‘Numerous weaknesses’ in infection control measures

‘Numerous weaknesses’ in infection control measures

By Aimee Walsh

A REPORT by the Health Information and Quality Authority (HIQA) identified “numerous weaknesses” in infection prevention and control measures implemented at Tallaght University Hospital to protect staff and patients against Covid-19.

The inspection report was completed following an unannounced inspection carried out on December 10, 2020 and focused on how Tallaght University Hospital had acted to try to minimise the spread of infections, particularly Covid-19.

Tallaght Hospital 10 1

The HIQA report identified weaknesses in infection prevention at Tallaght University Hospital

HIQA noted that the hospital had experienced a total of 19 outbreaks of Covid-19 from March to December 2020 - five outbreaks were ongoing at the time of the inspection.

The first patient tested positive for Covid-19 at Tallaght University Hospital on February 29, 2020 and from that date until June 14, 2020, 373 patients and 291 staff members had tested positive for the virus.

In addition to speaking with managers, staff and patients and looking at documentation, inspectors observed practice within the hospital in clinical areas such as Maguire Ward and Ruttle Ward as well as walkthrough of the emergency department.

According to the report, HIQA identified several risks – which when assessed – did not provide assurance to the inspection team that the measures that had been put in place to address these risks were entirely effective or sufficient.

These risks collectively presented a high risk particularly in the context of rising community Covid-19 cases, increasing presentations to the hospital and the numerous outbreaks ongoing at the time of the inspection.

The inspectors found that during phase one of the pandemic, 30% of the cases were hospital-associated which were linked to 10 wards.

In their walkthrough of The Emergency Department, inspectors also found that the controls in place to limit entry points and to reduce entry to accompanying adults were insufficient.

Controls to reduce risk associated with staff crossover and ensure adequate cleaning resources also were insufficient.

The inspectors also found that cleaning resources were shared across the emergency department which was “far from ideal”.

They also stated that cross over of staff between Covid-19 and non-Covid-19 pathways should be limited and improved on following the inspection.

HIQA identified that there were insufficient cleaning resources allocated to the department in general and observed one patient leave a pod and another patient sit in it directly after them without it being cleaned between use.

The staff said that the patient waiting area was cleaned “every one to two hours”.

One risk was that the screening for patients for exposure risk to Covid-19 did not take place until the patient was being registered, which was not in line with the HSE guidelines.

The report stated that this presented a “potential weakness” to the rapid identification and streaming of patients into Covid-19 and non-Covid-19 pathways.

These risks were escalated to the CEO of the Hospital on December 15, 2020.

In response, the hospital management said that it had taken action to address the findings and every effort would be made to dedicate teams to the Covid and non-Covid pathways.

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