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Hand washing via Shutterstock

Patients at risk at 'unclean' Waterford Regional Hospital by lack of hand washing

Waterford was not alone in criticism as HIQA also released reports for St Michael’s Hospital, Portiuncula Hospital, Louth County Hospital and Our Lady’s Hospital, Navan.

WATERFORD REGIONAL HOSPITAL has been criticised for hygiene standards and other poor practices by the health watchdog.

However, Waterford was not alone in criticism as the Health Information and Quality Authority (HIQA) also released the hygiene inspection reports for four other hospitals including, St Michael’s Hospital, Dun Laoghaire, Dublin; Portiuncula Hospital, Ballinasloe, Co Galway; Louth County Hospital; and Our Lady’s Hospital, Navan, Co Meath.

The unannounced inspections assessed “the hygiene as experienced by patients at any given time”.

Waterford Regional Hospital

The emergency department was visited by three authorised people from HIQA on June 25 between 09.15am and 14.30.

They found that the handing washing by staff was extremely low with just five of 23 hand washing opportunities taken by staff. This risked the spread of infection to other patients.

It was found that some staff wore sleeves to their wrists and wrist watches, which prevented adequate hand washing.

Four hand hygiene gel dispenser units in the hospital public corridors on the first floor were empty and the nozzles of some wall mounted hand gels in ED were clogged.

Overall, the authority found that the environment and equipment in areas assessed were generally unclean, placing patients at significant risk. It said there were poor waste management practices at the facility and a patient equipment room was cluttered with numerous items stored directly on the floor.

“We are very disappointed by the results of this inspection and we are trying to remedy it with immediate effect,” managing director Rob Landers told RTÉ’s News at One.

He added the findings were “unacceptable” and said that they will “up the level of instruction” to staff there.

The hospital looks after a population of 500,000 and covers Waterford, south Tipperary, Wexford, Carlow and Kilkenny.

Portiuncula Hospital, Co Galway

St Francis’ ward, theƒ Maternity ward andƒ St Clare’s five-day ward were checked by two authorized persons from the authority on July 9 from 9.00am to 13.00.

The authority found there were many improvements since the last HIQA visit on January 9, however, there are still many “unsatisfactory practices that remain non-compliant with the national standards”, such as dust found in all wards, and “sticky” patient equipment.

When it comes to hand hygiene, 25 of 34 hand hygiene opportunities were taken but HIQA said there was room for improvement.

St Michael’s Hospital, Dun Laoghaire

The emergency department (ED) and the male ward were given a surprise inspection on June 19 between 11.00am and 14.30.

The authority found that while the ED was clean, many of the practices observed were not compliant with best practice and the male ward was unclean and cluttered.

It also found chemicals, clinical waste and sterile equipment were stored in unsecured areas.

Seventeen of 22 hand hygiene opportunities were taken by staff there.

Louth County Hospital

The Minor Injuries Unit (MIU) and theƒ Stepdown Ward were visited on July 1 between 9.00am and 12:30.

The auditors found both wards to be generally unclean. Bed frames were also found to be dirty.

When it came to hand hygiene, the authority observed 24 of the 35 hand hygiene opportunities were taken, but only 20 were observed to comply with best practice hand hygiene technique of HIQA. It was also found that hand hygiene was not embedded at all levels.

Our Lady’s Hospital, Navan, Co Meath

The ED and female medical ward were assessed on July 4 between 14.00 and 17.30.

The ED was found to be unclean while the female ward was generally clean with some exceptions. Generally, the report found the hospital failed to protect patients and reduce the spread of infections.

The authority found that less that half all hand washing opportunities were taken – 13 out of a possible 27 times. It also found that some designated hand-wash sinks were unclean.

Read: Maternity unit and patient equipment at Tipperary hospital are unclean>

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38 Comments
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    Mute Barry
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    Aug 16th 2013, 2:27 PM

    I’ve been to WRH a number of times and it almost feels like a shopping centre due to the amount of people going in and out,

    Now no doubt there are staff issues regarding hygiene but without a doubt there are bigger issues with the general public not cleaning hands, I’ve almost never seen people visiting clean their hands!

    Compare this to the Whitfield clinic in Waterford where anytime I visited somebody I’ve seen them actually call people back and instruct them to wash hand if they didn’t upon entering the front door. Ok its private but this is what should be happening, we can’t just blame staff on this one.

    When I was a kid i remember not being allowed into hospital to visit, whatever happened to this rule? These rule made sense when you consider how often kids get sick.

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    Mute Lucy
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    Aug 16th 2013, 2:48 PM

    Completely agree. Hardly anyone cleans their hands walking into WRH and i think there should be a system like a turnstile kind of thing that opens when the hand wash is activated.

    Its one thing for visitors but if staff are not doing it then thats worrying :/

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    Mute Deasun Mac An Choiligh
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    Aug 16th 2013, 2:51 PM

    Not so long ago the medical fraternity frowned upon been told washing their hands saved lives….swings and roundabouts encircles us

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    Mute Tom H
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    Aug 16th 2013, 3:46 PM

    Imagine the cost of these rubbish HIQA reports though?!! Some admin with a clipboard counting how many ‘hand hygiene opportunities’ are taken. Could they not invest in better facilities or staff in these underfunded institutions instead of another pen-pusher admin?? These services are stretched to breaking point. No wonder there are problems. Another report from these guys to justify their very existence is of no help.

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    Mute Kathryn Marsh
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    Aug 16th 2013, 4:01 PM

    When you are trying to stop the spread of infection in hospitals the facilities that need to be invested in are opportunities to wash hands. It isn’t a rubbish report if it stops you and me being killed by a member of staff who can’t be arsed to wash when there are gels and hand basins all over the place. I don’t go into a hospital without cleaning my hands, why should I pay the wages of someone who knows it is critical to stay clean but doesn’t bother. There is no cheaper way of saving lives than washing hands

    37
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    Mute Simon King
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    Aug 16th 2013, 4:04 PM

    HIQA aren’t ‘pay as you go’ in terms of inspections Tom – cost of employing inspectors & producing reports remains consistent

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    Mute John Scott
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    Aug 16th 2013, 5:00 PM

    was just thinking the same myslef

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    Mute Jim Walsh
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    Aug 16th 2013, 5:04 PM

    @Tom H – “Services are stretched to breaking point”. Maybe they are but it takes less than 20 seconds to wash your hands thoroughly and personally I’d prefer to be sure that if I am being attended by a doctor or nurse that their hands are not possibly contanimated from dealing with another person. This is just basic hygiene.

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    Mute james doyle
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    Aug 16th 2013, 5:45 PM

    Ardkeen hospital was a lot cleaner place when the nuns had it,since it’s now been run by hse it rewards the cleaning contracts out to the cheapest bidder which means some people that work for little money for the contract cleaner couldn’t give a rat’s arse about the place,that’s why a lot of outbreaks are happening in these hospitals

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    Mute James Nugent
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    Aug 16th 2013, 8:49 PM

    Barry ” we can’t just blame the staff for this one ” actually yes we can. The report states out of the 23 occasions when staff should have washed hands they only washed on 5 occasions. So you can’t blame the public for that. In medical, nursing, physio,and radiology training, days and days of training goes into the importance of hand washing. Quite simply in hospitals washing hands saves lives. Dirty hands can cause infections and on occasion death in the very sick patient. The report is what it is. It is positive to read facilities visited in January had made improvements, however staff found consistently breaching cleanliness and hand washing practices should be sanctioned, regardless of unions or being a public servant. If you value your job and the people you are paid to look after wash your hands or have consequences.

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    Mute Martin Stapleton
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    Aug 16th 2013, 3:07 PM

    It always amazes me that staff need to shower in and out of places like pig farms but staff can walk out of a hospital, hang around smoking shelters, go to the shops or petrol station and go straight back into a ward. Contract cleaning does not work either and staff need to take responsibility even if management won’t!

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    Mute Paul Walsh
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    Aug 16th 2013, 4:28 PM

    Also in food preparation facilities the staff must be clean faced with their hair covered. When my mother was in isolation having gotten MRSI in hospital, I and other visitors put on the appropriate garb when visiting. However I observed nurses flick their hair and put their hands to their face while attending to my mother. Even if they washed their hands before attending to their next patient the bug could have been on their face and hair.

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    Mute Jessie
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    Aug 16th 2013, 2:36 PM

    Staff should have the sense to clean their hands and have good hygiene practices. They shouldn’t have to be chastised and reminded to do it, if they’d just be conscientious in the first place. Granted visitors should also take caution, and wash their hands on entering and leaving a hospital.

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    Mute Thomas M Bourke
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    Aug 16th 2013, 3:29 PM

    When one of the rugrats was born, they ended up in the ICU for a few weeks. I dutifully followed the instructions on the board above the sink outside the ICU on every visit so much so one of the nurses asked if I was a doctor…

    Did make me wonder how badly they saw people wash their hands nornally

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    Mute WanderArch
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    Aug 16th 2013, 6:31 PM

    Staff don’t have to be chastised – they wash their hands. If that was the extent of the problem, it would’ve been fixed years ago.
    What this shows (yet again) is the unsuitability of hospital buildings in Ireland. Sinks at every bed, bins under every sink and beside every bed, one bed to a room, each room with its own wet room, with a sink, toilet and shower (without a shower tray, or shower door/curtain), loose the curtains, the need for medical staff to wear “professional attire” is ridiculous (any member of hospital staff who comes into contact with a patient – should be wearing colour coded scrubs), children under 12, anyone not hygienic in appearance (clean clothes, shoes etc), anyone with colds/flus/fails to wash hands on way in – all out. Hand gel dispensers at every door and sink, with a bin under each one. Chewing of gum – also out. Implement this, then talk about staff and their hand washing.

    22
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    Mute sydney shaw
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    Aug 16th 2013, 4:01 PM

    Is it a coincidence that these are the hospitals they either want to close or downgrade ?

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    Mute James Nugent
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    Aug 16th 2013, 9:55 PM

    No coincidence at all Sidney

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    Mute Rebecca Evans
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    Aug 16th 2013, 3:37 PM

    Denmark has the lowest level of hospital acquired infections in the EU, Why? because 1) All patients have single rooms. 2) Their use of antibiotics. Until recently in Ireland Doctors didnt have sufficient training in the use of anti-microbials during their studies. Antibiotics have been over prescribed for decades or in many instances the wrong type of antibiotic for the infection and then patients themselves not taking their antibiotics correctly, such as finishing the full coarse or sharing tablets with relatives etc. The bacteria have therefore developed resistance. This doesn’t excuse poor hygiene in hospitals such as basic hand washing but there is a much bigger picture in the fight against hospital acquired infections and with the increasing pressure on our already fragile health service we will likely see these figures rise.
    With regard to the comment about Doctors and hand washing, you notice now the younger Doctors are much more aware of hand washing/ gowning up etc. and don’t feel ‘above’ this.

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    Mute Liz Cashin
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    Aug 16th 2013, 5:00 PM

    Only people who need to be in a hospital should be there , hospitals are crazy with cafes , shops you have a constant stream of people in and out with dirty hands dirty shoes and clothes . How would there not be a spread of infection

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    Mute Parmenides
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    Aug 16th 2013, 2:23 PM

    But hand washing is boring… And when I’ve spent €78 on hand moisturiser I sure as sh!t ain’t washing it off.

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    Mute Piarais Mac An TSaoir
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    Aug 16th 2013, 3:32 PM

    Not sure if this is attempt at comedy, wit or satire, but you have failed at all 3.

    48
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    Mute Joe McAndrew
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    Aug 16th 2013, 2:43 PM

    Every day in the Irish health system, much needed resources are diverted into the promotion and adoption of the WHO’s so called “5 moments of hand hygeine”. Unfortunately there is no good evidence that this corelates with a reduced incidence of healthcare associated infections. What an utter waste of time.

    http://m.bjj.boneandjoint.org.uk/content/94-B/4/441.abstract

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    Mute Thomas M Bourke
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    Aug 16th 2013, 3:03 PM

    Joe… One guesses you have never had a secondary infection from an irish hospital BECAUSE it wasn’t clean?

    Let me tell you it’s isn’t nice, and the waste of time for the patient in going back and forth to get dressings changed and infection site checked makes the 5 moments time pale into insignificance

    28
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    Mute Tom H
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    Aug 16th 2013, 3:47 PM

    Thank you for some logical, evidence-based input and not an NHS-regurgitation. They need to stop plotting money into HIQA and these layers and layers of HSE admins

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    Mute TheIrishBrain
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    Aug 16th 2013, 2:24 PM
    14
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    Mute ciara mckeown
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    Aug 16th 2013, 3:59 PM

    probably because this is a story about hygiene levels in hospitals, one has nothing to do with the other. Maybe you should try posting that to a story where it might be relevant.

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    Mute TheIrishBrain
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    Aug 16th 2013, 4:06 PM

    @ciara mckeown
    It concerns all users of Gas And power, but obviously you don’t use either of those or maybe you just don’t have to pay for them.

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    Mute ciara mckeown
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    Aug 16th 2013, 8:41 PM

    @theirishbrain because you know me so well and know what energy or heat source i pay for? exactly what i said was this comment wasn’t exactly relevant to this comment thread! everyone is entitled to an opinion and this was mine- i didn’t ask you to like it or agree!

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    Mute Nollaig Lonergan
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    Aug 16th 2013, 3:57 PM

    When I was in hospital in Galway I was quite shocked by medical teams coming the intothe ward going from patient to patient and not washing hands when leaving the ward (let alone beteen patients)

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    Mute Lillian O'Connor
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    Aug 16th 2013, 4:35 PM

    Nollaig imagine being in a 6 bd ward there ….blood under one bed for 3 days until I had opened up on cleaning staff…2 nurses came into a room in this same hospital few yrs back where an uncle was ( he had gangerine) the door propped open with rubbish bin..nurses proceeded to glove up on entering room & 1 nurse moved bin to shut door & this same nurse was the one that was going to change dressings on the uncle……do you think I let her? ?????

    13
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    Mute WanderArch
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    Aug 16th 2013, 6:38 PM

    That is likely because most hospitalised patients in Ireland don’t need to be hospitalised – are you going to put alcohol gel and soap dispensers along with a sink at your front door at home? Because that’s what it’s akin to doing – you’re not in a vacuum in a hospital.
    Talk about step down facilities, community services and I’ll listen to anything you’ve to say.

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    Mute Deborah Kelly
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    Aug 16th 2013, 9:34 PM

    You wonder whether HIQA are being used as a tool to manipulate public opinion to undermine certain hospitals. Are they doing spot checks in a systemised way, looking at all the hospitals in this country? Spot checks are obviously the way to go but let’s see St James The Mater or St Vincents

    11
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    Mute susanna smyth
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    Aug 16th 2013, 9:38 PM

    It’s a really hypocritical system when they let nursing homes know weeks ahead when they plan to inspect them

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    Mute Laura
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    Aug 17th 2013, 1:49 PM

    They did perform them in those hospitals too, but they fared better. They’re only highlighting the ones with issues.

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    Mute Gemma Linnane
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    Aug 17th 2013, 9:02 PM

    Nursing homes are notified of the initial visit only. After that they appear out of the blue. I work in a nursing home and we have had four inspections. Three unannounced.

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    Mute Lillian O'Connor
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    Aug 16th 2013, 3:20 PM

    Am NOT SURPRISED..enough said.

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    Mute MeholeMartin
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    Aug 17th 2013, 7:07 AM

    Doubt anyone is surprised to see drogheda hospital on the list.

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    Mute Neill's Growing Skepticism
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    Aug 16th 2013, 9:14 PM

    Go on the Déise.

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