Raising concerns with the right person


Dr McDonald is ST5 and works on rotation on a geriatrics ward in Scotland. She works as part of a multi-disciplinary team (MDT), with Nurse Wright, a senior nurse who is particularly supportive.

The Health Board has a clear policy on hand washing as part of its drive to reduce hospital acquired infections (HAI).


During the time Dr McDonald has been working with Nurse Wright, she has rarely seen her wash her hands after patient contact. This includes after changing wound dressings and, on a number of occasions, when moving between patients following procedures requiring mandatory hand washing.
Dr McDonald is worried about the heightened risk of HAIs on a ward with elderly patients with multiple conditions, where such infections could have serious consequences for their health.

Dr McDonald does not want to jeopardise her good working relationship with Nurse Wright by confronting her about what she has seen. At the same time, she knows that she cannot ignore the potential risk.

What the doctor did

Dr McDonald decides to talk with her Clinical Supervisor about her concerns. He shares her concerns and tells her he will broach it with the Ward Sister, Sister Jacob.

Following the meeting with the Clinical Supervisor, Sister Jacob has a one to one meeting with Nurse Wright. She explains that her colleagues have observed her not washing her hands and stresses that she must in future follow the WHO five steps  to hand hygiene at all times, in line with the National Infection Prevention and Control Manual

At the next safety briefing session, Sister Jacob reminds all staff of the risks of HAIs, the increased risks on the geriatrics ward, and the importance of taking extra care to follow hospital policy on hand washing practices.