Poor hand hygiene putting Rotunda patients at risk

Hand hygiene standards in a number of Irish hospitals have been criticised in a series of new reports from the Health Information and Quality Authority.

Patients attending the Rotunda Maternity Hospital in Dublin, South Tipperary General Hospital, Sligo General Hospital and South Infirmary Victoria University Hospital in Cork were found to be at risk of contacting a hospital acquired infection because of poor hygiene practices.

Hand hygiene practices at the Rotunda Maternity Hospital in Dublin were found to be inconsistent with standards and to pose a clear risk to patients of contracting a hospital-acquired infection.

Inspectors found that the clinical areas assessed were generally clean, though there were opportunities for improvement. They pointed to “clutter” in the nurses’ station, a lack of store for equipment and patient belongings and unsecured clinical waste and chemical storage.

At South Tipperary General Hospital, the absence of several roles fundamental to the control of hospital acquired infections posed a significant risk to patients, they warned. These deficits included the lack of a specific budget and the lack of a infection-related audit and communications strategy.

“There was very little evidence provided as to how the Executive

Management Board at South Tipperary General Hospital can be assured that the prevention and control of HCAIs (healthcare associated infections) is regularly considered, assessed and managed to comply with the National Standards, and the associated risks to patients monitored and mitigated.”

The hospital, which was found to be partially compliant with standards, has been ordered to publish a quality improvement plan within six weeks.

Patients at South Infirmary Victoria University Hospital in Cork were also at clear risk of contracting a hospital acquired infection as a result of hand hygiene practices which were inconsistent with national standards, a separate report found.

The hospital, which has been told to develop a quality improvement plan, has been warned it faces further monitoring of its hygiene performance.

The report on Sligo Regional Hospital recognised progress made since a previous inspection uncovered poor hand hygiene practices but said compliance at operational level was not fully embedded.

Staff are not taking adequate responsibility for their hand hygiene practices and attendance at training was low, Hiqa said.

The hospital was found to be partially compliant with standards and a “significant number of risks” were identified that could potentially increase the possibility of patients contracting a hospital acquired infection. Management have been ordered to implement 16 recommendations to improve governance and standards.

Our Lady Hospital for Sick Children in Crumlin was praised for the increased level of hand hygiene since a previous unannounced inspection. Hiqa said this showed that a culture of best practice for hand hygience may be becoming embedded throughout the hospital.

However, inspectors expressed concern that prevention and control of infection was not a standing agenda item for meetings of the hospital’s senior managers or board.

They also found that attendance at hand hygiene train had been problematic, with a low uptake from staff last year.