Hiqa found Temple Street patients at high risk of infection

Patients at a major children’s hospital were at a “high risk” of infection because of poor hygiene, it has emerged.

The Health Information and Quality Authority (Hiqa) raised the alarm about the state of Temple Street Children’s University Hospital in Dublin after an unannounced inspection.

During the inspection last July, “immediate high-risk findings” concerning infection prevention and control were identified.

Standards of environmental and patient equipment hygiene were so worrying that Hiqa reinspected the hospital after six weeks.

During their initial visit, the inspectors found that cleaning processes in the hospital did not appear to be efficiently organised or overseen.

Factors contributing to poor environmental hygiene in the wards inspected included an outdated hospital infrastructure and poor maintenance.

There was very limited space in patient care and ancillary areas and a lack of storage space. Also, the design and position of furnishings did not allow effective cleaning.

Also, the hospital did not have a pro-active preventative maintenance programme.

The structure and design of the oldest parts of the hospital did not facilitate compliances with the National Standards for the Prevention and Control of Healthcare Associated Infections.

Also, the wards inspected did not meet the desirable specifications of a modern children’s hospital as the infrastructure was outdated.

When inspectors revisited the hospital in September, they found that significant improvements had been made.

Cleaning processes had been systematically revised, and the hospital was trying to address findings identified within the constraints of the hospital infrastructure.

Inspectors said it was apparent that the hospital management team and staff had worked together to address the conclusions of the previous inspection.

Hiqa pointed out that the hospital achieved a “commendable” hand hygiene compliance score over the summer that exceeded the HSE’s national compliance target of 90%.

The authority said it was aware that hospital staff worked in a “compromised physical environment” dealing with a high level of activity and complex cases.

“Notwithstanding infrastructural deficiencies, hospital environments should be kept clean and proactively maintained to facilitate effective cleaning,” it stated.

The hospital is due to move to the new national children’s hospital beside St James’s Hospital in Dublin in 2020.

Meanwhile, an unannounced inspection carried out in The Rotunda Hospital in Dublin last August found that, overall, patient equipment and the environment in the delivery suite was generally clean, with a few exceptions.

However, inspectors found the infrastructure and design of the operating theatre in the delivery suite did not meet international best practice guidelines and presented challenges for effective cleaning.

There is a proposed national plan that the hospital will move to a new site in the grounds of Connolly Hospital in Blanchardstown, but this could take some years to complete. Hiqa said the hospital should continue to explore all potential options to improve current facilities because of the time it will take to build and open a new hospital.