Two inspection reports on infection prevention and control practices in public acute hospitals have been published today by the Health Information and Quality Authority (HIQA). HIQA monitors infection prevention and control in hospitals against the National Standards for the prevention and control of healthcare-associated infections in acute healthcare services. Inspections were carried out in May 2017 at the Coombe Women and Infants University Hospital, Dublin and St Luke’s General Hospital Kilkenny.

Coombe Women and Infants University Hospital, Dublin

An unannounced inspection of the Coombe Women and Infants University Hospital, Dublin was carried out on 31 May 2017. HIQA found on the day of inspection that the hospital had effective leadership, governance and management arrangements around the prevention and control of healthcare-associated infection.

The hospital had an established infection prevention and control team and committee who were supported by effective governance and oversight of infection prevention and control in the hospital.

The hospital had up-to-date policies, procedures and guidelines in relation to the prevention and control of infection and had implemented a number of measures to promote education and training of clinical staff which represented a commitment to promoting safer patient care. Recent hand hygiene audit results indicated that the hospital had exceeded the Health Service Executive (HSE) national target for compliance.

Overall, patient equipment and the patient environment in the areas visited on the day of inspection were generally clean. There was good ownership in relation to hospital hygiene and evidence of clear processes and responsibilities from clinical areas to executive management.

HIQA found that the risks associated with outdated infrastructure identified in a previous inspection in 2016, which could not be adequately eliminated locally, had been escalated through the Health Service Executive (HSE) hospital group structure. It is acknowledged that risks in relation to hospital infrastructure cannot be mitigated until building works are complete.

Overall, this inspection found that the hospital was committed to implementing evidence-based practice in relation to infection prevention and control and to producing relevant information to inform improvements needed.

St Luke’s General Hospital, Kilkenny

An unannounced inspection of St Luke’s General Hospital Kilkenny took place on 25 May 2017. During this inspection, HIQA found that some but not all essential elements of an infection prevention and control programme were in place at the hospital.

Implementation of a comprehensive infection prevention and control programme was limited by the daily need to address the placement of patients requiring isolation in a frequently overcrowded hospital with poor inpatient accommodation infrastructure and a lack of isolation facilities. Some of the risks impeding effective infection prevention and control as they exist cannot be sufficiently mitigated at local hospital management level. Mitigation of these risks will require support at senior HSE and hospital group level to address the infrastructural deficiencies and capacity.

Governance and management arrangements around the prevention and control of healthcare-associated infection at St Luke’s General Hospital were not aligned to the current Ireland East Hospital Group governance structure. These arrangements should be reviewed and addressed by the hospital.

The hospital participates in the national hand hygiene audits, results of which are published twice a year. Since 2015, the hospital has consistently achieved the required HSE national hand hygiene compliance target of 90%.

Notwithstanding the identified areas for improvement found during this inspection, inspectors found that the infrastructure of some facilities for people attending the hospital had been recently significantly improved. Specifically, the hospital had opened a newly built Emergency Department and day and out-patient facilities one year prior to this inspection. This is a welcome development.

Notes for Editors

• HIQA’s infection prevention and control monitoring programme aims to examine and positively influence the adoption and implementation of evidence-based practice in public acute hospitals regarding infection prevention and control.
• HIQA’s approach to monitoring public acute hospitals against the National Standards has been revised in 2017 in consideration of infection risk factors for patients, previous HIQA inspections and review findings, and increasing antimicrobial resistance in Ireland. The revised monitoring programme seeks to determine if service providers have essential elements in place in order to prevent and control healthcare-associated infections.
• HIQA’s Guide to the Health Information and Quality Authority’s Infection Prevention and Control Monitoring Programme in Public Acute Hospitals outlines the requirements for service providers in this programme.