Overcrowded A&E did not comply with infection control guidelines in non-Covid cases

Overcrowded A&E did not comply with infection control guidelines in non-Covid cases

Hiqa said key improvements had been made, but some risks remained

An inspection has found that one of the west's busiest hospitals had an overcrowded Emergency Department for non-Covid-19 cases, meaning it did not comply with public health and infection prevention and control measures.

The unannounced inspection of Mayo University Hospital, which had two "significant" Covid-19 outbreaks last April, also found a number of infrastructural and maintenance issues in the wards inspected.

Hiqa found that the closure of 38 beds due to ongoing renovations meant reduced inpatient capacity that was contributing to overcrowding of the Emergency Department dealing with non-Covid cases

It also said the hospital was non-compliant when it came to providing a clean and safe physical environment that minimises the risk of transmitting a healthcare-associated infection.

While Emergency Department B — dealing with Covid cases — was fully compliant with requirements such as social distancing, Hiqa said patient placement within Emergency Department A, for non-Covid cases, "was not optimal from an infection prevention and control perspective as overall the treatment areas were cramped and cluttered". 

It said: "Minimal spatial separation between trolleys did not comply with public health guidelines for minimum physical spacing and increased the risk of cross-infection."

The Hiqa report found high standards of compliance with other standards and was told that 40 additional acute inpatient beds had been made available offsite. 

"However uptake of the additional beds was not maximised with 15 empty beds available within this unit on the day of inspection," it said.

Elsewhere Hiqa said key improvements had been made in response to the outbreaks, but some risks remained, including a lack of appropriate isolation facilities in the emergency department, inpatient wards, and intensive care unit.

An inspection of Waterford University Hospital found high levels of compliance and noted that it cared for 30 Covid-19 patients between March and July, with no cases of hospital transmission among staff or patients.

At St Theresa’s Hospital in Clogheen in Tipperary, inspectors found keeping to infection control standards was challenging in the old building. Issues included there being no separate room for the storage and preparation of medicine, and no hand sink in the cleaning equipment room for staff to use. 

The hospital needs to review the continuation of the onsite laundry services a priority.

The rehabilitation unit at St Ita’s Community Hospital, Newcastlewest, was also inspected and was found to be compliant or substantially compliant on six measures.

Inspectors however raised concerns around the work patterns of some staff known as “multi-task attendants” who were working as care assistants and cleaners, while a separate report on Gorey Hospital in Wexford, which had a Covid-19 outbreak among the staff, found it needed infrastructure improvements.

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