Infection control issues identified at community hospitals

Hiqa identified issues at facilities in Limerick and Waterford.

The health watchdog said existing issues with infrastructure and maintenance could worsen any potential risks of infection control.  

None of a group of three community hospitals inspected by Hiqa were fully compliant with basic national standards for infection control.

This is despite well-publicised concerns over the past seven months about the safety of patients in small hospitals and other residential care settings.

St Patrick’s Hospital, John’s Hill, in Waterford was only fully compliant in one of six national standards, while a rehab unit at St Camillus’ Hospital in Limerick was only compliant in three of the six standards.

In addition, Belmullet Community Hospital in Co Mayo was only compliant in two areas.

Issues raised by inspectors included the fact that St Patrick’s was admitting patients from an acute hospital that were not tested for Covid-19 prior to admission.

In addition, the hospital had not — on date of the inspection on September 2 — put measures in place to isolate patients transferred from an acute hospital and who had not been tested for Covid-19 in line with national guidance.

Hiqa said: “The above issues were brought to the attention of senior management at the hospital during the inspection.

“This was done so that the hospital could act to mitigate and manage the identified risks as a matter of urgency.

Compliance with guidelines

They added that in light of the ongoing global pandemic and its impact on safety of care for patients, Hiqa had sought assurance regarding arrangements in place to ensure compliance with the national guidelines.

It has since received that assurance from the HSE.

Hiqa also noted: “A number of infrastructural issues which had the potential to impact on infection prevention.

Control measures were identified during the course of the inspection including general wear and tear throughout the ward

With Belmullet Hospital, inspectors, on July 29, viewed two previous external infection prevention and control reports from November 2019 and April 2020.

The latest of the two had only been completed after a Covid-19 outbreak was declared a few weeks before the inspection.

Hiqa said hospital management stated risks identified in these reports, which were similar to those identified on the latest inspection, had been — in effect — flagged up within the HSE.

However, the health watchdog said hospital management acknowledged on the day of the inspection that there was no “time-bound action plan in place to address these risks”.

A spokesperson said: “It was evident that Belmullet Community Hospital had escalated locally identified infection prevention and control related risks.

“However, Hiqa had concerns that such escalation was not resulting in a sufficiently timely and reciprocal response.

“It was not clear if escalated risks were being actioned.

Local risk registers in Belmullet Community Hospital need to be better managed, reviewed and escalated in line with national policy

The health watchdog added that "longstanding infrastructural and maintenance issues" which had the potential to impact on infection prevention and control at all three facilities.

"While these issues have been escalated (within the HSE), they have not been addressed," Hiqa said.

"Hospitals need to address the areas for improvement identified on inspections in order to facilitate compliance with the National Standards for infection prevention and control in community services and other existing national healthcare standards."