HIQA statement on risk-based infection prevention and control inspections of acute hospitals and rehabilitation and community inpatient healthcare services
Today, the Health Information and Quality Authority (HIQA) has published four inspection reports on compliance with infection prevention and control in acute hospitals and rehabilitation and community inpatient healthcare services during the COVID-19 pandemic. Risk-based inspections were carried out in November and December 2020 in:
• Tallaght University Hospital
• Wexford General Hospital
• University Hospital Kerry
• Rehabilitation Unit, St Patrick’s Hospital Cashel, Co Tipperary.
A significant amount of work had been undertaken by Tallaght University Hospital, Wexford General Hospital and University Hospital Kerry in implementing measures to mitigate and manage potential threats posed by COVID-19. Systems were in place to identify and manage risk in relation to the prevention and control of healthcare-associated infections in all hospitals. These reports present the findings on the day of each inspection.
Two wards were inspected in each hospital; one ward on the COVID-19 pathway, one ward on the non-COVID-19 pathway and a walkthrough of each emergency department was undertaken. Overall, the environment and equipment were clean in all three hospitals. As previously highlighted in HIQA reports, infrastructure, including lack of single room capacity and maintenance issues remained a challenge in all hospitals inspected.
University Hospital Kerry had yet not experienced an outbreak of COVID-19 at the time of inspection. Tallaght University Hospital had a number of outbreaks ongoing on the day of inspection, while Wexford General Hospital had experienced outbreaks in April 2020.
However, inspectors found specific risks related to infection prevention control practices at Tallaght University Hospital and Wexford General Hospital. In addition, specialist infection prevention and control staff deficits were identified at University Hospital Kerry. All risks were escalated to each Chief Executive Officer (CEO) and or hospital manager for mitigation. Assurances were provided that appropriate measures were implemented to address the risks identified at each hospital.
While all three hospitals had antimicrobial stewardship programmes in place, staffing resources were found to impact programmes established at Wexford General Hospital and University Hospital Kerry.
Overall, hand hygiene training, fit testing for clinical staff likely to undertake procedures that involve or may involve the generation of aerosols should be progressed. Occupational health supports were provided onsite at all three hospitals.
Rehabilitation and community inpatient community services:
HIQA has also published an inspection report on compliance with infection prevention and control in the Rehabilitation Unit in St Patrick’s Hospital Cashel, Co Tipperary in November 2020.
The unit had systems in place to identify and manage risk in relation to the prevention and control of healthcare-associated infections. Overall, inspectors found that the environment and equipment were clean.
While the unit had not experienced an outbreak of infection, management had a system in place to identify, manage, control and document an outbreak of infection. However, there was limited monitoring of infection prevention and control practices within the unit and no ongoing monitoring of antimicrobial stewardship activities.
Staff had access to the community assistant director of nursing for infection prevention and control in the HSE’s Community Healthcare Organisation (CHO) 5 and access to expert public health medicine advice. Staff were up to date with infection prevention and control training.
Note to Editor:
- The acute hospitals inspection programme monitors compliance against the National Standards for the prevention and control of healthcare-associated infections in acute healthcare services; 2017. The focus of inspection is on governance and risk management structures and measures to ensure the prevention and control of healthcare-associated infections during the COVID-19 pandemic.
- HIQA has developed two guides to its targeted monitoring programmes against the National Standards for the prevention and control of healthcare-associated infections in acute healthcare services during the COVID-19 pandemic 2020 and the National Standards for Infection Prevention and Control in Community Services in rehabilitation and community inpatient healthcare services during the COVID-19 pandemic 2020 which can be viewed at www.hiqa.ie