Serious hygiene deficiencies potentially putting patients at risk of infection have been uncovered by the health safety body HIQA in a recent inspection of Waterford Regional Hospital.

HIQA's report of an inspection carried out in June says it identified specific hygiene issues which may have presented serious risks to the health and welfare of patients at the hospital. The inspection examined the emergency department and a medical and surgical ward.

The hygiene issues included:

* Although isolation rooms were available, a patient with a suspected communicable disease was accommodated in a bay in the main area of the emergency department. One single isolation room was used as a storeroom.

* Hand hygiene of staff assessed in the ED was not in line with best practice guidelines, posing a risk of spread of
healthcare associated infections (HCAIs) to patients in the ED.

* Overall, HIQA found that the environment and equipment in areas assessed were generally unclean, placing patients at significant risk of HCAIs.

* In the medical ward assessed, the floor area directly around the toilet and the base of a toilet cistern for patient use was heavily stained with a mould-like substance. A mould-like substance was also present around the water outlet grid of an adjacent hand-wash sink, the base of the wall around the shower, around the point where shower outlet was fixed to the wall and in a soap holder. The shower chair was unclean; grit and a mould-like substance was visible on its surface.

* Access along the emergency department corridor was hindered due to cluttering with trolleys, items of patient medical equipment, bed tables, waste collection bins and chairs.

* A medication fridge on a medical ward containing insulin and antibiotic solutions and a cupboard containing medicated sprays, were unlocked and accessible to unauthorised persons.

* On the medical ward, HIQA found that the surfaces of two commodes assessed were stained; a member of staff was observed by the Authority failing to clean a used commode after use.

* A commode on the surgical ward had visible soiling on the seat, lids of two commodes were unclean; in one commode a decontaminated bedpan was heavily stained and needed to be withdrawn from use. Two other bedpans assessed were also stained.

* In the ED, commode wheels were dusty and rusted; areas of the frames were stained and had a sticky residue on their surface.

* Not all cleaning equipment was clean; for example, mop head holders used in both wards assessed were dusty. Mop trays were soiled around the rims in the surgical ward.

* Although isolation rooms were available, a patient with a suspected communicable infection was accommodated in a bay in the main area of the emergency department. One single isolation room was used as a storeroom.

* Another isolation room was used for ear, nose and throat consultations. Staff reported to HIQA that these single rooms were not used due to staffing level challenges.

HIQA concluded that  there was much evidence of practice in Waterford Hospital that was not compliant with the National Standards for the Prevention and Control of Healthcare Associated Infections in all three areas assessed
Hospital.

HIQA found that while the emergency department was recently opened, many of the practices observed were not compliant with best practice. The environment and patient equipment in the medical ward and patient equipment in the surgical ward were generally unclean with some exceptions.

The safety authority says Waterford Regional Hospital must now develop a quality improvement plan (QIP)
that prioritises the improvements necessary to fully comply with the National Standards for the Prevention and Control of Healthcare Associated Infections.

This QIP must be approved by the service provider’s identified individual who has overall executive accountability, responsibility and authority for the delivery of high quality, safe and reliable services.

HIQA says details of the improvements must be published by Waterford Hospital on its website within six weeks