HIQA report recorded low staff take-up of ’flu jab

Just over a third of staff at the two public hospitals in Galway City had taken the ‘flu jab, a rate far below the national uptake target.

The figure was revealed in the latest report from the Health Information and Quality Authority (HIQA), which carried out an unannounced inspection of University Hospital Galway (UHG) and Merlin Park Hospital on August 22.

The inspectors focused on the prevention and control of transmission of superbugs and infections and decontamination facilities outside of designated controlled decontamination units.

The hospital has experienced an ongoing outbreak of the superbug CPE (Carbapenemase Producing Enterobacterales) since June 2017 and continued to screen in excess of the national HSE CPE screening guidelines. It had also had outbreak of Legionnaire’s Disease in 2018.

Overall the two hospitals were given the thumbs up from HIQA. They both had “formalised governance arrangements with clear lines of accountability and responsibility around the prevention and control of healthcare-associated infections”.

The report found the institutions were “committed to improving infection prevention and control practices in the hospital and were endeavouring to fully implement the National Standards for the prevention and control of healthcare-associated infections in acute healthcare services”.

Inspectors praised their progress and compliance levels in relation to outbreak management, environmental hygiene on St Teresa’s Ward and the Haemodialysis Unit, despite infrastructural challenges, the antimicrobial stewardship programme and the on-going microbiological surveillance programmes.

However, some areas were identified which needed addressing. These included the ‘flu influenza vaccine uptake among healthcare workers, which at 35 per cent was far behind the national target of 60 per cent.

There also needed to be greater clarity among staff about the application of CPE screening guidelines.

The inspectors highlighted the need for greater compliance with mandatory hand hygiene training, more hygiene committee meetings, improvement in patient equipment hygiene and the storage of cleaning equipment.

The report outlined the need to improve the design and layout of St Teresa’s Ward and the central laundering facility.

Although a number of mitigating measures had been implemented at the hospital – including screening of patients in excess of the national HSE CPE screening guidelines – new cases of CPE continued to be identified.

Ongoing sampling of water and monitoring for Legionnaire’s Disease was ongoing at Merlin Park following the 2018 outbreak. “It was reported that the samples have shown a positive reduction in legionella counts which indicated that the remedial actions were working effectively.”

Among the more visible downfalls in hygiene standards were “unacceptable levels of dust and inappropriate storage of sterile supplies” observed in a room used to get in and out of changing and toilet facilities for patients.

This also meant that patients had unattended access to sterile supplies.

In St Teresa’s Ward extensive red staining was visible on the surface of several integrated sharps trays in the clinical room. Red staining was observed on two intravenous pumps.

“This was brought to the attention of the ward manager and was addressed immediately,” noted the report.

Outdates facilities at UHG continued to attract the criticism of HIQA, which pointed to the lack of single rooms to effectively isolate or segregate all patients with infections.

There were also insufficient numbers of showers and toilet facilities for patients.

“CPE contact patients were cohorted in a room without en suite facilities,” it was pointed out.