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 November 2017 at Bantry General Hospital, Cork and Cavan and Monaghan Hospital.

Bantry General Hospital, Cork

n unannounced inspection at Bantry General Hospital, Cork was carried out on 9 November 2017. On the day of inspection, HIQA found that infection prevention and control governance arrangements at the hospital did not adequately support the effective implementation of infection prevention and control and antimicrobial stewardship programmes.

Despite prior recommendations in previous HIQA inspection reports, progress to date in relation to addressing identified deficiencies relating to the infection prevention and control service has been limited; specifically access to dedicated clinical consultant microbiology programme leadership.

HIQA also found that there was potential to further align the infection prevention and control governance structures at Bantry General Hospital with the Cork University Hospital Group. Greater collaboration in this regard would allow the sharing of knowledge and expertise and increase the support to a smaller hospital with limited resources.

Despite the challenges faced in implementing an infection prevention and control programme at the hospital, the commitment to and compliance with the principles and practices of infection prevention and control by staff was evident at the hospital on the day of inspection.

The environment in the clinical area visited by inspectors was generally clean with few exceptions. However, the hospital hygiene supervision arrangements need to be sufficiently resourced and progressed as a priority.

It is recommended that the hospital, under the broader governance of the South/ South West Hospitals Group, acts to formalise the infection prevention and control governance arrangements at Bantry General Hospital to fully support the effective implementation of the hospital’s infection prevention and control programme.

Cavan and Monaghan Hospital

An unannounced inspection of Cavan and Monaghan Hospital took place on 15 November 2017. HIQA found that the recent depletion of resources in respect of the Infection Prevention and Control Team at Cavan and Monaghan Hospital had led to a number of gaps in the provision of the infection prevention and control service which were of concern given the size of the hospital and complexity of services provided. Deficiencies in respect of infection prevention and control team and clinical microbiology resources and supports need to be addressed in the short term.

Overall, inspectors found that governance arrangements at the hospital could be strengthened to ensure that information produced through local monitoring is used to identify potential risks and opportunities for improvement in relation to the prevention and control of healthcare-associated infection. Documentation reviewed by inspectors showed that prior to August 2017 the Infection Prevention and Control Team had a well-established infection prevention and control programme.

The patient environment and equipment in the clinical areas inspected were clean with some exceptions. Work was in place to improve the hospital infrastructure which included plans to extend Cavan General Hospital and increase isolation room capacity.

The hospital needs to build on work to date to ensure that hand hygiene practice is improved and national targets are achieved.

Overall, it is recommended that efforts to re-establish and develop the infection prevention and control programme at the hospital are expedited. Improvement in the delivery of an effective infection prevention and control programme at the hospital will require improved leadership, governance and management both at senior management level, and within the infection prevention and control team. Cavan and Monaghan Hospital should be supported through the RCSI Hospital Group structure in this regard.

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.