The safety of patients at Our Lady of Lourdes Hospital in Drogheda is at serious risk from poor hand hygiene among staff, a lack of cleanliness and a threat of contracting Legionnaires’ disease, according to a new report.
The Health Information and Quality Authority (Hiqa) issued a formal warning to the hospital in June to rectify the problems identified during an unannounced inspection and, in particular, to take immediate action to deal with risks arising from legionella and aspergillus bacteria.
Hiqa described the risk of legionella persisting in the hospital water supply as of significant concern and said it was unacceptable that patients were subjected to inadequate showering facilities for a prolonged period.
Shower heads removed
Shower heads were removed for over 18 months to reduce the risk but Hiqa said this was unacceptable in terms of patient hygiene and dignity.
Hiqa said the June inspection identified a number of high risks, also including hand hygiene compliance, safe injection practice, environmental and patient equipment hygiene and maintenance.
A follow-up inspection in July identified some improvements, but found substantive risks remained in relation to maintenance, hand hygiene practice, hand hygiene facilities and ward infrastructure.
Unacceptable levels of dust were found in some of the wards inspected and in utility rooms used to prepare medication and store medical equipment.
The hospital blamed the dust levels on a shortage of floor mop heads required for cleaning and the non-availability of a vacuum cleaner.
Inspectors were told legionella species were found in water samples in some patient areas in the older hospital block.
Issue persisted
The issue persisted for over 18 months despite investment in a water treatment system, and shower heads were removed from wash rooms as a safety measure - though no patients contracted Legionnaires’ disease.
The hospital said an independent report commissioned since July showed the risk of Legionnaires’ disease was greatly reduced.
A “robust system” for minimising the risk of infection from legionella was in place and the shortage of cleaning equipment noted by inspectors was the result of a “single incident” caused by a lack of awareness of processes.
The report says a key factor explaining why maintenance and bed spacing issues are not resolved is the ongoing high bed occupancy rate at the hospital. Drogheda needs support from its wider hospital group to address these issues, it says.
A separate report on Beaumont Hospital also noted significantly high levels of legionella were identified in water samples. The areas inspected were generally clean and well maintained.
A third report on a post-natal ward at the Rotunda Hospital found it to be well maintained and generally clean, with some exceptions.