Dirty patient equipment was discovered on a ward for the elderly during a visit by the Healthcare Environment Inspectorate (HEI) to Glasgow's Victoria Infirmary.
NHS Greater Glasgow and Clyde has been told it must meet six "high priority" requirements within a month to address the problems.
The health board said it was "extremely disappointed and concerned" by the findings.
A report by the HEI said dirty bed frames, bed control panels and intravenous drip stands were found in the hospital's elderly assessment ward south 2.
Patient hoists on the ward were "contaminated and dusty" and a chair weighing scale was unclean.
A bin with protruding sharp implements was also discovered on the same ward.
"During the inspection, we found that over a period of time, there were recurring issues on ward south 2 with cleanliness of patient equipment, sharps and waste management," the report said.
"We were not assured that a managed environment could be consistently demonstrated to minimise the risk of infection and maintain necessary improvements identified through environmental audits and other audit tools.
"We observed poor compliance in some standard infection control precautions, in particular, sharps management in ward 17 and ward south 2 - for example a sharps bin in a clinical preparation area with protruding sharps and temporary closure mechanisms not used on sharps bins."
Inspectors checked 17 commodes throughout the hospital and found eight to be unclean, the report said.
Stained mattresses were also uncovered during the unannounced inspection on July 23 and 24.
Susan Brimelow, the HEI's chief inspector, said: "We have identified six high priority requirements that we expect NHS Greater Glasgow and Clyde to address within the month.
"These include a requirement that staff follow the correct procedure for cleaning patient equipment, which we also identified as a requirement in our two previous inspections of the hospital.
"We will return to ensure action has been taken to improve standards of infection control, cleanliness and hygiene for patients using the Victoria Infirmary."
Rory Farrelly, NHS Greater Glasgow and Clyde's acute director of nursing, said: "We have received the inspector's report and are extremely disappointed and concerned that some areas fell short of the standards expected in all our hospitals.
"Clearly we need to reinforce some of our policies with both clinical and facility teams. We have already taken steps to ensure that patient equipment is clean and ready for use, and have addressed the issues raised in connection with ward 2.
"We have also put in place a comprehensive action plan to ensure the other requirements and one recommendation highlighted in the report are addressed."