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HIQA report highlights issues at Louth


The findings of an unannounced inspection at Louth County Hospital, Dundalk by HIQA inspectors have identified areas which need to be improved to help prevent the spread of hospital super-bugs.

It found that the hospital hasn't enough single rooms to manage the increasing number of patients requiring isolation, which has been highlighted two years ago.

The inspection took place on March 5 of this year and the areas of the hospital which were inspected were the stroke rehabilation unit and the Ophthalmology (Eye Department) Out-Patient Department.

The focus of the inspection was to see what measures are taken to minimise the spread of what are commonly known as hospital super bugs.

The HIQA inspectors that found that there weren't enough single wards for patients who needed to be isolated, beds were placed too close together, and signage was not erected in multi

-occupancy rooms ensuring patients privacy and confidentiality is preserved.

They also found that the hospital did not have an antimicrobial stewardship pharmacist and antimicrobial stewardship rounds did not take place, and, according to the report posted on the HIQA website last week this 'needs to be addressed'.

During inspections of the clinical areas, the inspector noted some fixtures on the ward

were in a state of disrepair, eg, a number of window sills were chipped, and some woodwork on doors was damaged, which does not facilitate effective cleaning. In addition, bedpans were not

managed in line with best practice guidance, which increases the risk of contaminating clean supplies with faecal or other micro organisms and could increase the risk of spreading infection. The inspector was also told that dedicated commodes are not always allocated to patients requiring trans mission-based precautions. However, following this inspection, hospital management confirmed that commodes were cleaned and disinfected after every patient use

A inspector was informed that there was no designated clinical hand wash sink for staff in the four en-suite single rooms. The report found that the design of clinical hand wash sinks in the clean utility room did not comply with standards.

Inspectors found that overall leadership, governance and management arrangements were in place for the infection prevention and control and decontamination programmes within Louth County Hospital. The Louth Hospital had an infection prevention and control risk register in place which was last updated in July 2018.

The report found that The Louth Hospitals' management team need to put measures in place to address: patient placement; insufficient isolation rooms;maintenance of the hospital infrastructure antimicrobial stewardship programme.

The hospital had achieved 94.3% compliance in the national hand hygiene audits in October

2018 exceeding the required compliance target of 90% set by the HSE. In the clinical area inspected hand hygiene compliance audits showed 91% and 93% compliance was achieved in May and October 2018 respectively. Hand hygiene training was mandatory for relevant staff at induction and every two years thereafter; 80% of hospital staff were up to date with this training on the day of inspection.

In regards to the decontamination and reprocessing of reusable medical devices in a satellite decontamination facility, HIQA found that the hospital was working to improving decontamination and reprocessing practices.

In the eye department equipment was decontaminated at point of use even though it this should have been done in a dedicated decontamination room.

While evidence of good practice observed by HIQA included clear lines of accountability and responsibility and management arrangements in relation to decontamination, a number of recommendations were also made.