Hiqa inspectors warn of fungal infection risk

Health inspectors have warned of the risk of patients acquiring a serious fungal infection from construction work at the site of the planned new national children’s hospital.

The Health Information and Quality Authority (HIQA), in a report on St James’s Hospital in Dublin, says there is an increased risk to some patients of acquiring invasive aspergillosis while in hospital when construction or renovation activities are taking place.

The report is critical of the failure of the hospital to put in place a comprehensive education programme on the prevention and control of aspergillosis, which it says it not in line with best practice.

Aspergillosis is a group of illnesses caused by mould (fungus) which affects the respiratory system. The aspergillus mould occurs commonly in nature and is largely harmless, but patients with weakened immune systems can suffer serious illnesses when spores are inhaled.

Inspectors who visited a number of wards at St James’s last month noted that construction was evident in the hospital on the day of their inspection. While recommended environmental controls were in place, there was no formal education or training on aspergillosis.

Construction of the national children’s hospital is not expected to begin on the St James’s campus until next year.

Inspectors found that the four wards they visited were generally clean, though some required improvements were identified.

While the intensive care ward was found to be clean, there was staining on tiles, and blood staining on equipment. Mattresses were found to be “compromised” with covers torn and stained. Paint was chipped and scuffed, and shelves and cupboard doors had damaged surfaces that would impair proper cleaning.

The practice of placing yellow clinical waste bags in bins labelled non-healthcare risk waste was not in line with guidelines, according to the report.

Hiqa says St James’s has demonstrated commitment to best practice in hand hygiene. Some 33 out of 44 “hand hygiene opportunities” observed by inspectors were taken.

“The hospital needs to continue to build the approach taken to promoting awareness and best practices relating to hand hygiene to ensure that high performance is sustained and improved.”

A separate report on Mallow Hospital found that the medical assessment unit was clean with a few exceptions, while St Mary's Ward was found to be generally unclean. Some improvements in hand hygiene practices were required.