Inspections reveal 'serious risks' at more than a quarter of Irish hospitals

More than a quarter of public acute hospitals inspected by HIQA have been given formal notifications of “serious risks”.

None of the 49 hospitals inspected were found to be fully compliant with infection prevention and control standards.

The notifications were issued to 13 of the hospitals inspected.

These related to cleanliness, hand hygiene and on communicable and/or transmissible disease control.

Of these, observed hand hygiene practice (hand washing and/or use of hand-rub) was the most commonly identified serious risk, warranting six out of the 13 notifications to hospitals.

HIQA carried out 54 inspections, covering 49 of the 50 public acute hospitals in Ireland (one inspection covered three hospitals), during a 14-month inspection period between November 2012 and December 2013.

Ten inspections were announced and 44 were unannounced.

Seven hospitals were inspected twice by HIQA arising from initial checks, while 100 recommendations were issued to the 10 hospitals which had an announced inspection.

Other risks included drug trolleys not being maintained in accordance with best practice guidelines, and inappropriate accommodation of patients. This included patients observed on trolleys located outside of screened treatment bays in the emergency department and on extra beds placed into wards.

“All hospitals which underwent announced and unannounced inspections were found to be partially compliant with the National Standards for the Prevention and Control of Healthcare Associated Infections,” said Phelim Quinn, HIQA’s Director of Regulation.

“However, no hospital was found to be fully compliant with all of the Standards at the time of their individual inspection.”

“We noted that most of those hospitals that required a second inspection had improved and generally the feedback from the hospitals demonstrates a positive and constructive attitude to the recommendations made by HIQA as a result of its inspection programme.

“The quality improvement plans being put in place by hospitals as a result of the inspections show the impact and effectiveness of inspections on leadership, culture and practice within healthcare settings.”

During the inspections, nearly 1,500 hand hygiene opportunities (key moments when staff should wash their hands and/or use appropriate hand-rub) were observed by the Authority.

“Of the hand hygiene opportunities observed by the Authority, an average of 69% were undertaken by hospital staff,” Phelim Quinn stated.

“Non-compliances with best hand hygiene practice observed by the Authority during inspections related to issues such as not taking long enough to perform the hand hygiene technique, not performing the correct hand hygiene technique or wearing a wrist watch, jewellery or long sleeves,” said Mr Quinn.

One hospital – University Hospital Galway – was not inspected against the hygiene standards as it was the focus of a separate regulatory process by the Authority during this time.

“The monitoring programme during 2013 was also aimed at enabling service providers to prepare for the eventual monitoring of services against the National Standards for Safer Better Healthcare,” said Mr Quinn.

“This area of patient safety will continue to be a priority for the Authority and will remain a core focus in its standards monitoring programme in the next three years and as part of the future licensing of healthcare facilities when the appropriate legislation and regulation are introduced.

“The monitoring programme for 2014 will continue to include both announced and unannounced inspections.”

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