A HIQA report, following an unannounced inspection of the Mid Western Regional Maternity Hospital, Limerick, in July, raised health and safety concerns and pointed to a risk to patients of contracting Healthcare Associated Infections (HCAI).
These findings also suggest that although some improvement has been achieved since the previous inspection in November, the physical environment, waste management and cleanliness of patient equipment were still not effectively managed and maintained, “to protect service users and reduce the spread of HCAIs”.
Stating that hand hygiene is recognised internationally as the single most important preventative measure in the transmission of HCAIs, the report said that it recognised that the hospital had implemented initiatives to improve hand hygiene compliance by hospital staff.
“However, the authority found that hand hygiene practices were inconsistent with the national standards and this poses a clear risk to patients of contracting a HCAI,” it said.
Based on the findings of this assessment, HIQA said it would, within the next six months, undertake a followup assessment.
In response to the findings, the HSE said the hospital took immediate steps to address the issues and are in the process of implementing an ac- tion plan to address the deficiencies.
Frank Keane, Directorate Manager, Maternal and Child Care, said, “We recognise the important and valuable role of HIQA in promoting safety and quality in the healthcare services and we immediately took action when we received the draft report. We acknowledge the infrastructural challenges of our hospital building and some of the quality improvement plans will take longer to implement, as they will involve changes to the physical environment requiring significant capital funding.
“We recognise the importance of hand hygiene and its significant role in infection control prevention and we have been working to improve our hand hygiene compliance. We provide hand hygiene training to all staff – this is mandatory training and is repeated frequently. We monitor hand hygiene techniques and all non-compliances are reported to the relevant line managers. We will con- tinue to work towards developing a stronger hand hygiene culture across all disciplines to ensure best practice,” he said.
“We are committed to continuing to improve patient safety and the environment for patients and this report has identified evidence of good practice on the wards and in facilities management. We are implementing our action plan to address the deficits identified and build on the many areas where we have demonstrated good practice.”
The maternity hospital serves Clare, Limerick and Tipperary catering for a population of approximately 360,000 people.
In 2012, there were 4,901 live births, 6,648 obstetric admissions and 926 admissions to the neonatal unit.
An unannounced inspection at Merlin Park University Hospital, Galway, also in July, was another “snapshot of the hygiene levels in two areas of the hospital at a point in time”, according to HIQA.
Based on the findings of this assessment, the authority said it would also undertake a follow-up assessment at his HSE West hospital.
The authority said it found that there was evidence of practice that was not compliant with the National Standards for the Prevention and Control of Healthcare Associated Infections in the areas assessed.
It stated that although the patient environment was generally clean in both areas assessed with some exceptions, hygiene management of patient equipment requires active management to mitigate risk to patients of contracting HCAIs. There was evidence of uncontrolled access to hazardous clinical waste material and clinical equipment by failure to use security measures already in place.
“Therefore there was evidence to conclude that some key areas were not effectively managed and maintained to protect patients and reduce the spread of HCAIs,” it said.