Hygiene standards criticised at Limerick hospital

The State’s health watchdog has criticised “especially poor standards” of hygiene at University Hospital Limerick.

The Health Information and Quality Authority wrote to the hospital last November saying it was concerned over the risk to patients from a variety of issues identified by inspectors, including unclean patient equipment and “longstanding extra bed placement” on a ward.

Hiqa was also critical of a failure to respond to maintenance requests at the hospital. It gave the example of a macerator which was out of order for three days before inspection, and was not fixed until the time of the inspection. In one ward, a crack in a window had gone unrepaired for several months, forcing a patient to cover it with paper and tape in order to keep the draught out.

Inspectors found environmental hygiene on ward 1D to be “particularly poor” during the inspection last November, with “widespread unacceptable levels of dust” in patient areas, sanitary facilities, storage facilities and the linen storeroom. Heavy dust was present on high ledges and staining was observed on curtains around patient beds.

Unacceptable varying levels of dust were also found on patient equipment and hand hygiene compliance on the ward was just 33 per cent. This increased to 93 per cent on re-inspection.

“The widespread nature of dust throughout the ward indicated to inspectors that the systems in place to manage and maintain environmental hygiene were not as effective as they should be.”

The cleaning regime was intensified, and significant improvements were noted by Hiqa during a re-inspection last January.

The report says UHL was one of the first hospitals in Ireland to report a highly drug resistant and infectious superbug, carbapenem producing Enterobacteriacea (CPE) and has experienced outbreaks caused by this bacterium.

The hospital has explained a “small proportion” of the patient population in its catchment area are “chronically colonised” with organisms containing this resistance mechanism.

“The hospital must therefore continually ensure that patients who are colonised with CPE who present for treatment are rapidly identified and appropriately managed to ensure that they do not become infected with CPE during treatment, and that the risk of spread to other patients is managed effectively.”

Hiqa says it is vital the hospital ensures all measures are in place to manage the risk from CPE, pending the opening of a new emergency department in 2017.

Staff told Hiqa’s inspectors overcrowding on the wards they examined was a near permanent situation due to overcrowding throughout the hospital.

A separate report on Cork University Hospital was critical of hand hygiene and environmental hygiene at the hospital.