PATIENTS who were being treated in three of the country's major hospitals were left at serious risk of infection or scalding, while some medical equipment was dirty and staff failed to wash their hands.
Inspectors who visited the Mater, Tallaght and St Vincent's hospitals have provided another damning insight into failures by staff to follow basic infection-control rules.
A separate report on Nenagh hospital in Tipperary found a dirty utility room did not have a door even though it housed soiled and contaminated equipment, materials and waste.
And in the Mater, one patient was at risk of serious infection after a door between two isolation rooms was left open.
The inspectors also discovered stained bedpans and a lack of proper controls over access to areas with hazardous waste and chemicals.
The report from the Health Information and Quality Authority (HIQA) comes in the wake of previous worrying inspections of other major hospitals.
The report, following inspections in August, again found that doctors were not washing their hands between treating patients, while staff followed key infection-control protection on just nine of the 17 times they were observed.
The inspectors discovered a "black substance" in some shower areas, unclean hand sinks and "unlabelled syringes" containing unknown solutions that posed a risk of injury.
The report warned: "Observations suggest that a culture of hand-hygiene practice is not embedded at all levels, especially among staff practices observed by the authority on St Joseph's ward."
Equipment at St Vincent's, including the ECG machine, was unclean and dust was discovered on trolleys, while two damaged electrical sockets in one ward were still in use, and staff washed their hands on just 14 of the 24 occasions they should have.
In Tallaght, inspectors found that water from the taps in one ward was so hot that patients were in danger of being scalded, while a fridge storing drugs wasn't properly secured.
In Nenagh, bedsteads were grimy and dusty and the shower rooms were mouldy.
Inspectors also found sticky residue on bedside lockers, crumbling wall surfaces, dusty surfaces, faulty electrical fittings and dirty patient toilets and showers.
A thermometer was unclean and there were stained floors, unclean surfaces and severed electrical wiring hanging free in a utility area.
Beds and floors were also unclean, while specialist equipment was stored alongside laundry in a cluttered corridor.
However, Ennis hospital in Clare was given a positive report – with inspectors saying it was "very clean with few exceptions".
But Prof O'Keane also blamed "culture and resources", saying they were under pressure while some of the wards were old and in need of refurbishment.
Last month, HIQA found that staff in St James's, Dublin, – the country's largest hospital – were flouting infection-control rules by failing to wash their hands as often as they should.