HIQA finds 'high risk' to patients at Wexford hospital

Wednesday 11 June 2014 22.24
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HIQA said that there did not appear to be a culture of hand hygiene best practice at Wexford General Hospital
HIQA said that there did not appear to be a culture of hand hygiene best practice at Wexford General Hospital
The hospital said that annual hand hygiene training and education were mandatory by May 2013
The hospital said that annual hand hygiene training and education were mandatory by May 2013

The report of a hygiene inspection by the Health Information and Quality Authority into Wexford General Hospital found issues that posed "a high risk to the health or welfare of patients."

Unannounced inspections were conducted on 4 March and 17 April last.

HIQA said that the evidence reviewed during inspection did not demonstrate an executive commitment to reducing the risk to patients of acquiring healthcare-associated infections.

The authority said that there did not appear to be a culture of hand hygiene best practice at the hospital and there was resistance to attendance at educational sessions.

The hospital told HIQA that annual hand hygiene training and education were made mandatory for all disciplines by May 2013.

However, during the inspection on 4 March, HIQA found that only 52% of nurses and healthcare assistants in one of the clinical areas inspected were up to date with hand hygiene training.

Wexford General Hospital has said that a new state-of-the-art Emergency Department, inclusive of isolation facilities, is operational from today, which will provide a much enhanced environment for patients and staff.

The new Emergency Department also includes a new reception and waiting areas, 

The hospital said it had a solid record as a safe provider of health care to the people of the Co Wexford area. 

The HSE said it was a big, busy hospital but has an Action Plan in place both to address the HIQA hygiene audit observations and to ensure that the mandatory hand hygiene practices are observed.

HIQA says that in 2013, Wexford General reported a hand hygiene audit compliance rate of just under 72%, which is 18% less than the HSE national target of 90%.

The watchdog says that worryingly, the hospital did not report results in the national hygiene audit for October 2013.

Due to conflicting evidence, HIQA was unable to verify the exact number of staff who had completed hand hygiene training.

The hospital told HIQA that some hand hygiene audits did not take place due to "a lack of resources".

It said it had advised staff that a failure to attend hand hygiene training may result in disciplinary procedures and sanctions.

The inspections uncovered other problems.

In a five-bedded isolation room, a waste bin was observed to be wrongly labelled as domestic non-risk waste, but had a clinical waste bag inserted into it.

Other issues identified by inspectors were a dusty and cluttered resuscitation trolley, foot operated levers on the clinical and non-clinical waste disposal bins were not working correctly and had to be manually closed, and paintwork on walls in wards and in day units was scuffed and chipped, hindering effective cleaning.

There was no personal protective equipment provided inside a five-bedded isolation room, hindering the ability of staff to attend to more than one patient during a single visit to the room.

The management of healthcare risk waste in isolation rooms also raised a concern for HIQA.

It said there should be a clinical/healthcare risk waste bin in every isolation room.

HIQA said that 114 hand wash sinks needed to be upgraded to meet current standards of design.

The hospital told HIQA that the sinks would be upgraded as part of improvement projects which were due to commence in May.

The Clinical Director of Wexford General Hospital said the HIQA report is very hard hitting, and that he completely accepts it.

However, Dr Colm Quigley insisted there was a complete executive commitment by the board of management to Wexford General Hospital complying with hand hygiene.

He said that HIQA's details could be upgraded and the hospital could provide the authority with further information.

However, he said the hospital completely accepted the HIQA report and embraced it.

He said the hospital would make sure that all mandatory hand hygiene practices would be carried out.