All 49 hospitals fail Hiqa infection controls

Of the 49 hospitals inspected by the Health Information and Quality Authority (Hiqa) since Nov 2012, not one was fully compliant with infection control standards, and practices in 13 hospitals posed “serious risks”.

Hiqa has published an overview report of its hygiene inspections in public acute hospitals between Nov 2012 and Dec 2013.

Of the 1,500 hand-washing opportunities for hospital staff observed during those inspections, only 69% were taken. Furthermore, in nine of the hospitals inspected, 50% or less of the hand-washing opportunities that were taken complied with best practice. Staff did not take long enough to clean their hands; did not perform the technique properly; or were wearing a wrist watch, jewellery, or had long sleeves.

Of the 13 serious-risk notifications issued to hospitals, six were for hand hygiene issues. Other risks included drug trolleys not being maintained according to best practice guidelines, and inappropriate accommodation of patients. That included patients observed on trolleys outside screened treatment bays in the emergency department and on extra beds put into wards.

Hiqa said all hospitals which underwent the announced and unannounced inspections were partially compliant with the national standards for prevention and control of healthcare-associated infections. However, no hospital was found to be fully compliant with all the standards during inspections. In fact, seven had to be reinspected because of the issues discovered during the first probe, among them Beaumont Hospital and Our Lady’s Children’s Hospital in Dublin.

Poor levels of cleanliness were found in a large number of the hospitals — sticky substances on furniture, flaked paint, dusty surfaces, and dirty cleaning equipment were all common.

One significant culprit for poor hand hygiene was Waterford Regional Hospital. In its emergency department, just five of 23 hand- hygiene opportunities were taken. Across the hospital, just 20 of 45 opportunities were taken. Hiqa found that four hand-hygiene gel dispenser units on the hospital public corridors on the first floor were empty, while the nozzles of some wall- mounted hand gels in the emergency department were clogged.

At South Tipperary General Hospital in Clonmel, which also came in for significant criticism, an “immediate serious risk” was found relating to the accommodation of patients with communicable diseases on the main corridor adjacent to the emergency department which was used as a main thoroughfare.

“The authority observed a lack of cleanliness of both the physical environment and equipment,” said Hiqa. “Whilst this unannounced assessment was limited to two patient areas and the ED of STGH, it would be of concern to the authority if these areas were reflective of the hospital in its entirety.”

In Letterkenny General Hospital, just 28% of hand- washing opportunities were taken, though that rose to 58% when the hospital was reinspected.


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