Bloodstains found on ICU machine during hospital inspection

Bloodstains on a machine in South Tipperary General Hospital’s intensive care unit and red stains on a mattress and pillow were discovered during an audit of the hospital’s three units.

Hiqa inspectors have said the standard of environmental hygiene at South Tipperary General Hospital is “sub-optimal” while “unacceptable” levels of dust are an ongoing issue.

The findings were contained in a report on an unannounced inspection of the 193-bed hospital in Clonmel which took place last month and which also noted that just 54% of doctors had attended hand-hygiene training during the previous 12 months.

HIQA inspectors also found “unacceptable dust levels” in a number of areas of the 193-bed hospital and said that, while this was referred to the hospital’s household manager by the ward managers in the coronary care unit and one of the wards, it remains “an ongoing issue”.

The cleanliness of patient environments in the hospital’s coronary care unit and medical one ward was “of concern to the authority”, the inspectors said.

“On the coronary care unit, unacceptable levels of dust were present on floor edges and corners, on skirting boards, high surfaces such as curtain rails and bed frames,” they said. “On medical one, dust was observed on the under surfaces of beds, on the casements above beds, on skirting boards, floors, window ledges and curtain rails.”

The patient sanitary facilities in both areas were also “unclean”, the report said, with an “unclean” shower basin and a “stained” toilet brush. “The findings of the inspection indicate that environmental hygiene is suboptimal and dust has been highlighted through internal hygiene audits as an ongoing issue,” it said.

The Hiqa report said adherence to standard precautions and “fundamental” infection-control principles “such as the safe management of sharps and waste, effective cleaning of equipment, hand hygiene and education are essential in preventing transmission of blood borne pathogens such as hepatitis B virus and hepatitis C virus”.

Meanwhile, other equipment including thermometer probes, blood pressure cuffs, a commode and glucometer holders were found to be “unclean” in the coronary care unit.

“In accordance with national and evidence-based guidelines, direct contact patient equipment should be clean and equipment which is shared by patients should be cleaned and decontaminated between each use,” Hiqa said.

The unannounced inspection took place on July 10 and focussed on the intensive care unit, the medical one ward (St Monica’s Ward) and the coronary care unit, including the step-down section.

The hospital’s catchment population is 134,000 across south Tipperary, west Waterford, and part of north Tipperary.

Support staff at the hospital work on both cleaning and catering, in spite of Hiqa’s standard that these areas of work should be kept separate.

“The authority is concerned that the lack of a dedicated cleaning staff on the coronary care unit and medical one may have contributed to the findings on the day of the inspection,” said Hiqa.

On the day of the inspection, hand hygiene compliance among staff was just 36% although this was based on a small sample size.

Hospital general manager Grace Rothwell said: “STGH welcomes this report and can assure the public that the hospital has a solid record as a safe provider of health care to the people of South Tipperary.”