Report criticises hospital over its hygiene standards

South Tipperary General Hospital has been criticised over its hygiene standards with a report from the health watchdog claiming that some ward areas and equipment were mostly unclean.

The Health Information and Quality Authority (Hiqa) carried out inspections on five hospitals, including Our Lady’s Hospitals for Sick Children in Crumlin, the Rotunda in Dublin, and the South Infirmary in Cork.

The checks are the latest to be carried out by Hiqa under the monitoring programme for the national standards for the prevention and control of healthcare associated infections.

The Hiqa report on South Tipperary General Hospital found it only partially compliant with the standards while “poor attendance at hand hygiene training and poor hand hygiene audit results were significant”.

The 193-bed hospital had its emergency department, maternity ward, and its female gynaecological surgery and male surgery areas checked. Inspectors found “the absence of several fundamental roles in regard to the prevention and control of Healthcare Associated Infections posed a significant risk of HCAIs, both directly and indirectly, to patients in South Tipp-erary General Hospital”.

Shortcomings included the lack of a reported PCHCAI-specific budget and of comprehensive surveillance, plus insufficient auditing.

The report said: “There was limited evidence provided as to how the Executive Management Board at South Tipperary General Hospital can be assured that the prevention and control of HCAIs is regularly considered, assessed and managed to comply with the National Standards, and the associated risks to patients monitored and mitigated.”

Hiqa also found “the edges and corners of flooring in the patient areas were unclean”, with “grit and pieces of waste paper on the floor surface of a room for storing baby feeds”.

In addition to issues of dust in some parts of the hospital inspectors noted that “cleaning staff multitask between cleaning and kitchen duties such as providing tea and toast for patients, without any change of uniform between duties.”

The emergency department did not have a clean utility room, curtain rails were heavily soiled with black dust, while seven sharps bins of varying sizes containing hazardous waste, including that generated from the previous evening, were stored on the floor of the “dirty” utility room and had not been collected from the area by 10.45am.

The hospital’s waste management policy was issued in Nov 2007 and due for review in 2008.

“In conclusion, the Authority found that the South Tipperary General Hospital did not adequately ensure that the cleanliness of the physical environment and equipment was effectively managed and maintained,” the report read.

Other results:

Hiqa also checked other hospitals as part of its hygiene inspections, including the South Infirmary Victoria University Hospital.

The unannounced check covered its outpatients department, the Victoria level 1 — orthopaedic trauma rehabilitation, and the Ground floor south 2 — female surgical.

Hiqa did not find any immediate serious risks to the health and welfare of patients receiving care in the areas assessed, but there were some issues such as hazardous waste temporarily left in an unused patient shower room while awaiting collection, and all-bar-one shower in a rehab ward not fit for purpose as they were domestic-type shower units with a step up into the shower, with no evidence the shower was cleaned between patients.

Hiqa also found hand hygiene practices were inconsistent with national standards.

In the Rotunda, the pre-natal ward and post-natal ward were checked and Hiqa said it did not identify any immediate serious risks to the health and welfare of patients.

At Our Lady’s Hospital in Crumlin Hiqa urged further improvement in areas such as hand hygiene but overall found it had been adhering to standards.

In Sligo General, the emergency department, male medical, and male surgical areas were checked and among the issues uncovered was staff hand-hygiene training attendance and compliance not meeting an adequate standard.