Friday 23 March 2018

High-risk levels of poor hygiene found in Temple Street Children's Hospital

Temple Street Children's Hospital
Temple Street Children's Hospital

Eilish O’Regan

Poor levels of hygiene in a hospital caring for some of the country’s sickest children were of immediate “high risk”, a damning report revealed today.

Temple Street Children’s Hospital in Dublin had stained cot frames, bedside storage units and recliner chairs in St Patrick’s Ward after they had been “cleaned”.

Multiple surfaces within the wards inspected were dusty and these included bed undercarriages, chairs, examination couches, floors, over-bed lights, wall surfaces, radiators, ventilation grilles, staff workstations, a games table and horizontal ledges, the inspectors from the Health Information and Quality Authority (Hiqa) found.

They carried out their first unannounced inspection of St Patrick’s ward and St Brigid’s ward in the hospital, built in 1872, in July but had to re-visit in September to  check if improvements were made.

They said other factors which contributed to poor environmental hygiene in the wards inspected included an outdated hospital infrastructure, poor maintenance and very limited space in patient care and ancillary areas.

There was a lack of storage space while the design and positioning of beds and cots and bedside storage units did not allow for effective cleaning.

The standard of patient equipment hygiene in St Patrick’s Ward was not in line with national best practice guidelines.

There was red staining on an integrated sharps container tray. Dust and/or stains were seen on blood pressure cuffs, bedside suction catheter holders and holders for thermometers.

It was also found on auroscope disposable covers, an observation monitoring trolley, humidifiers, a portable suction machine, a drip stand, syringe drivers and a stainless steel trolley.

The inspectors were told the ward did not consistently have the required number of staff necessary for such cleaning.

When the inspectors returned in September there were significant improvements made in relation to environmental hygiene in both St Patrick’s Ward and St Bridget’s Ward.

Both ward environments were found to be clean. It was evident that enhanced cleaning had been performed in both areas.

Cleaning processes had been systematically revised and the hospital was trying to address findings identified within the constraints of the hospital infrastructure.

“It was apparent that the hospital management team and staff had worked together to address the findings of the previous inspection,” said the inspectors.

They said that Hiqa acknowledges that Temple Street hospital  staff work in a compromised physical environment dealing with a high level of activity and complex cases. “Notwithstanding infrastructural deficiencies, hospital environments should be kept clean and proactively maintained to facilitate effective cleaning.”

Meanwhile, an unannounced inspection was carried out in The Rotunda maternity hospital on August 9.

The Hiqa inspectors found overall, patient equipment and the environment in the delivery suite were found to be generally clean with a few exceptions, and there was evidence of good local ownership and teamwork in relation to hygiene.

However, the infrastructure and design of the operating theatre in the delivery suite does not meet international best practice guidelines for operating theatre infrastructure and presents challenges for effective cleaning.

The hospital had improved the uptake of hand hygiene training among staff and has also implemented and embedded peripheral vascular care bundles across inpatient clinical areas in line with best practice guidelines.

Surveillance was performed in the hospital to monitor the incidence of wound infection following caesarean section.

“This represents good practice and demonstrates a commitment to monitoring the quality of patient care,” said the inspectors.

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