ST. LOUIS • After years of citations for poor patient care, federal investigators found no major faults with the St. Louis VA Health Care System in an annual survey of the John Cochran and Jefferson Barracks medical centers.
The hospitals scored good marks for their leadership, painkiller management and colon cancer screening programs, according to the report released Wednesday from the Department of Veterans Affairs.
Investigators from the department’s Office of the Inspector General found problems with cleanliness, training and safety during their July visit to the sites.
Nearly half of the clinical areas inspected had dirty exam rooms, soiled linens or holes in the walls. Fire extinguishers were not stored in two kitchen areas as required. Oxygen tanks were not stored properly in seven of 11 patient care areas.
Four employees in the John Cochran dental clinic had not been trained in laser safety before using the devices. Safety needles were not in use at the Jefferson Barracks dental clinic, according to the report.
Inspectors noted problems in the hospitals’ sedation procedures, where informed consent was not always documented and two patients were allowed to leave unaccompanied after being sedated.
Hospital staff did not always follow up as necessary with mental health patients, including those at high risk of suicide. Records also showed that some patients with traumatic brain injuries did not receive appropriate follow-up care.
The hospitals were also advised to improve their policies on keeping medications safe and preventing contraband from entering.
RimaAnn Nelson, director of the St. Louis VA Health Care System, agreed with the inspectors’ findings and signed off on an improvement plan that is under way.
“The recommendations were administrative and did not impact patient care or patient outcomes,” said Marcena Gunter, spokeswoman for the system, in a statement. “We see these reviews as an opportunity to demonstrate improvements made in delivery of safe, quality health care.”
Stanley Brown, president of the Gateway Paralyzed Veterans of America, pointed to Cochran’s poor patient satisfaction scores as proof that more improvements are needed. The report notes that 44 percent of local patients were satisfied with their care in the first half of 2012, compared to 64 percent at veterans’ facilities nationwide.
The John Cochran facility on North Grand Boulevard has been plagued with problems for the last several years.
Citations were reported in June after a 58-year-old man died after kidney dialysis. A nurse did not report that the man became unresponsive during his five-hour treatment. Additional nurses were hired in response to a federal inquiry.
In September, federal authorities announced a nurse in the intensive care unit was banned from patient care after “several egregious acts” involving potentially lethal doses of painkillers.
Investigators in September closed their investigation into sterilization problems in the hospital’s dental clinic. In 2010, more than 1,800 veterans were notified that they might have been exposed to HIV, hepatitis or other viruses after dirty dental tools were discovered. No illnesses have been linked to the incident.
More sterilization problems turned up in February 2011 after rust stains were found on surgical equipment. The operating rooms were shut down for a month of tests and cleaning. This year, the hospital has hired additional staff and opened a $7 million sterilization center.