Thursday 14 December 2017

Serious hygiene risks in two of Ireland’s busiest hospitals - Hiqa

Health watchdog highlights concern for hospital hygiene
Health watchdog highlights concern for hospital hygiene
Ralph Riegel

By Ralph Riegel

SERIOUS hygiene risks were identified at two of Ireland’s busiest hospitals by a health watchdog during unannounced inspections.

The Health Information and Quality Authority (HIQA) confirmed high risks were found at Cork University Hospital (CUH) and University Hospital Limerick (UHL) during unannounced hygiene inspections last November.

In the case of CUH, high risks were identified over cleaning practices on Ward 3B and the cleanliness of patient equipment on that ward and Puffin Ward.

HIQA warned that the approach to hand hygiene was “fragmented across the hospital campus.”

In the case of UHL, a patient on Ward 1D was forced to cover an unrepaired window crack with newspaper and tape as protection from the wind.

“(HIQA) was informed that this (window crack) had been logged on the maintenance system for several months,” the report found.

One CUH ward was found not to have enough alcohol-rub units to promote hand hygiene.

In another case, alcohol-based hand rubs which had been removed because of a possible fire threat due to electrical beds but were reinstalled after the risk was deemed to be minimal.

UHL emergency department
UHL emergency department
CUH. File photo

HIQA inspectors also spotted inappropriate cleaning practices on a ward which had a patient in isolation.

In another case, temperature probes holders were found to be unclean while commodes were dirty, mattresses were stained and dust was found on key patient equipment.

In the 364-bed UHL, HIQA inspectors found environmental hygiene to be “particularly poor.”

This was despite the fact UHL has an historic problem with Carbapenem Producing Enterobacteriacea (CPE), a drug-resistant bacteria.

Inspectors found unacceptably high levels of dust on Ward 1D, poor management of sanitary facilities, stains on curtains by patient beds and dirty equipment.

“The widespread nature of dust throughout the ward indicated to inspectors that the systems in place to manage and maintain environmental hygiene were not as effective as they should be.”

“Sticky residue and staining were also present on blood pressure monitoring equipment and on the surface of a resuscitation trolley.

Several pieces of equipment inspected were unclean, including the interior of a nebuliser, the basket on blood pressure monitoring equipment and the surface of an intravenous pump.”

HIQA said both CUH and UHL have shown a marked improvement in follow-on inspections conducted in January.

CUH and UHL are amongst the busiest hospitals in Ireland.

In 2014, the 800-bed CUH alone had 65,000 emergency department presentations 8,000 births, 210,000 out-patient attendances, 48,000 inpatient discharges and 86,000 day cases.

“Management of the (CUH) patient environment, sanitary facilities, waste and isolation rooms also raised concerns for (HIQA) during the November inspection, particularly on Ward 3B,” the HIQA report revealed.

The report found that while the Health Service Executive (HSE) aims for a 90pc hand hygiene compliance rate, CUH achieved only 74.8pc last year.

That is in contrast to CUMH, located on the same general site, which had a hand hygiene compliance rate of over 97pc.

“Hand hygiene compliance observed by HIQA in the (CUH) recovery area in theatre during the November inspection was poor with only 33pc (four out of 12) of the opportunities being taken.”

CUH’s Ward 3B had a cluster of patients last September suffering from a multi drug-resistant organism – but, despite this, poor hand hygiene audits were noted on the ward.

Audits since November has shown compliance rates are now over 80pc.

In both CUH and UHL, the issues were brought to the attention of both staff and management.

UHL immediately ordered “a deep clean” to tackle the ward issues highlighted.

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