Report into infection prevention and control at LUH published

The Health Watchdog has published a report on infection prevention and control in Letterkenny University Hospital.

Two wards were inspected in the hospital; one ward on the COVID-19 pathway and one on the non-COVID-19 pathway.

Improvements were required around the hygiene of equipment in one ward area of the hospital.

Overall the inspection identified that Letterkenny University Hospital was substantially compliant.

Improvements were required in the governance and management arrangements for the prevention and control of healthcare-associated infection at the hospital.

Documented governance arrangements viewed by inspectors had not been finalised.

However, these arrangements and changes made to the governance structures at the onset of the pandemic were understood and articulated by staff in discussions with inspectors.

The hospital had implemented parallel pathways for the streaming of patients into COVID-19 and non-COVID-19 services and was working on ways to ensure compliance with updated HSE guidance relating to pre-triage assessment in the emergency department.

While the hospital had some measures in place relating to the antimicrobial stewardship programme, it was acknowledged by senior management that progress to date with this regard had been relatively slow.

Inspectors assessed two clinical areas with differing age profiles and infrastructure.

Medical 3 Ward, a newer build, was well maintained and generally clean while the Orthopaedic Ward had an older infrastructure and general wear and tear was evident.

Deficiencies in ward maintenance in the older hospital wards can potentially contribute to outbreaks.

HIQA has advised that hospital address the maintenance issues already identified by the hospital and seen by inspectors following this inspection to ensure the patient environment facilitates effective cleaning in line national guidelines and standards.

While patient equipment was clean on Medical 3 Ward, improvements were required in the management of patient equipment on Orthopaedic Ward.

The processes in place on Medical 3 Ward designated as one of the COVID-19 Wards needs to be revisited to ensure that COVID and non-COVID zones and signage provide better clarity for staff.

Greater assurance on the processes to limit staff crossover was also required. While overall findings at the time of the inspection did not present an immediate high risk to patients, the composite nature of the issues identified were relatively poor in the context of an ongoing pandemic.