Cork University Hospital must improve infection prevention, says watchdog

Cork University Hospital (CUH) needs “to ensure best practice improve infection prevention”, the Health Information Quality Authority (Hiqa) has found.

In reports on six of the State’s hospitals released on Friday, Hiqa also said the Cork hospital was “particularly challenged” by having limited access beds in the community, to which to discharge patients.

The authority said this resulted in several patients experiencing a delay in their transfer of care and contributed to congestion in CUH’s emergency department (ED).

The report arose from a planned inspection in July and Hiqa said while there was evidence of progress and commitment by CUH’s management to improve its emergency department, “further substantive improvements are needed to ensure compliance with the national standards in the short, medium and long term”.

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In a report on Dublin’s Mater University Hospital, Hiqa said the emergency department “was observed to be clean and well maintained on the day of inspection. Patients who spoke with inspectors on the day of inspection were complimentary about staff”.

The unannounced inspection, which took place on July 6th, found that “from an operations perspective, the ED was functioning well. There was evidence that the executive management team was responsive and reactive to the issues impacting on performance in the emergency department.”

The hospital had several measures in place to support effective patient flow through the ED and wider hospital. “Overall, there was evidence that hospital management and staff were aware of the need and availed of opportunities to respect and promote the dignity, privacy and autonomy of people receiving care in the emergency department,” Hiqa said.

However, it found the Mater hospital was reliant on agency staff to ensure adequate staffing levels were maintained. Hiqa said this was not sustainable in the long term.

An announced inspection of Ennis Hospital, Co Clare, in May, found the hospital was only partially compliant with a national standard, due to the older infrastructure of the medical assessment unit.

Hiqa said it found “generally good levels of compliance” in the wider Ennis Hospital and inpatient clinical areas visited on inspection.

It said the hospital’s medical assessment unit and local injury unit were functioning well and were compliant with Health Service Executive targets related to patient experience times. People who spoke with Hiqa inspectors were positive about their experience of receiving care in the hospital and were very complimentary of staff.

Also in May, Hiqa conducted an announced inspection of the National Maternity Hospital at Holles Street in Dublin, where it found “effective systems to proactively identify, manage and minimise potential risk of harm to women and babies and act on opportunities to continually improve the quality, safety and reliability of the maternity services including management of complaints”.

Areas identified at the maternity hospital for improvement included a staffing shortfall across all staff grades, in particular midwifery and nursing, as well as staff attendance and uptake of training. “Notwithstanding these areas for improvement, good overall compliance was found on inspection,” Hiqa said.

An unannounced inspection of Tipperary University Hospital’s emergency department in August found the hospital had “defined corporate and clinical governance arrangements in place for assuring the delivery of high-quality, safe and reliable healthcare”

Hiqa said the emergency department was “functioning effectively on the day of inspection, and patient experience times were among the better-performing hospitals”. But it noted the department was “overcrowded”, and “improvements were required to provide staff and patients with adequate facilities”.

An announced inspection of St Mary’s Hospital, Phoenix Park carried out in July found that systematic monitoring arrangements were in place to identify and act on opportunities to continually improve the quality and safety of all services.

“Notwithstanding this, there were a number of vacancies across all staff disciplines, most evident across health and social care professionals, which had the potential to impact on patient care and this must be addressed,” Hiqa said.

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