The health safety body HIQA ordered Our Lady's Children's Hospital in Crumlin last month to tighten up its infection control procedures, including those relating to medical equipment.

The directive came before the hospital discovered that a colonoscope it had used on child patients had become contaminated with a microbiological growth. The hospital announced last night that it has been contacting families of children who had undergone colonoscopies using this particular scope.

The bug discovered on the scope is known as ESBL. This is an enzyme produced by bacteria which usually lives in the bowel and is normally harmless. However, it can sometimes cause infections in patients, which can be difficult to treat as many of the commonly used antibiotics are ineffective against the bug.

HIQA, following an inspection of Crumlin Hospital carried out in March, told the hospital in a report published on June 21 to perform an audit of all invasive medical devices, which would include colonoscopes, in order to be assured that infection is being effectively prevented and managed in relation to such devices.

The hospital says it has been contacting families of 18 child patients on whom the scope was used between mid-May and early July - the contamination was confirmed on July 10. The scope was immediately quarantined once the contamination was discovered, the hospital has said.

HIQA said it would have informed the hospital of its inspection report findings earlier in June, around two weeks before its official publication.

The inspection report, while positive on some aspects of infection control procedures in Crumlin, made a number of criticisms and recommendations for improvements.

The report noted that while a hygiene/infection audit had been undertaken on use of intravenous catheters, Crumlin needed to undertake audit on the use of all medical devices in order to be assured that infection was being effectively prevented and managed in relation to such devices.

HIQA said it was of concern that infection prevention and control was not a standing item on Crumlin's management team or board of directors' meetings.

It said the hospital needed to amend its infection control communications policy to include details on strategy and concentrate on goals and objectives.

The safety body, in its report, also noted that their was poor attendance by some groups of staff at hand hygiene training last year, although there was evidence that hand hygiene had been given greater priority since then and that hand hygiene practice was improving.

The report said, however, it was essential that systems were improved and implemented to support an ongoing improvement in hand hygiene practices.

The HIQA report noted that at the time of the inspection in March, all hospital staff were still not receiving mandatory training in relation to the prevention and control of healthcare-associated infections.

The report noted that there was evidence of the hospital improving its systems to reduce infection risk to patients. It said there was clear monitoring and reporting of defined healthcare-associate infection performance metrics.

However, the report criticised how Crumlin Hospital was managing patient complaints relating to hygiene and infection.

HIQA said it was unclear why complaints regarding healthcare infections were dealt with by the hospital risk manager and not through the complaints path.

The safety body said it was concerned on how information and learning from patient complaints on infection were categorised, analysed and disseminated, but noted that the hospital had recently launched an online reporting system to include a report mechanism for incidents and complaints.

The report also noted that Crumlin had provided documentation that it was regularly monitoring for bugs such as ESBL.

Crumlin apologises over contamination issue