Why were potentially exposed nurses allowed to work on non-Covid wards at Waitakere Hospital? Melanie Reid reports

Urgent questions are now being asked about nursing protocols at Waitakere Hospital after 57 staff were stood down as Covid-19 risks.

Nurses are now asking why there were no protocols in place to prevent staff working with Covid-19 patients from also working with other patients, and why health and safety  recommendations to that effect were not accepted by management.

The 57 staff had all been in contact with three nurses who had already tested positive for Covid-19.

“That is a lot of staff, a lot of families and a lot of bubbles,” says Kerri Nuku from the NZ Nurses Organisation. “Patients are also very angry that the system they trusted to look after them has let them down.”

The nursing roster at Waitakere apparently allowed nursing staff to move between infected and non-infected patients in different wards.

Nuku says when the first Covid-19-positive patients arrived at Waitakere, a health and safety representative on behalf of staff told management that in order to eliminate 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 did not agree, and staff were required to work between A and B wings.”

Nuku points to the Health and Safety at Work Act, saying this requires the elimination of risk where possible, and where not possible, risk be minimised.

“It’s our view that, had the employer taken the concerns seriously, then the risk would have been eliminated in accordance with the requirements of the Act,” she says.

According to Nuku risk management protocols and directives are the DHB’s responsibility.

Newsroom has asked the Waitemata DHB to respond, and to explain what guidelines and directives were provided at the hospital regarding the rostering of nursing staff.

About 8.30 Sunday night the Northern Regional Health Coordination Centre, representing the Waitemata, Auckland, Counties-Manukau and Northland DHBs, issued a statement from its clinical group backing the Waitemata staffing plan.  It said it supported staff working in both Covid-19 and non-Covid-19 areas of the hospital so long as usual precautions such as correct use of PPE gear, handwashing and daily self-monitoring for any effects were employed.

Concern has been raised over the adequacy of PPE use at Waitakere Hospital, with one nurse saying it “beggars belief” that protective equipment would fail.

It is unclear whether the use of PPE by nurses at Waitakere was considered adequate protection against infection, allowing them to be rostered onto other wards as part of normal duties.

However, new research reported in the Journal of the American Medical Association suggests “the current recommendations for personal protective equipment may not fully prevent exposures in emergency department settings.”

Waitematā DHB Deputy CEO Dr Andrew Brant has said full personal protective equipment was made available and worn by staff at all times but that appropriate use of PPE for all Covid-19 patients was being audited. 

The serious situation at Waitakere was revealed on Friday May 1 after Newsroom questioned the hospital management about one nurse who had tested positive. 

Staff at the hospital raised concerns that the hospital seemed to have allowed a flexi-nurse to be in contact with Covid-19 patients and then work with patients who were not infected with the virus.

In one Facebook post a nurse revealed her flexi-nurse colleagues were being assigned to different departments every day and said she was alarmed they could be spreading Covid-19 while asymptomatic.

Newsroom also understands staff are concerned hospital management are too remote from day-to-day operations to respond adequately to their queries and concerns.

The Waitakere infection began when 21 elderly residents from CHT St Margaret’s Hospital and Rest Home in Te Atatu were admitted to either Waitakere or North Shore Hospitals as a Covid-19 and precautions left the facility without enough staff.  Three residents have since died and it is understood seven are still being treated.

The three deaths were of a woman in her 90s and two women in their 70s. A total of 34 cases had arisen in the St Margaret’s cluster by Thursday April 30, according to the Ministry of Health, with 13 having recovered. Of those remaining in Waitakere, some elderly patents have been transferred to North Shore Hospital in recent days. Both North Shore and Waitakere hospitals are administered by the Waitemata District Health Board.

A young and seriously ill Covid-19 patient has also been moved from Waitakere to North Shore’s dedicated Covid-19 Ward 11 – previously the infectious diseases ward. 

Another patient from the St Margaret’s cluster in North Shore Hospital who previously  tested negative has now tested positive.

* Made with the support of NZ on Air *

Melanie Reid is Newsroom's lead investigations editor.

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