Risk of infection at Cork hospitals ‘shocking’

A damning report by the health watchdog has found substandard bug control measures at two Cork hospitals are exposing patients to significant risk of infection.

Cork University Hospital (CUH) and Mallow General Hospital (MGH) have been found substantially derelict in meeting national standards for the prevention and control of healthcare associated infections (HCAIs).

HCAIs include bloodstream infections such as MRSA, catheter-linked urinary tract infections, and ventilator-associated pneumonia. Infections may occur at surgery sites, known as surgical-site infections.

Irish Patients Association spokesman Stephen McMahon said it is “absolutely shocking” that CUH, one of the country’s busiest hospitals, serving a population of more than 550,000, has yet to meet infection control standards four years after their introduction.

“The real issue here is governance, and it goes back to the Health Service Executive and right up to the health minister,” said Mr McMahon. “Four years after the standards were brought in, people are still taking an à la carte approach to infection control.”

Among criticisms by Hiqa (Health Information and Quality Authority) were:

- MGH had no infection control nurse or microbiologist and there was no formal outreach microbiology support from CUH;

- No audits of surgical site infections were conducted at either CUH or MGH;

- Audits were not being undertaken at CUH in relation to the use of invasive medical devices. This meant there was no way of knowing if infection was being “effectively prevented and managed in relation to such devices”;

- No audits of antibiotic usage at MGH. No surveillance was undertaken as the post of surveillance scientist had not been filled;

- Poor attendance hand hygiene training. Only 10 out of 43 MGH staff observed washed their hands correctly;

- No evidence of a comprehensive antimicrobial stewardship programme which would look at using the right agent, at the correct dose, for the appropriate time, in order to cure or prevent infection, while minimising toxicity and emergence of resistance.

These failures means patients are exposed to a “significant number” of infection risks, Hiqa said, adding that “inadequate governance arrangements” compounded the shortcomings.

Hiqa referred to the fact that MGH was the focus of a 2011 report into the quality and safety of services.

Last night, HSE South said an action plan was being formulated on foot of Hiqa’s 10 recommendations, led by CUH Group Infection Prevention and Control Committee.

In a statement, the HSE said the plan would be “monitored on its delivery and effectiveness” by the hospital executive. In addition, from July, it will be mandatory for all staff to receive hand hygiene training at induction. Staff will also have to complete a hand hygiene education programme every two years as part of continuous training.