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 June and July 2017 at Naas General Hospital, Kildare and Temple Street Children’s University Hospital respectively.

Naas General Hospital

An unannounced inspection of Naas General Hospital, Naas, Co Kildare was carried out on 21 June 2017. HIQA found on the day of inspection that the hospital had clear lines of accountability and responsibility around the prevention and control of healthcare associated infection and were endeavouring to meet National Standards.

Implementation of a comprehensive infection prevention and control programme was limited by lack of sufficient isolation rooms and poor hospital infrastructure. These risks had been escalated through the Health Service Executive (HSE) governance structures. Mitigation of these risks will require support at senior HSE and hospital group level to address the infrastructural deficiencies and capacity.

The hospital had a suite of policies, procedures and guidelines in relation to the prevention and control of healthcare associated infection and had implemented and audited a number of evidence based care bundles. The hospital had recently implemented and audited a ventilator-associated pneumonia care bundle and developed draft guidelines to support this.

Overall, patient equipment and the patient environment in the areas visited on the day of inspection were generally clean with a few exceptions. There was good ownership in relation to hospital hygiene and evidence of auditing processes in relation to environmental and patient equipment hygiene.

Temple Street Children’s University Hospital

An unannounced inspection of Temple Street Children’s University Hospital took place on 13 July 2017. During this inspection, HIQA found that the hospital had effective leadership, governance and management arrangements in place for the prevention and control of healthcare associated infection.

The hospital had systems in place to identify and manage risks in relation to the prevention and control of healthcare-associated infections. Risks escalated to the Health Service executive governance structures included the lack of availability of single rooms for isolation of patients with infection and insufficient resources to undertake preventative maintenance in the hospital.

The hospital had up-to-date policies, procedures and guidelines in relation to the prevention and control of infection and implementation of these policies was facilitated by the Infection Prevention and Control Team. The team also facilitated the development of a revised mandatory staff education programme around the prevention and control of healthcare-associated infection.

The most recent hand hygiene compliance audit results showed that the hospital achieved 94% compliance with both hand hygiene and a ‘bare below elbow’ policy, which is commendable. The hospital reported that 64% of relevant staff had received influenza vaccination during the 2016 to 2017 influenza season, which was the highest reported uptake in comparison to other hospitals that reported influenza vaccine uptake to the HSE.

Patient equipment and the patient environment were visibly clean in the areas inspected with few exceptions. The hospital had significantly revised and strengthened local arrangements for managing hospital hygiene and infrastructural maintenance since the last HIQA inspection in 2016. There was good ownership in relation to hospital hygiene and evidence of clear processes, responsibilities and monitoring arrangements from clinical areas through to executive management level.

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.