Infection control at Kilkenny hospital criticised

A HSE-run hospital in Kilkenny has been criticised for not having all “essential elements” of an infection prevention and control programme in place.

Following an unannounced inspection by the Health Information and Quality Authority, governance and management arrangements around the prevention and control of healthcare-associated infection at St Luke’s General Hospital were found to be not aligned to the current Ireland East Hospital Group governance structure.

Inspectors found that the implementation of a comprehensive infection prevention and control programme was limited by the daily need to address the placement of patients requiring isolation in a frequently overcrowded hospital with poor inpatient accommodation infrastructure and a lack of isolation facilities.

Some of the risks impeding effective infection prevention and control as they exist cannot be sufficiently mitigated at local hospital management level.

Hiqa said that the management of these risks will require support at senior HSE and hospital group level to address the infrastructural deficiencies and capacity.

However, Hiqa also praised the hospital in other areas. The hospital participates in the national hand hygiene audits, the results of which are published twice a year. Since 2015, the hospital has consistently achieved the required HSE national hand hygiene compliance target of 90%.

“Notwithstanding the identified areas for improvement found during this inspection, inspectors found that the infrastructure of some facilities for people attending the hospital had been recently significantly improved.

“Specifically, the hospital had opened a newly built emergency department and day and out-patient facilities one year prior to this inspection. This is a welcome development,” the inspection report said.

Separately, a second inspection report on the Coombe Women and Infants University Hospital in Dublin found that it had had effective leadership, governance and management arrangements in place around the prevention and control of healthcare-associated infection.

The hospital had an established infection prevention and control team and committee who were supported by effective governance and oversight of infection prevention and control in the hospital.

The hospital had up-to-date policies, procedures, and guidelines in relation to the prevention and control of infection and had implemented a number of measures to promote education and training of clinical staff which represented a commitment to promoting safer patient care.

Recent hand hygiene audit results indicated that the hospital had exceeded the HSE national target for compliance.

Overall, patient equipment and the patient environment in the areas visited on the day of inspection were generally clean. There was good ownership in relation to hospital hygiene and evidence of clear processes and responsibilities from clinical areas to executive management.

Hiqa noted that the risks associated with outdated infrastructure which was identified in a previous inspection in 2016 had been escalated through the HSE. It acknowledged that risks in relation to hospital infrastructure cannot be mitigated until building works are complete.

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