Trolley crisis breaches agreed care standards as flu illness rates quadruple

An average of 190 patients a day spent more than nine hours on trolleys over the last five days, breaching agreed care standards and forcing the activation of escalation policies in a number of hospitals.

But despite the acute crisis in emergency departments (EDs), health workers are continuing to ignore pleas to get the flu vaccine raising the risk of spreading the illness to vulnerable patients.

This is against a backdrop of warnings from the Health Service Executive (HSE) that flu-like illness rates have quadrupled since the start of the year.

Just one in four workers in public hospitals and long- term care facilities have been vaccinated this winter.

The HSE began a campaign in 2013 to encourage its staff to get vaccinated and although the vaccine is free for health workers, the uptake remains stubbornly low.

Trolley crisis breaches agreed care standards as flu illness rates quadruple

Latest figures show that less than a quarter (23.7%) of staff across 42 hospitals have the current vaccine, while 26.1% of workers in 85 long-term care facilities have been vaccinated.

Two long-term care facilities in Cork and one each in Mayo and Donegal have no staff vaccinated — but one facility in the country, St Colman’s House, Macroom, has a 100% uptake. The highest uptake among individual hospitals was 46.8% in the National Rehabilitation Hospital, Dun Laoghaire; and the lowest was 6.9% in Lourdes Orthopaedic Hospital, Kilkenny. Vaccination is seen as key to infection control and the HSE is aiming at a 40% uptake in the short-term and 75% in the longer-term.

A report by the Health Surveillance Protection Centre (HSPC) said health care workers must be made see that vaccination “is integral to duty of care” for patients.

Trolley crisis breaches agreed care standards as flu illness rates quadruple

Separately, Professor Tim McDonnell, consultant respiratory physician and HSE national clinical lead for Chronic Obstructive Pulmonary Disorder (COPD), said the number of patients with the chronic lung disease presenting at EDs for treatment was exacerbating the overcrowding crisis. A lack of GP access to spirometry (a breathing test) was a major impediment to successful management of the disease within primary care he said, with the result that patients with a suspected diagnosis were being referred to hospital for diagnosis and ongoing management.

“Less than one in five GPs have access to spirometry. It makes sense to train and equip more GPs to diagnose it,” Prof McDonnell said.

There is also a need for more nurse-led COPD clinics in the community. Prof McDonnell said Ireland has the second-highest rate of admission for COPD in the OECD and rates were 50% higher than in Britain “which is not that culturally different”. Despite the fact that an estimated 400,000 people in Ireland are affected by COPD, awareness of the disease is low among the public, with symptoms often confused with asthma or chronic bronchitis, he said.

ED overcrowding has been so severe in the past week that larger hospitals continued to cancel scheduled surgeries yesterday as part of a nationally agreed approach to tackling the crisis in EDs. That approach involves placing extra beds on wards to transfer patients out of EDs.

A spokeswoman for the Dublin Midlands Hospital Group said 10 elective surgeries were cancelled at the Midlands Regional Hospital in Portlaoise yesterday while two were cancelled at Naas General Hospital. She said the HSE’s escalation policy has been activated at the hospital and they are asking patients to consider visiting their GP for initial assessment.

Trolley crisis breaches agreed care standards as flu illness rates quadruple

“The situation will be reviewed on an ongoing basis,” she said.

Earlier in the week Cork University Hospital (CUH) cancelled 30 non-urgent procedures; Beaumont Hospital cancelled five and three were postponed within the University of Limerick hospitals group.

A spokesperson for Beaumont said there were “no plans to postpone any procures planned for Monday, January 25”.

The Ireland East hospitals group was unable to provide information on possible cancelled surgeries yesterday afternoon.

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