Wednesday 13 December 2017

Sick babies at 'high risk' as new National Maternity Hospital faces further delay

Dr Rhona Mahony
Dr Rhona Mahony
Eilish O'Regan

Eilish O'Regan

The construction of a new National Maternity Hospital is in danger of being further delayed with no planning permission for the urgently needed facility submitted yet, the Irish Independent has learnt.

The dire need to move the hospital from its 19th century building to a new, purpose-built maternity hospital facility on the grounds of St Vincent's Hospital was dramatically highlighted again yesterday after inspectors warned that sick babies are at high risk of infection in the outdated conditions.

However, even though the original pledge in 2013 was that it would be ready by 2018, it is not now expected until 2020 at the earliest.

Holles Street Master, Dr Rhona Mahony, admitted yesterday that the busiest maternity hospital in the country, with 9,000 births annually, is "not fit for purpose".

She was responding to a damning report by inspectors who warned that vulnerable newborns in the intensive care unit are in danger of infection.

Inspectors, who made an unannounced visit in October, found patient welfare was also at risk because of poor hygiene controls and overcrowding.

The inspection sparked an immediate letter to Dr Mahony from the patient safety body, the Health Information and Quality Authority (Hiqa).

It warned that overcrowding in the neonatal intensive care unit - caring for the sickest babies - caused risk of infection. The newly opened unit was designed to accommodate 36 babies but on the day of inspection, 46 babies were accommodated there.

One cot was near a sink which could pose a risk of a water-borne infection.


The quality of cleaning in the delivery ward was insufficient on the day of inspection. Dust control measures were not up to standard and splashes of blood were present on patient beds, wall surfaces and patient equipment. This led to the danger of blood-borne viruses and other bugs being passed on.

The care and storage of medications given intravenously was not in line with best practice.

Anaesthetic drugs drawn up in syringes and infusions were not properly labelled and stored hygienically in the delivery ward.

The design of beds did not allow for effective cleaning or inspection of mattresses. There were poor processes in place for bed cleaning.

Inspectors found a patient bed was put in a lobby outside the mothers' delivery rooms in a storage area used for clean supplies. This was not proper patient care and did not allow for dignity, confidentiality or privacy. A single mop head was used to clean up body fluid spillages in different rooms.

Surfaces, finishes and some furnishings in patient rooms including windows, wall paintwork, wall coverings, woodwork, wood finishes and bed heads were worn and poorly maintained.

The inspectors acknowledged the hospital was built in the 19th Century and faces major infrastructural problems while also coping with a high number of births.

In response, Dr Mahony told Hiqa that, because of the poor clinical surfaces and old and unsuitable infrastructure, it is unlikely that the hospital will achieve compliance with the high standards set by the patient safety body.

She said the hospital has had no major bloodstream infection for over five years.

There have also been no outbreaks of the winter vomiting bug during that time at the hospital.

"The delivery ward has 10 delivery rooms falling far short of the optimum number of 24 delivery rooms required to cater for this volume of activity.

"In 2015, there were 9,355 infants delivered in the hospital, approximately 25 to 30 deliveries per day and on occasion up to 40 babies in one 24-hour period."

She said the Hiqa demand for deep cleaning would require access to each room for a number of hours and this was not possible because of the volume of activity.

The planning of the hospital was stalled for several months last year after St Vincent's Healthcare, which owns St Vincent's campus, wanted a greater say in the running of the hospital.

Discussions resumed in July.

A spokesman for St Vincent's Hospital said last night that talks on the new hospital are ongoing and the Department of Health said the design process for the new hospital is almost complete.

A planning application will be made to An Bord Pleanala but the spokesman did not say when.

The NMH move from Holles Street to Vincent's is part of the €3bn capital plan.

As a strategic infrastructure project, a planning application will be made to An Bord Pleanala. An indicative sum of €150m has been approved in the HSE's Capital Plan to allow this project to proceed.

Irish Independent

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