Hygiene inspectors find 'immediate high-risk findings' in Coombe maternity hospital
Inadequate hygiene standards in one of the country’s biggest maternity hospitals left mothers and babies at risk of infection, an inspectors’ report has revealed.
The unannounced inspection of the Coombe maternity hospital in August revealed “immediate high-risk findings in infrastructure and design.”
The operating theatre department did not comply with basic best practice guidelines, the Health Information and Quality Authority (Hiqa) inspectors found.
They said that due to inadequate storage facilities, sterile supplies were being stored inappropriately within operating rooms.
The substantial amount of exposed pipe work and electrical wiring on ceilings and along walls did not facilitate effective cleaning.
And decontamination facilities for the reprocessing of flexible endoscopes- used for diagnostics - within the theatre department were not in line with current good practice.
The inspectors said some good practice was observed including surveillance of women who had caesarean section to measure the incidence of wound infection.
“This represents good practice and demonstrates a commitment to monitoring the quality of patient care.”
HIQA said it acknowledged that risks in respect of old infrastructure of the hospital cannot be addressed without major capital investment.
“However, some of the other risks identified on this inspection could be addressed in the short-term,” they added.
In response a spokesman for the Coombe said it accepts the conclusions reached by HIQA.
He said : “The Coombe welcomes the finding that there is good ownership and teamwork in relation to hygiene in general, and that the hospital has an effective system in place in relation to cleaning in the operating theatre department.
“The Coombe endorses HIQA’s key finding that risks in respect of operating theatre infrastructure cannot be addressed without major capital investment, and acknowledges that the implementation of a major re-development will contribute to the quality and standards of service delivered in the theatre department.
“Patient safety is central to the care provided at the Coombe. For some considerable time, senior management has had extensive, ongoing engagement with the HSE concerning essential upgrading of the Theatre Department and a detailed Business Case for this work was submitted to the HSE earlier this year.
“Since HIQA’s visit, the Coombe has received notification that the theatre re-development business case has been approved by the HSE, and the hospital is currently awaiting details of the timeline for the necessary funding.
“In the interim, improvements are ongoing in the theatre department in advance of the planned major theatre re- development project. We will continue to improve our facilities within the existing infrastructural challenges to ensure a safe, high quality service for our patients. The Coombe acknowledges that the implementation of the HIQA recommendations will improve the quality of the care environment and the standard of service for both patients and staff.”
A separate report on an unannounced inspection in Our Lady’s Children’s Hospital, Crumlin in August 23 found that patient equipment and the environment was clean and well maintained on paediatric intensive care unit 1 and St Peter’s Ward.
“The hospital has consistently exceeded the HSE national target of 90% for hand hygiene compliance since May/June 2012 which is commendable,” said the inspectors.
They added:”Our Lady’s Children’s Hospital has successfully embedded a suite of infection prevention care bundles and audits into routine practice.
“The hospital had a robust programme in place to monitor Healthcare Associated Infection. A commitment to implementing evidence-based practice and to producing outcome-based information to inform any improvements needed was exemplary in Our Lady’s Children’s Hospital.
“This demonstrates a strong focus on patient safety.”