Two hospitals in breach of HSE guidelines on superbug, Hiqa finds

CPE was described in October as the biggest threat of its kind facing the health service

The Midland Regional Hospital was ‘not fully aligned’ to the current hospital group governance structure.

The Midland Regional Hospital was ‘not fully aligned’ to the current hospital group governance structure.

 

Two hospitals have been found to be in breach of the HSE’s guidelines on the screening of patients for a superbug that was described by health officials last year as the biggest threat of its kind.

In October, then HSE chief executive Tony O’Brien urged the Government to immediately direct health chiefs to prioritise tackling healthcare-associated infections and antimicrobial resistance.

He said the biggest concern was a group of antibiotic-resistant bacteria known as carbapenemase-producing enterobacteriales (CPE). The superbug is hard to kill with antibiotics, is carried in the bowel, and can cause blood stream infection in the elderly.

Five inspection reports on infection prevention and control practices in public acute hospitals were published by the State’s health watchdog on Thursday.

The Health Information and Quality Authority (Hiqa) identified Kilcreene Regional Orthopaedic Hospital in Kilkenny and Midland Regional Hospital in Portlaoise as being in breach of the HSE’s guidelines.

“Given that the threat associated with CPE has been declared a national public health emergency, Hiqa escalated concerns to two hospitals and the HSE to seek assurances around how each hospital might ensure compliance with the HSE’s own guidelines,” said the watchdog.

In terms of the Midland Regional Hospital, inspectors found it was “not fully aligned” to the current hospital group governance structure due to “legacy regional hospital group arrangements”.

Screening

Inspectors found that it had not successfully ensured that screening patients for CPE was fully embedded in the hospital. Hiqa considered this to be a “high risk”.

“Some risks identified by the hospital in relation to infrastructure and lack of isolation facilities which impeded effective infection prevention and control as they exist cannot be sufficiently mitigated at a local hospital management level,” the inspectors said.

“It is recommended that the hospital continues to assess and manage the impact of these risks in relation to the infection prevention and control programme and escalate accordingly.

“All future refurbishment of existing in-patient accommodation should be planned to reduce the number of patients per room and to install en-suite facilities in each room, in line with the recommendations.”

At Kilcreene Regional Orthopaedic Hospital, inspectors also judged the hospital “had not fully ensured that screening patients for CPE was fully aligned to the latest national guidelines”.

Hiqa said the overarching governance and management arrangements in relation to the infection prevention and control programme at the facility and at a wider hospital group level required “considerable improvement”.

The general manager provided written assurance in response to Hiqa stating that, following the inspection, the hospital was now in compliance with HSE guidelines around screening patients for CPE.

Tallaght University Hospital, Dublin; Galway University Hospitals; and Mayo University Hospital, Castlebar, were in compliance with the guidelines.