Patients' safety at risk in overcrowded A&E, damning report finds
Overcrowding at a major hospital emergency department has made it impossible to clean and is threatening the safety of up to 60,000 patients every year, a damning report found.
The health watchdog said the emergency department of University Hospital Limerick (UL) was "not fit for purpose" and highlighted persistent overcrowding and long delays.
In one incident a critically ill patient was left lying in the emergency department even though he required a high-dependency care bed.
The Health Information and Quality Authority (HIQA) report highlighted other delays in transferring patients to Intensive Care and the High Dependency Unit.
It said ambulances were being delayed when waiting to transfer patients to trollies, which meant that ambulances were potentially unable to respond to emergencies. At the time the assessment was carried out – which the hospital had been notified about – there were 37 patients on trolleys.
But there was just one toilet in the emergency department for all patients and no single rooms to isolate patients with communicable diseases. HIQA director of regulation Phelim Quinn said the conditions increased the risk of infections and severely reduced patients' privacy and dignity.
A new children's area was developed at the hospital, but was closed, the report found.
HIQA noted there had been progress in the way in which services within the University of Limerick Hospitals group were being governed and organised.
Responding to the report, a statement from UL Hospitals said construction of a new €20m emergency department was under way – and would offer the most modern ED services in Ireland when it opens in 2016.
The statement added: "It has been publicly acknowledged by UL Hospitals that the ED in UL Hospitals Dooradoyle is in need of a major redevelopment." It added that, in the interim period, management had undertaken a "number of measures".
Since the inspection, a 17-bed short-stay unit had been opened and it was hoped this would be extended to cater for up to 49 patients. A separate paediatric emergency area is now fully open and provides a child friendly area for children who require an emergency response.
This new area has an isolation facility and its own toilets. A new €35m Critical Care Unit was also opened recently.
Ann Doherty, chief executive of the UL Hospitals group which controls University Hospital Limerick, said she is "very aware" the emergency department is not acceptable.
"However we are in the middle of the construction of our new emergency department which is being built to 21st Century standards," she said.
"In the interim we have put in place a range of initiatives to offset the current limitations of the old emergency department."
The HIQA report was welcomed by Siptu, and sector organiser Kevin Figgis said it highlighted the concerns of members working within emergency departments.
The Irish Nurses and Midwives Organisation (INMO) said the report highlighted concerns at the hospital first raised by its members in 2004.