Poor conditions for patients and long wait times at the Emergency Department have been reported at Our Lady of Lourdes Hospital in Drogheda, according to HIQA.
During an unannounced inspection by the Health Information and Quality Authority earlier this year, one patient aged over 75 was found to have been waiting longer than 24 hours in the ED after registration, with six aged over 75 waiting longer than nine hours.
This inspection was one of seven carried out by HIQA at healthcare services across the country to assess compliance with the National Standards for Safer Better Healthcare.
They took place between March and August 2024 at Wexford General Hospital, St Luke's General Hospital Kilkenny, Mercy University Hospital, Our Lady of Lourdes, Drogheda, University Hospital Galway, University Hospital Waterford, and Our Lady's Hospice and Care Services, Harold's Cross.
Overall, the healthcare services inspected were found to be substantially or partially compliant with the national standards monitored, with Wexford General Hospital being the only facility found not to be compliant in one of the standards assessed during an unannounced inspection carried out at the hospital on 5 and 6 March.
HIQA said the staffing of nurses in the special care baby unit at Wexford General Hospital was inadequate, and significant staffing deficits are present throughout the hospital, some of which are due to difficulties in recruitment.
Hospital management submitted an urgent compliance assurance to address the issues in the short term with additional resources planned to support the service in the medium term.
Staff absenteeism rates at the hospital remain above the national average.
An unannounced inspection of University Hospital Galway on 8 and 9 May found the hospital to be compliant or substantially compliant in four standards and partially compliant in seven of the 11 national standards monitored.
It found patient flow within the hospital was not functioning as it should, and a mismatch between availability and demand for inpatient beds resulted in 29 patients admitted into hospital being treated on trolleys and chairs in the emergency department.
Waiting times showed that the hospital was not in line with the majority of the HSE’s targets, although it had improved on the previous inspection.
On the day of inspection, 31 patients had delayed transfers of care out of the hospital, which was attributed to a deficit of community beds in the region.
HIQA said staff were challenged to maintain privacy and dignity in large multi-occupancy rooms and in the overcrowded ED.
The hospital was found to monitoring and evaluating healthcare services to improve care, but HIQA said it was not clear what action had been taken to address issues identified in areas such as medication safety, deteriorating patient, sepsis and clinical handover.
During the unannounced inspection of the ED of Our Lady of Lourdes Hospital on 24 April, HIQA found the hospital to be substantially compliant in one standard and partially compliant in three of the four national standards monitored.
It said the hospital’s ED was overcrowded resulting in increased patient experience time (PET).
The accommodation of 19 admitted patients in the ED on the day of inspection, impacted on the meaningful promotion of the patients’ dignity, privacy and autonomy, HIQA said.
An announced inspection of Mercy University Hospital in Cork on 18 and 19 April found the hospital to be compliant with three national standards, substantially compliant with five national standards and partially compliant with three national standards assessed.
HIQA found the hospital’s overall compliance rates with infection prevention and control training for standard based precautions and transmission-based precautions was low for both nursing and medical staff.
It also found quality improvement initiatives were not always implemented when standards fell below acceptable levels.
An unannounced inspection of St Luke’s General Hospital Kilkenny on 9 and 10 April found the hospital to be compliant or substantially compliant with ten national standards and partially compliant with one national standard.
Overcrowding was reported on the hospital's acute floor, which incorporates the hospital entrance, emergency department and acute medical and surgical units.
HIQA said the patient experience times (PETs) could be improved for patients aged 75 or more. It also noted that from the start of 2024 up to the week of inspection, the overall attendance rate at the hospital’s ED was 8% higher when compared to the same period in 2023.
An announced HIQA inspection of the community rehabilitation unit in Our Lady’s Hospice and Care Services, Harold’s Cross on 31 July and 1 August found the unit to be compliant or substantially compliant with 10 standards and partially compliant with one standard assessed.
It said improvements were required in the standard of environmental hygiene in the unit. It noted all patients that inspectors met at the facility were complimentary about the care received, and there were numerous initiatives in place to support social interactions and promote patients’ autonomy.
HIQA’s unannounced inspection of University Hospital Waterford on 5 and 6 June found the hospital to be compliant or substantially compliant with all national standards that were assessed.
Inspectors found evidence of "good operational grip" by the management team. Patients also spoke positively about their experiences of receiving care in the hospital.
There were reported shortfalls in nursing and healthcare assistant staff that had the potential to impact on care delivery, but HIQA said staffing shortfalls were limited in the areas visited on the days of inspection.
