Despite calls for stricter rostering protocols to prevent cross-infection at Waitakere Hospital, nurses working in Covid-positive wards were also deployed across the hospital. Melanie Reid and Bonnie Sumner report.
Newsroom can reveal that staff working in a Covid-19-positive ward at Waitakere Hospital worked across multiple wards, not just between two wards as previously suggested.
Three nurses at the Waitemata DHB hospital were last week diagnosed with the virus, with three close contacts.
Initially, 57 staff were stood down and 37 remain at home to isolate. The Covid-positive nurses had been working in Muriwai Wing A ward which housed six infected patients from St Margaret’s rest home, three of whom have since died.
Acting associate professional services manager of the NZNO, Kate Weston, says, “Despite concerns raised by the NZ Nurses’ Organisation when the patients were first admitted, staff were asked not only to move between the Covid-positive A wing and non-Covid B wing patient areas of the ward, but also to other non-Covid wards containing patients who were already unwell with other complex medical issues.
“Potentially exposed patients have now been screened for Covid and are in a ‘static’ ward with no further admissions coming in.”
Nurses had asked to stay in one area to eliminate any risk to patients by inadvertent exposure. This was raised with management on several occasions but was turned down.
Says Weston: “Health and safety concerns were raised about rostering over several wards at Waitakere Hospital by members when it became clear that staff who had been working with Covid-positive patients were being requested to work in other wards at Waitakere Hospital, rather than keeping a discreet bubble of staff to manage those patients and others in the ward.”
Despite this, the Northern Region Clinical Technical Advisory Group continued to support the movement of nurses between wards, stating in a press release on Sunday May 3, that staff were able to move from Covid-19 areas to non-Covid-19 areas for work as long as they followed the “usual principles for infection protection control when working with patients who have infectious disease.” This included appropriate use of PPE, good hand hygiene and physical distancing.
A day later, May 4, a week after the first nurse tested positive, the Waitemata DHB – which oversees Waitakere Hospital – responded to pressure and decided to institute ward “bubbles” after all.
“In managing our current Covid patients, the DHB is striving to maintain staffing ‘bubbles’ in response to concerns raised by our staff. This involves taking additional precautions that go even further than the CTAG guidance to protect health and safety and give our staff peace-of-mind.”
In early March, Waitemata DHB stood down over 50 nurses doctors and allied health staff at North Shore Hospital after exposure to a Covid-positive patient. A similar situation occurred at the West Coast DHB, when staff from a neighbouring DHB had to be redeployed after an exposure there in late March.
Weston says that in the early days of Covid’s arrival, the recommendations were for “pod rostering” of staff teams and limiting the number of patient contacts with multiple staff. She says she doesn’t know why this hasn’t been happening at Waitakere Hospital.
“We need to develop sustainable strategies to manage the ongoing reality of Covid being with us for some time, and we cannot have a huge number of staff stood down every time a case pops up. But while we could take stronger measures to eliminate a risk, I am unsure why these aren’t being enforced.”
She adds that the approach of moving staff around is contingent on PPE being 100 percent effective.
Prime Minister Jacinda Ardern said in an interview on RNZ earlier this week that “PPE – and even experience – is not fool proof when it comes to this virus.”
A Major Incident Review into the outbreak at Waitakere Hospital is due out Friday.
“We know we have got to staff a hospital,” says Weston, “but we need to take all measures to eliminate risk and minimise exposure for both staff and patients. DHBs have to be open to all strategies to stop the spread between patients and staff and not rely exclusively on effective use of PPE.
“You just have to look at the facts – nationally, more than 100 health care workers have been infected with Covid and, as has been previously reported, around 50 percent were likely to have contracted [it] from the workplace.”
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