HIQA publishes reports on hospital cleanliness and hand hygiene

Date of publication: 
Wednesday, January 30, 2013

New hygiene and infection prevention inspection reports published today by the Health Information and Quality Authority (HIQA) have found that poor hand-washing practice in many Irish hospitals is potentially putting patients at risk of acquiring a Healthcare Associated Infection. The Authority also found wide variations in regard to hospital cleanliness.

Phelim Quinn, Director of Regulation with HIQA, commented: “A good hand hygiene practice is the single most important measure to protect patients from Healthcare Associated Infections. Staff at all levels within our hospitals deserve credit for their awareness of the importance of, and the good examples of, hand hygiene practice found by the Authority. This reflects their commitment to patient safety.

“In many cases, however, we found hand hygiene actions were not always undertaken, or carried out in the right way, despite the efforts of the staff involved. A number of hospitals have now been asked by HIQA to evaluate their level of hand hygiene compliance, in the context of infection rates, in order to assess the impact on patients.

12 unannounced assessment reports published today by HIQA focus on hand hygiene and hospital cleanliness, and two announced assessment reports deal with a range of elements essential for the control and prevention of Healthcare Associated Infections. The reports are part of a new programme of work for HIQA to assess the impact of its National Standards for the Prevention and Control of Healthcare Associated Infections on improving patient safety within our hospitals.

Phelim Quinn continued: “We also found variations in how clean our hospitals are. Many facilities were observed to be clean and free from visible dirt and clutter, with appropriate infection control signage and practices in place, and the work of hospital staff should be acknowledged in ensuring high levels of hospital cleanliness that were found in some units. However, further improvements are still required in a range of areas and in some facilities we found dust and dirt on surfaces, soiled bedpans, worn and damaged furniture, black residue in shower areas, splash marks on equipment, and blood stains in various locations. There were also cases where the management of linen and healthcare waste was not in line with official guidance. The reports detail examples of these findings.

“During the assessments, some immediate serious risks to patients were also identified. These included the inappropriate accommodation of emergency department patients with communicable/transmissible diseases. These kinds of deficits are not acceptable and required immediate action on the part of clinical and management staff concerned when HIQA’s officers were on site. To date, one facility has been asked to conduct a hospital-wide review of its compliance with the National Standards for the Prevention and Control of Healthcare Associated Infections.

HIQA, through its work, aims to provide assurances to the public that hospitals are implementing and meeting these National Standards, and the overarching National Standards for Safer Better Healthcare, and are therefore taking the necessary steps to make hospitals safer and better places for patients and staff.

Phelim Quinn concluded: “The aim of the National Standards – together with these assessments – is to reduce the incidence of Healthcare Associated Infections. Implementing evidenced-based standards, together with checks on compliance with them, is vital to improving quality and patient safety. Hospitals are now being asked to develop quality improvement plans that prioritise changes necessary to fully meet the National Standards for the Prevention and Control of Healthcare Associated Infections. These plans must be published by the hospitals concerned on the Internet within six weeks of the publication of HIQA’s reports.

“HIQA will continue with this programme of announced and unannounced assessments, to ensure that hospitals have implemented their quality improvement plans, in order to provide assurances to the public that the National Standards are being implemented, and that patients are being safeguarded.


Further Information: 

Marty Whelan, Head of Communications and Stakeholder Engagement 01 814 7480 / 086 2447 623 mwhelan@hiqa.ie

Notes to the Editor: 

HIQA’s monitoring programme will focus on the essential capacity and capability factors necessary to implement four of the practices that international research has shown to contribute significantly to reducing Healthcare Associated Infections and improve patient safety, as follows:

1. Hand hygiene compliance.
2. The cleanliness of the environment and equipment.
3. The appropriate use of antimicrobial antibiotics (antimicrobial stewardship).
4. The prevention of Healthcare Associated Infections associated with invasive medical devices such as intravenous lines and urinary catheters.

HIQA has to date assessed 16 hospitals all over the country to check hygiene standards, whether staff are adhering to the best possible hand hygiene practice, as outlined in the National Standards, and if hospitals put in place the essential systems to reduce the risk of patients acquiring a Healthcare Associated Infection. These are the first such reports published by HIQA and other reports will follow.

The Authority will continue to carry out both announced and unannounced monitoring assessments this year. Unannounced assessments consider hand hygiene compliance and the cleanliness of facilities and equipment. Announced assessments consider all the above four elements that are shown to considerably reduce Healthcare Associated Infections and improve patient safety.

  • Phase 2 of the Authority’s monitoring programme will commence later this year and will include the assessment of compliance with the National Standards by the Health Service Executive’s National Ambulance Service.
  • The Authority will advise the Minister for Health and the Health Service Executive on its findings. The Authority will publish all of its findings on how organisations are complying with the Standards.