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5 DC-area hospitals have failed infection control inspections since 2018. Here's what that means in the age of coronavirus

Hospitals in the D.C. area have been cited for everything from protective wear violations to failing to properly sanitize surgical suites.

WASHINGTON — Five hospitals in the D.C. area have been cited for failing to follow proper infection control protocols over the past two years, according to a WUSA9 analysis of data from the Centers for Medicare and Medicaid Services.

The hospitals were cited for issues ranging from staff improperly using personal protective equipment to dining services failing to properly sanitize dishware.

The data comes from regular inspections performed by the Centers for Medicare and Medicaid Services. The data set is maintained by the Association of Health Care Journalists.

In the D.C. area, the five hospitals cited for infection control violations since 2018 were:

  • Berkeley Medical Center (Martinsburg, West Virginia)
  • Inova Fairfax Hospital (Woodburn, Virginia)
  • Mary Washington Hospital (Fredericksburg, Virginia)
  • Medstar Washington Hospital Center (District of Columbia)
  • United Medical Center (District of Columbia)

The most common violation – found at three of the five hospitals – was nurses and other hospital staff failing to properly use personal protective equipment. At Medstar Washington Hospital Center, for example, inspectors observed an occupational therapist exit the room of a patient under infection control while still wearing a mask, and then dispose of that mask in another patient’s room.

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At the same hospital, inspectors witnessed a dining service worker exiting a room under infection control without removing their mask or sanitizing their hands. The employee then retrieved another lunch tray from the cart in the hallway and entered a second patient room.

Other violations observed included:

  • At Mary Washington Hospital in Fredericksburg, Virginia, inspectors could find no record of a surgical suite being properly cleaned after an operation involving a patient diagnosed with bacterial pneumonia and MRSA.
  • At United Medical Center in D.C., inspectors found there was a failure to monitor air samples in the pharmacy, including samples repeatedly identified as “highly pathogenic.”
  • At Inova Fairfax Hospital, the director of dietary services was cited to failing to ensure safe and hygienic food handling practices, including the hospital’s dishwashing machine running multiple loads without reaching the temperature necessary to properly sanitize dishware.

We reached out to all five hospitals for comment, and to see how they were adapting to the coronavirus. MedStar Washington Hospital Center and United Medical Center both responded with statements:

MedStar Washington Hospital Center Statement

“MedStar Washington Hospital Center welcomes regulatory review as a valuable tool for maintaining high-quality care for our patients. Since our review in April, we implemented corrective action plans to address the issues mentioned. We were subsequently resurveyed and found to be in compliance. 

“We maintain a constant state of readiness for treating complex illnesses, including the coronavirus. Since the outbreak of the disease, MedStar Washington Hospital Center —like other hospitals and health systems across the country—has been preparing staff to accurately screen for risk of coronavirus and isolate any suspected cases immediately. We are following the guidance of the U.S. Centers for Disease Control and Prevention (CDC), so these patients will be able to get the care they need while protecting the health and safety of our associates and the community at large.”

United Medical Center Statement

“To date, we have not experienced an uptick (more than expected during flu season) in patients with flulike symptoms. However, we are prepared to handle patients with such symptoms within our existing capacity of beds and negative pressure rooms. We are in compliance with all health regulations with regard to our supply of personal protective equipment (PPE) and have multiple packages of PPE available and in storage so department supplies can be replenished as needed. 

“Both clinical and non-clinical staff are undergoing continuous training regarding COVID-19 as new information becomes available and procedures put in place. On Monday, March 9, 2020, we held hourly town hall style meetings to ensure all staff received clear and consistent guidance. Educational information is posted in our lobbies, waiting rooms, and clinical units for visitors and families. Finally, all visitors should be prepared to answer a list of screening questions to allow UMC to determine if the visitor poses a potential risk to current patients and staff.”

Inova Fairfax Hospital told WUSA9 it wouldn’t be able to respond by our broadcast deadline due to ongoing coronavirus preparations, but the hospital’s website lists a number of precautions that have gone into effect this week, including restricted visitation hours and a verbal screening for visitors entering the facility.

We asked Dr. Linda Nabha, an infectious disease specialist at D.C.’s Price Medical, whether she would have any hesitation sending a patient to a hospital with an infection control violation. She said no.

"I absolutely trust these systems," Nabha said. "When my patients are sick, I don’t hesitate to send them to one of our local hospitals. I know they’re going to be well taken care of." 

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Credit: WUSA9
Dr. Linda Nabha is an infectious disease specialist working in Washington, D.C.

“We live in an imperfect system,” Nabha said. “There are protocols in place, set by infection control, for example, in times like coronavirus, to help keep that infection within a certain room. Many staff – doctors, nurses, cleaning staff – are coming in and out of the rooms. Trying to keep that area clean, trying to sanitize, is of the utmost importance. And that’s why we set these protocols in place. Are these protocols 100%? No. But we try. And that’s why we have people coming in and making sure staff are following those protocols.”

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That being said, Nabha said, in the age of coronavirus, there are things you can do and questions you can ask to help protect yourself and others while in the hospital.

“You always need an advocate at the hospital. You need to be an advocate for yourself,” she said. “I urge my patients: Ask. When you don’t know, ask. You have to be in the know. You have to be aware. Your loved ones have to be aware of what’s going on. Why are they under certain precautions? There are different types: there’s respiratory; there’s contact; there’s airborne. There’s so many different levels of prevention, and it’s good for you to educate yourself and educate the patient and ask those questions.”

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Jordan Fischer and Eric Flack are investigative reporters with WUSA. Follow them on Twitter at @JordanOnRecord and @EricFlackTV.