HIQA inspection criticises hygiene risks at Waterford Regional Hospital

Friday 16 August 2013 22.30
Poor hygiene practices noted in Waterford Regional Hospital's Emergency Department
Poor hygiene practices noted in Waterford Regional Hospital's Emergency Department

A report into hygiene at Waterford Regional Hospital has found there were "immediate serious risks" to the health and welfare of patients.

The hygiene inspection report from the Health Information Quality Authority (HIQA) also reported other poor practices at the hospital.

During the unannounced inspection on 25 June, HIQA says the immediate risks were due to non-compliance with hand hygiene practice in the Emergency Department.

Although isolation rooms were available, a patient with a suspected communicable infection was placed in a bay in the main area of the Emergency Department.

The environment was unclean, emergency supplies of needles, syringes and medications were stored on an unsecured trolley on a main corridor.

Inspectors brought the immediate hand hygiene risk to the attention of the hospital's general manager to allow the hospital take action as a matter of urgency and notified the HSE.

The Waterford Regional report is one of five published today by HIQA.

The inspection report also says there was a lack of cleanliness of both the physical environment and equipment as well as poor waste management practices.

While the Emergency Department was recently opened, many of the practices observed were not complaint with best practice.

One isolation room was used as a storeroom, while another was used for Ear, Nose and Throat consultations.

Access along the corridor was hindered due to cluttering with trolleys, items of patient medical equipment, bed tables, waste collection bins and chairs.

The environment and patient equipment in Medical 2 and patient equipment in Surgical 7 were generally unclean, with some exceptions.

HIQA says they were not effectively managed and maintained to protect patients and reduce the spread of healthcare infections.

Inspectors also found that four hand hygiene gel dispenser units located on the hospital public corridors on the first floor were empty and the nozzle of some wall-mounted hand gels in the Emergency Department were clogged.

Only five of the 23 hand hygiene opportunities for medical and nursing staff observed by inspectors were taken.

Some staff wore sleeves to their wrists and wrist watches, which is not best practice as it prevents adequate hand washing.

Inspectors found a hand wash sink contained soaking medical equipment and a hand wash procedure was carried out without removing these.

A medication fridge containing insulin and antibiotics was unlocked and hazardous chemicals were stored on an open shelf in one utility room.

Four other hygiene reports published

During an unannounced inspection on 4 July at Our Lady's Hospital, Navan, Co Meath, inspectors found that the environment in the Emergency Department was generally unclean and some hand wash sinks were unclean.

Both the Emergency Department and the Female Medical Ward were very cluttered with patient equipment, which hindered access and effective cleaning.

The unannounced assessment at Louth County Hospital on 1 July last did not identify any immediate serious risks to the health and welfare of patients.

However, there was much evidence of non-compliance with the national standards for the prevention of healthcare associated infections.

The environment and patient equipment on the step down ward were generally unclean with some exceptions.

The unannounced inspection of St Michael's Hospital, Dún Laoghaire in Dublin on 19 June found that a culture of hand hygiene is not yet embedded within all staff specialties.

The Emergency Department was generally clean but the Male Ward was generally cluttered.

Of two temperature probes examined, one was visibly unclean and the second had a sticky residue on the screen.

The unannounced inspection of Portiuncula Hospital in Ballinasloe, Co Galway found that although there were many improvements made since the last visit, there were still problems with the physical environment, waste management and cleanliness of patient equipment.

Doors to two isolation rooms were also found to be open.

The clinical director at Waterford Regional Hospital, Rob Landers, said it was "unacceptable" that a catalogue of bad hygene and health risks were discovered at the facility's Emergency Department.

Mr Landers said the hospital was "extremely disappointed" with the results published today.

He said that hand hygiene training would be made compulsory for all workers in future. At present, hand hygiene training is only compulsory for certain members of staff.

Mr Landers said that up to this any staff who were observed to have poor hygiene were notified to their line managers, but he said he hoped to make future hygiene breaches a disciplinary matter.

He reassured patients at the hospital that it was safe to attend Waterford Regional Hospital, despite the findings of today's report.

Mr Landers said that on the day HIQA made an unannounced visit on 25 June, the hospital's Emergency Department was particularly busy but he said he was not attempting to make excuses for unacceptable hygiene levels.