Standards of hospital hygiene improved marginally last year but most hospitals still have room for significant improvement, according to the latest national review by the Health Information and Quality Authority (Hiqa).
Only one of the 50 public hospitals surveyed - Cappagh National Orthopaedic Hospital in Finglas - scored a "very good" mark for hygiene, according to the second national hygiene service quality review.
Six hospitals received a formal warning letter from Hiqa drawing attention to risks identified by the assessors, the review states. Nine facilities, most of them smaller hospitals in rural towns, scored "poor", and a further 29 hospitals were rated "fair". Eleven hospitals were awarded a "good" rating.
Hiqa said hygiene had improved in a number of areas since the first review was published over a year ago. These include hand hygiene, the management of bed linen and waste and the structure of hygiene services in hospitals.
Among the areas it says are in need of improvement are the reporting and evaluation of information, the monitoring of staff satisfaction and health, and the evaluation of staff.
"Healthcare associated infections continue to be an increasingly important patient safety issue and a growing challenge for many healthcare systems. Reducing these infections should be a priority for all involved in the provision of health and social care services. High quality hygiene services are essential in driving down these infections", said Dr Tracey Cooper, Hiqa chief executive.
The Health Services Executive (HSE) said the review provided clear, independent evidence that it was providing care to patients in hospitals that were cleaner, year on year. The number of hospitals receiving a "good" or "very good" award from Hiqa rose from seven in 2007 to 12 in 2008, it pointed out.
Taken together with a 7 per cent reduction in MRSA rates in the past two years, the report showed the HSE was effectively addressing the issues of hygiene and infection in hospitals and was delivering positive results.
Minister for Health and Children Mary Harney this afternoon welcomed publication of the Hiqa report and saidshe was encouraged by the fact that there has been an improvement in the quality of hygiene services in
the hospitals assessed in the review.
"We see from the 2008 report, published today, that Hiqa is saying that the standards in service delivery have been maintained and there has been a marked improvement in corporate management,” said Ms Harney.
However, Fine Gael health spokesman Dr James Reilly said the dearth of "very good" ratings showed that progress on hygiene was painfully slow. He noted that 24 hospitals which had rated either "fair" or "poor" last year had achieved the same rating this year, while the rating of eight hospitals had actually disimproved.
While twice as many A ratings were handed out to hospitals in this year's review, Hiqa says there continues to be wide variations in hygiene standards, with some hospitals "considerably below" the average. It suggests significant gains in standards could be made if the better performing hospitals shared their good practice with less well performing hospitals.
In a survey of patient perceptions, recurring concerns were expressed about the toilet facilities in hospital wards. Many patients said these were inadequate for the size of ward, resulting in over-use and a failure to clean them as regularly as necessary.
The survey also revealed that many patients do not feel comfortable asking doctors and nurses to wash their hands before examining them. Less than 10 per cent had actually done so.
