Most clinical staff complied with hygiene rules
A hospital has been asked to review its dress code policy for staff after inspectors found that not all employees were complying with hygiene advice.
The Healthcare Environment Inspectorate (HEI) said most clinical staff at Raigmore Hospital in Inverness kept arms bare below the elbow as required.
However, some were found wearing "non-compliant items of jewellery".
The HEI said all wards and departments were clean. NHS Highland has welcomed the inspectorate's report.
On dress code, the inspectorate said there was some confusion on guidelines aimed at reducing the risk of infection being spread by clothing and accessories.
NHS Scotland recommends that staff keep arms bare from the elbow down.
The HEI said: "Most staff appeared to be aware that it should be implemented at the point of patient care, however, some members of clinical staff were observed wearing non-compliant items of jewellery whilst on wards.
"It was apparent that there was some confusion among clinical staff with regards to the application of the policy in the clinical environment."
The HEI said the responsibilities of Raigmore's infection control management did not fully comply with government guidelines and have recommended that this also be reviewed.
The inspection team also said there was not enough sinks available for washing hands and some taps were not of the type recommended for improving hygiene.
However, the team added that NHS Highland had started work on changing the taps and looked at increasing the number of sinks.
The HEI said all wards and departments were visibly clean.
The team said tape was being used to confirm that patient equipment was clean and ready for re-use.
It also noted that special arrangements were in place to communicate infection control advice to staff who do not speak English as a first language.
The inspection was carried out between 15 and 16 December 2009
Raigmore has 577 beds
The hospital has nine operating theatres as well as accident and emergency and maternity departments
Pictorial information on hygiene rules was also available to foreign staff.
Una Lyon, lead nurse at Raigmore Hospital, said the report was credit to all staff.
She said: "Staff worked particularly hard in the lead up to the inspection.
"We know that the 'real' test will be when the inspectorate team return unannounced in the future, but I have every confidence that the team will be able to demonstrate the same high standards.
"To this end, we have already set up local inspection teams to continue close monitoring and support to staff."
Heidi May, nurse director for NHS Highland, said it had been a positive visit and the HEI had commented on how clean wards and departments were.
Health Secretary Nicola Sturgeon said HEI reports were helpful in driving up standards at hospitals.
She said: "Today's report on Raigmore is largely positive and the inspectors were clearly impressed with NHS Highland's approach to hand hygiene.
"NHS Highland have put in place an action plan to address the issues raised and the Healthcare Environment Inspectorate will ensure this is implemented without delay."