A hospital that was at the centre of controversy over a series of baby deaths more than a decade ago has been criticised in a Health Service Executive (HSE) report over aspects of its maternity care.
Portlaoise hospital is using out-of-date guidelines on foetal heart monitoring and not all staff are up to date with their training on it, according to the report by HSE auditors
The auditors, who make three high-risk recommendations in their report, say they can give only limited assurance about its operation of national clinical guidelines for foetal heart rate monitoring.
The hospital was unable to show women were being informed about foetal heart rate monitoring or were given the standard leaflet on the subject during their pregnancy, according to the report, obtained under freedom of information.
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“There was no record of affording women an opportunity to discuss this aspect of care, including no documentation of their individual preferences,” the audit team led by Dr Cora McCaughan found.
The maternity unit had not adopted the national clinical guidelines, introduced in 2021, to underpin the way it monitors the foetal heartbeat, it said. Instead, it was using UK guidelines, and its use of “descriptive language” on the subject was not in line with the recommended international classification.
Some 84 per cent of midwives and 50 per cent of doctors had completed CTG (cardiotocography, or continuous electronic monitoring during labour) training and just 77 per cent of midwives and 36 per cent of doctors had completed training in intermittent auscultation (listening to the heartbeat for short periods).
The aim of foetal heart monitoring is to detect any deterioration of the baby in the womb so early intervention can be made. It is one of a number of parameters that are monitored to ensure safe delivery.
Auditors found the unit operated a number of guidelines but they were “due for revision”. They recommended the most senior person accountable should ensure out-of-date guidelines are updated.
They reviewed a sample of 20 CTG files and found that a second opinion was obtained from a senior midwife, as recommended, in only three cases.
About 1,500 babies a year are delivered at the hospital. From 2012, it emerged that at least five babies had died at Portlaoise due to a lack of oxygen after staff failed to recognise or act on signs of foetal distress. The ensuing controversy sparked several critical reports and the introduction of new guidelines on safe delivery.
