handwash sinks in clean and soiled utility rooms, these must be available at all times.
There is moisture damage near the window in W 282. Repairs are scheduled. There is moisture damage to the walls near the tub in WP 25 and WP 14.
0.0
28.
Clean the floor in the receiving storage area. Dust and small debris can be found under the shelving and pallets. Sweep linen closets and equipment storage rooms as needed.
Change a stained ceiling tile in room 3 in chest pain unit. Change stained ceiling tiles in receiving area.
0.0
8.
The handrails in the bathrooms in the womens center are built in sections. This creates small spaces on each handrail that cannot be cleaned.
0.0
28.
The data closet floor in One East needs to be cleaned ( a lot of dust ). Clean the receiving area floor. There is debris, dust, and sand under the pallets.
0.5
32.
Start replacing the lactation support pillows as needed. Several have worn spots with bare fabric showing. Worn spots cannot be effectively cleaned. Repair or replace chairs in patient rooms that have worn or cracked covers.
Note : The handrails are of a type that is installed in sections. There are small gaps between the sections. This makes the handrails not easily cleanable. They need special attention during times like the flu season, for example.
0.0
17.
The fountain across from room 210 has a very small steady leak. Repair the fountain.
0.0
28.
Sweep and clean storage room floors where needed. Include floors in larger storage areas. Move pallets frequently to avoid debris build-up under the pallets. The Lost and Found room C1 needs additional shelving to keep items off the floor.
Sweep the storage areas. In the med rooms, for example, cups and wrappers can be found between the pieces of equipment. In the storage room in the receiving area, debris can be found under the pallets.
Remove the quick connect and hose bibb adapter from the sink faucet in the central sterile room. Hoses should only be connected where there is a vacuum breaker or other approved back flow preventer.
Running hot water temperature in patient areas on third floor wing and second floor I.C.U. were 119 to 120 degrees F. Adjust hot water flow so that temperature does not exceed 116 degrees F.
1.0
33.
Bed linens with permanent stains should not be used. Ex: Second floor I.C.U. room.
1.0
General Comments
Keep patient cup inserts stored in plastic sleeves. Clean storage drawers in nutritional supplement rooms. Keep items like blankets stored above the floor in storage area for infant care wing. Clean beneath pads on patient shower table in neurological wing.
Repair ceiling leak in third floor store room. Replace water damaged ceiling tile after leak is fixed.
1.0
8.
Repair clogged sink drains in rooms for telemetry wing.
1.0
General Comments
Clean area around cardboard dumpster. Remove stained linen from bed in emergency room/patient area. Replace stained shower curtain in post partum room. Clean window ledge behind nutritional/med counter in infant area. Clean wall vents in patient rooms.
Monitor cold food storage temps. in refrigerators at nurses stations. Refrigerators on first and second floor had internal temps. between 48 degrees F and 50 degrees F. Milk in second floor cooler was at or slightly above a temp. of 50 degrees F. Verify that all cold foods are stored at temps. of 45 degrees F. or less. Have coolers serviced A.S.A.P. Store potentially hazardous foods like milk in other refrigerators until coolers are repaired.
2.0
General Comments
Replace slighty split mattress pads in surgical wing operating rooms. Repair ceiling leaks in main store room for environmental services and in clean linen delivery area. Keep thermometers in refrigerators in nurses station in easily visible locations. Repair room sinks with slow or partially clogged drains. Have waste contractor repair or replace nonfunctional exterior trash compactor A.S.A.P.
Ceiling damage/leak in Rm 230 (Med-Surg). Ceiling leak in Radiology.Repair leaks and replace ceiling tiles.
1.0
5.
Blinds dusty; Clean as needed.
1.0
General Comments
Use a scoop "with handle" to dispense ice. Observed good handwashing procedures in several locations. Environmenetal Services is doing a great job. Keep up the good work!
