Nurses criticise Waitematā DHB's apology after report into COVID-19 outbreak finds lack of proper PPE

Nurses who worked on the Waitakere Hospital COVID-19 ward where personal protective equipment (PPE) didn't fit staff properly say an apology from the DHB "is not enough".

An investigation into a COVID-19 outbreak at the hospital found the lack of appropriate PPE may have played a role in three staff being infected with the disease.

The report, released on Wednesday, also highlighted poor planning by management and spoke of the stressful situation nurses were left in as they cared for six infected patients.

Dr Andrew Brant, Deputy CEO of Waitematā DHB, said it was "deeply sorry" and would use the report to improve how situations of this nature are managed going forward.

But nurses told Newshub "being deeply sorry is not enough" as the poor planning has "sadly become part of the culture at the [Waitematā] DHB".

Twenty patients, including six with COVID-19, were abruptly shifted from St Margaret's Rest Home to Waitakere Hospital on April 17, with hospital staff getting just three hours notice.

The report reveals there was "no backup plan" by either the rest home or the DHB about how patients should be managed.

It also describes one of the patients dying on the ward and being put in a waterproof body bag, while staff continued to help other patients.

The findings follow Newshub's investigation 11 days ago, in which nurses raised concerns about unsafe rostering - claims that are verified in the report - and staff being given ill-fitting masks.

Earlier this month, Waitematā DHB revealed that three hospital staff had become infected after COVID-19 patients from St Margaret’s Hospital and Rest Home were transferred there due to a staff shortage.

A further four nurses who also worked on the hospital's COVID-19 ward subsequently tested positive.

The incident review report, published on Wednesday afternoon, found that while full PPE was available to staff at all times, there were problems with its usability.

The report also found there were changes in the types of PPE provided, which was stressful for staff - although it acknowledges the situation was extreme and fast-moving.

"Information provided to staff about PPE and expected practice was not always consistent, was updated frequently and posted to the staff COVID site," the report reads.

"Nursing staff were told that they did not need to use N95 masks and N95 masks should only be used for aerosol generating procedures, while the COVID-19 policy states that N95 masks must be used if the patient has uncontrolled coughing.

"With the high viral load of unwell COVID patients coupled with their incontinence and full care needs, this area should have been considered a high risk area, automatically receiving N95 masks."

The report notes, however, that nurses on the ward always wore and had access to the appropriate PPE. 

Dr Andrew Brant, Deputy CEO of Waitematā DHB, said it was "deeply sorry" and would use the report to improve how situations of this nature are managed going forward.

"We are deeply saddened that these nurses became infected with COVID-19," he said. "They were being selfless in caring for others in the middle of a difficult, evolving and intense situation at St Margaret's.

"We recognise their professionalism in caring for patients from St Margaret's and we regret that they became ill in the course of their work."

While it has made several recommendations, the report noted that Waitemata DHB had to make a quick decision on a Friday, leaving staff with a short time to plan and establish a ward that was ready for COVID-19 patients.

It also found that the patients had deteriorated quickly and required full nursing care, which increased the amount of time nurses spent at their bedsides, in close proximity to positive coronavirus cases.

"The report shows our staff were well-trained and PPE was used at all times," Dr Brant added. "We have also had confirmation that preparations at Waitakere Hospital were well-advanced to receive and look after COVID-19 patients.

"However, there are clearly some things we could have done better and which we need to learn from."

The report's key findings:

  • The nursing staff provided exemplary care to the six patients on the ward; they were compassionate, professional and worked to ensure the patients were provided with the best care possible.

  • The decision to transfer the residents was made quickly on a Friday, and staff had a short time to plan and respond putting together a COVID-ready ward.

  • The patients required full nursing care and deteriorated relatively quickly. Consequently, nurses needed to spend long periods of time at the patients’ bedsides.

  • There was no way for nursing staff to communicate with staff outside the patients' rooms which increased the frequency of donning and doffing PPE.

  • Full PPE was available to staff at all times. However, there were problems with the usability of the PPE and changes in types of PPE provided, which was stressful for staff.

Read the full report here.