Latest HIQA reports show some hospital hygiene standards not being met

Thursday 19 December 2013 22.57
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A used clinical dressing was found in a patient shower area at Holles Street hospital
A used clinical dressing was found in a patient shower area at Holles Street hospital
HIQA says a culture of hand hygiene practice is becoming embedded among staff at St Luke's Hospital, Rathgar
HIQA says a culture of hand hygiene practice is becoming embedded among staff at St Luke's Hospital, Rathgar

A report by the health watchdog has found that the National Maternity Hospital, Holles Street, was not compliant with some national hygiene standards following an unannounced inspection in October.

The Health Information and Quality Authority found that the patient environment was generally clean in both areas it inspected.

But there were opportunities for improvement regarding the cleanliness of the patient equipment, the report stated.

In one postnatal ward it inspected, the authority found a used clinical dressing was in a tray in a patient shower area and a heavy layer of dust was visible on the underneath surface of neonatal incubator.

In another area, large wheeled clinical waste storage bins were inappropriately stored in a stairwell adjacent to the postnatal wards.

The authority said it acknowledges the infrastructural challenges of an older building and has noted that the Dublin hospital has an action plan to reduce storage in corridors.

The authority also found that a culture of hand hygiene is not yet operationally embedded throughout the hospital. 

It found that 45% of the hand hygiene opportunities observed by the authority during the monitoring assessment were taken by the hospital staff.

HIQA said the hospital must now develop a quality improvement plan and will be subject to a follow-up assessment.

In a statement, the National Maternity Hospital said it was committed to further improving its performance.

It added that at the time of the audit, the hospital had commenced internal structural improvement programmes.

HIQA also found that the physical environment and patient equipment at St Luke's Hospital, Rathgar, was clean and well maintained, though with some exceptions.

If follows an unannounced inspection of the hospital by the authority last October.

The authority says while there was evidence of good practice, there was also evidence of national standards not being met.

It found the vinyl covering on a chair located in a single room was torn hindering effective cleaning, a light layer of dust was visible on electrical fittings, and a small amount of black matter was visible between the base of the shower and the wall in the washroom assessed.

The authority says the level of hand hygiene compliance observed across staff grades at the hospital at the time of monitoring was 82% indicating, the authority says, that a culture of hand hygiene practice is becoming embedded among staff in the hospital.

HIQA also found that the physical environment and patient equipment at Our Lady of Lourdes Hospital, Drogheda were clean and well maintained, but found some exceptions.

The authority made an unannounced inspection of the hospital in October and found evidence of food practice in areas such as waste segregation, the maintenance of lines and the upkeep of isolation rooms.

However, the authority found that bed spacing in the seven bedded ward was not planned and managed in a way that minimises the risk of spread of healthcare associated infections in accordance with national standards. 

It found there was rust coloured staining and black marks were visible in a shower tray in a washroom assessed and a workstation was cluttered, rendering adequate cleaning difficult.

The authority says it observed 26 hand hygiene opportunities, 24 of which were taken equating to a 92% compliance rate indicating.

The authority found that a culture of hand hygiene practice is well embedded among staff in the hospital.

The hospital must now develop a quality improvement plan that prioritises the improvements necessary to fully comply with national standards.

The plan must be published within six weeks.

HIQA found evidence of significantly improved hand hygiene compliance among staff at Beaumont Hospital and St Joseph's Hospital after it carried out an announced inspection last month.

It follows on from an unannounced assessment in July.

The authority said clinical areas and patient equipment assessed had mostly improved with some exceptions.

It also says there was evidence of key posts associated with infection prevention being vacant for prolonged periods in the recent past, but all posts are now filled.

However, the authority finds a lack of adequate isolation facilities poses risk to patients of contracting infections.

It also found that a number of areas were identified that could potentially increase the possibility of patients contracting healthcare associated infections. 

These risks have resulted in six recommendations being made to improve prevention.

While the authority found good practice in areas such as waste segregation, linen hygiene and isolation rooms, they did find evidence of practice that was not compliant with national standards.

They found sanitary waste disposal facilities were not available in the washroom assessed, rust coloured staining was visible at the wheel areas and base of a commode and chipped paint on radiators in a patient area.