Patients are at serious risk of infection in almost half the hospitals tested for hygiene by the State’s health watchdog, new reports reveal.
Health Information and Quality Authority (Hiqa) inspectors found that Connolly Hospital in Blanchardstown, Dublin, Portiuncula Hospital in Ballinasloe, Co Galway, South Tipperary Hospital and Mayo General Hospital placed patients at serious risk of hospital-acquired infection. At Our Lady’s Children’s Hospital in Crumlin and St Luke’s Hospital, Kilkenny, the risk was described as “clear and serious”.
There was a moderate risk of infection in three more of the 13 hospitals inspected – Cavan General, Mercy Hospital Cork and the Mid Western Regional Maternity Hospital, Limerick – while a low risk was reported in two hospitals, Roscommon General and the Coombe Women’s Hospital.
Dirt, dust and mould are commonplace in many of the hospitals under review, according to the series of inspection reports published by Hiqa yesterday. It says poor handwashing practices in many Irish hospitals is putting patients at risk of infection, and notes wide variations in the cleanliness of different hospitals.
Dust and dirt
Phelim Quinn, director of regulation with Hiqa, said inspectors found hand hygiene practices were not always undertaken or done in the right way.
“Many facilities were observed to be clean and free from visible dirt and clutter, with appropriate infection control signage and practices in place, and the work of hospital staff should be acknowledged in ensuring high levels of hospital cleanliness that were found in some units.
“However, further improvements are required in a range of areas and in some facilities we found dust and dirt on surfaces, soiled bedpans, worn and damaged furniture, black residue in shower areas, splash marks on equipment, and bloodstains in various locations. There were also cases where the management of linen and healthcare waste was not in line with official guidance.”
The assessments identified immediate serious risks to patients, including the inappropriate accommodation of an emergency department patient with a communicable disease among other patients at Connolly Hospital, and similar arrangements at South Tipperary hospital. “These kinds of deficits are not acceptable and required immediate action on the part of clinical and management staff,” Mr Quinn said.
Accountability
The Irish Patients’ Association said the reports made for “grim reading” and questioned the two-year delay since Hiqa last published hygiene reports. “We hear the talk about accountability when things are not right, but who is accountable for this situation? Probably no one,” said chief executive Stephen McMahon.
Hospitals where concerns were raised about hygiene have been given six weeks to publish their plans to develop improvements that meet national standards.
Crumlin hospital, where three of the four clinical areas assessed were found to be unclean, said it had responded to this deficiency. “Since the inspection took place in December, the hospital has taken steps to improve cleanliness. Deep cleans have already taken place in the areas identified in the report as ‘unclean’. All areas of non-compliance in relation to cleanliness identified in the report have been addressed and all maintenance issues are being actioned,” said a spokeswoman.
Connolly hospital said it had developed and implemented a plan to reduce and actively manage the risks identified.
The Mid-Western Regional Maternity Hospital expressed disappointment at the “sub-optimal” levels of hand hygiene found by inspectors but said much work was ongoing since the audit was carried out.
Hospitals with serious ris of infection:
Our Lady’s Children’s Hospital, Crumlin
>all areas assessed, with exception of emergency department, were unclean
>black, mould-like substance observed in one ward
South Tipperary General Hospital, Clonmel
>“unacceptable” use of corridor adjacent to emergency department for patients with communicable diseases
>lack of cleanliness in physical environment, equipment
Portiuncula Hospital, Ballinasloe, Co Galway
>three clinical areas were not clean
>soiled and stained commode basin on the maternity ward
St Luke’s Hospital, Kilkenny
>three clinical areas generally clean, but surgical area and emergency department cluttered
>physical environment not managed effectively
Connolly Hospital, Blanchardstown, Dublin
>patient with a transmissible disease cared for in a cubicle in emergency department , near other patients
>culture of hand hygiene practice not yet embedded
Mayo General Hospital
>poor hand hygiene a serious risk to patients
>all areas generally clean but moderate dust in some areas
Hospitals with moderate risk of infection:
Mid-Western Regional Maternity Hospital, Limerick
>healthcare waste not managed in line with national guidelines, posing moderate risk of infection
>poor hand hygiene
Mercy University Hospital, Cork
>hospital clean but management of an infectious patient not in line with best practice
>culture of hand hygiene not embedded at all levels
Cavan General Hospital
>culture of hand hygiene not embedded at all levels
>healthcare waste not managed in line with national guidelines
