Overcrowded isolation units in a cancer ward and unsafe injection practices are two of the most serious findings from a watchdog’s inspection of hospitals.
The Health Information and Quality Authority (Hiqa) revealed twice as many patients were being treated in an oncology/haematology unit in Mayo General Hospital than it was designed for.
During the spot check in March, 20 people were being kept in two rooms on a day ward set up five years ago as a temporary facility, with 16 of them in an open section where the risk of spreading infections like flu was increased, inspectors said.
“There are no designated isolation facilities on the ward for patients with known or suspected transmissible infection and there is only one designated patient toilet for use by patients undergoing treatment and patients in the ward waiting area,” the inspectors said.
Infection risk in paediatrics
A separate review of standards in the Midland Regional Hospital Mullingar in February found immediate high risk of infection on the paediatric ward with serious concerns for patients, visitors and staff.
The watchdog’s inspectors found 11 patients were isolated in a children’s ward for infection control but only five of the doors to rooms were closed.
The report found staff had poor and ineffective personal protective equipment and displayed poor hand hygiene.
Unsafe syringes at Cavan General
During the March inspection at Cavan General Hospital, a number of syringes holding medication were found lying uncovered in a disposable kidney tray in a fridge in an anaesthetic room in theatre.
Hiqa said one was dated four days prior to the inspection in early March and others were insufficiently labelled.
Its report stated: “Assurances could not be provided that the integrity and sterility of these medications were maintained from compounding to administration.”
Inspectors also raised concerns that there has been little improvement as the incidence rates of C difficile infection had been significantly above the national average and Health Service Executive targets in 2013 and 2014.
Hiqa said the hospital is addressing the issue by enhancing anti-microbial oversight and improvement the overall cleanliness of the hospital and hand hygiene standards.
“There is considerable room for improvement in hand hygiene compliance and a need to further progress the implementation of the antimicrobial stewardship programme in order to mitigate the risk posed by C. difficile.”
Still 'learning lessons'
Hand hygiene practices and audits – regarded as a primary step to prevent the spread of infection – also remained an issue in some areas of the hospitals in Mayo and in Mullingar.
Following the review of standards in Castlebar, Hiqa said a request for shower and toilet seats to be replaced had not been met and the risk of falls, slips and trips because of the design of showers also remained an issue.
The Mayo hospital management were said to be still “learning lessons” from previous inspections and significant improvements were required.
The reports on poor standards in the three hospitals were published along with reviews of hospitals in Bantry, Mallow, Sligo, South Tipperary, St Michael’s Dun Laoghaire and Wexford, and in Dublin at Connolly Hospital and the Coombe Women’s University Hospital.
Most hospitals showed improvements on standards from previous inspections.