Hospital staff facing sanctions over hygiene

Staff at Beaumont Hospital face a range of sanctions, from withdrawal of some privileges to disciplinary action, if they fail to comply with hygiene standards.

The threat of sanctions emerged following a dismal showing by the large Dublin hospital in a report compiled by the Health Information and Quality Authority (Hiqa).

The report found doctors at Beaumont are failing to engage in the simple act of hand-washing before treating patients, increasing the risk of spreading infection.

This omission comes despite repeated public health campaigns emphasising the crucial role of clean hands in healthcare settings. Of five hospitals surveyed by Hiqa, medical staff doing ward rounds at the neurological intensive care unit and the emergency department at Beaumont were the biggest offenders.

Hiqa inspectors said that, out of 60 opportunities doctors had to wash hands before or after treating patients, only 28 were taken.

These failings meant good hygiene practices “were not operationally embedded posing a risk to patients in Beaumont Hospital”.

Hand hygiene is recognised internationally as the single most important measure to prevent spread of healthcare associated infections (HCAIs).

Of the four other hospitals inspected — Merlin Park in Galway, the Mid-Western Regional Maternity Hospital in Limerick, Lourdes Orthopaedic in Kilcrene, and the Midlands Regional Hospital in Tullamore — just Kilcrene was found to have good hygiene practices “operationally embedded”.

Merlin Park almost achieved full compliance, but significant shortcoming were identified in other areas:

l Doors to isolation rooms were open on one ward, posing a risk of spread of infection to other patients;

lVisitors to isolated patients did not remove personal protective equipment on exiting the isolation rooms but continued wearing contaminated apron and gloves for the duration of their visits;

lIsolated patients with confirmed communicable infections were observed leaving the isolation facilities to use a communal bathroom and to sit outdoors.

At the Midland Regional Hospital in Tullamore, which has won awards for best healthcare building, inspectors found the environment and equipment in the emergency department were “generally unclean, placing patients at moderate risk of HCAIs”.

One patient with a suspected transmissible infection was being cared for in a room without hand-washing facilities and the door was open directly to where other patients were cared for.

Beaumont last night responded to the criticism saying it was “disappointed” that existing measures to ensure good hand hygiene had not been met — measures which include mandatory training for all staff.

On foot of the Hiqa report, the hospital said a Quality Improvement Programme is being developed which will be published in the coming weeks. This “will provide for the imposition of sanctions where staff are found non-compliant with hospital hand hygiene and standards precautions policies”, the hospital said.

A statement from the Midlands Hospital said a quality improvement plan is in place to address the report’s recommendations.

A statement from Merlin Park said it was “implementing our action plan to address the deficits identified and to build on the areas where we have demonstrated good practice”.