Report into deadly hospital outbreak still not acted on

AN internal hospital report calling for infection control improvements to prevent a repeat of last year’s deadly clostridium difficile outbreak at University Hospital Galway (UHG) has yet to be implemented six months after it was concluded.

The document – submitted to Galway University Hospitals management, which oversees UHG and the nearby Merlin Park University Hospital – was concluded in November after 22 cases of clostridium difficile were recorded at St Rita’s ward in UHG in January 2008.

The outbreak contributed to four deaths at UHG and led to a series of concerns being raised over the infection control policy in the ward as the clostridium difficile cluster was deemed to have been more severe than previous cases.

However, despite the internal hospital investigation report, obtained by Irish Medical News, warning of inadequate staffing levels, delays in antibiotic use, and stating St Rita’s is “entirely unsuitable” for managing an infectious outbreak, the document’s recommendations have yet to be fully implemented.

At the time of the outbreak St Rita’s ward consisted of three six-bed areas and a single room, with three toilets for all patients on the ward.

The internal report said the situation meant services needed to be improved, with en-suite facilities and increased space between beds among the infection control recommendations.

However, despite these calls a spokesperson for the hospital has confirmed that the ward’s layout and configuration is almost entirely unchanged from the time of the outbreak, with just one of the three six-bed units now acting as a five-bed unit to increase space between patients.

The hospital spokesperson stressed no further outbreaks have been recorded since January 2008.

Unlike MRSA, which is associated with a high-rate of anti-biotic use in the community, clostridium difficile is directly connected to a lack of cleanliness in hospital wards.

In a single four-month period between May and August last year, the Health Protection Surveillance Centre (HPSC) said there were 867 reported cases of the infection across the country, with the highest levels recorded in Dublin (317), Cork (35), Mayo (62), and Galway (40).

The infection was not classed as a notifiable disease until May last year.

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