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'Unclean equipment posed high risk to patients' at Tallaght Hospital

A report gave details of unclean equipment, unregulated isolation rooms and potential risk of inter-patient transmission of infective material because of low staffing levels.

TWO UNANNOUNCED INSPECTIONS of Tallaght Hospital found a number of deficiencies that are putting patients at risk.

The inspections were carried out by the Health Information Quality Authority (Hiqa) in July and August this year. The July inspection found that there were insufficient Clinical Microbiology resources in place to enable a timely response when needed in the treatment of patients with serious infections in the hospital.

Hiqa said that efforts to prevent and control healthcare associated infections at the hospital were severely restricted as a result, and this represented a “high risk to patients”.

During the same inspection, it was noted that in one unit several items of frequently used patient equipment such as glucose meters, a commode, hoists, an oxygen saturation probe, a temperature probe holder and vital sign monitors were “unclean”. The report said this equipment ‘poses a potential risk of inter-patient transmission of infective material’.

The authority was informed that there were reduced resources for cleaning patient equipment on the ward immediately prior to the inspection.

Daily cleaning checklists for equipment were found to be incomplete and inspectors were told that healthcare assistants in charge of this job were frequently required to help with direct patient care. This ‘impacted’ on the time they had to clean.

The report read:

It was explained to the Authority that healthcare resources on the unit are likely to be further reduced for a period in the immediate future due to an overall reduction in the number of healthcare assistants available to the unit.

In addition, it was found that the switch to control pressure levels in an isolation room on one ward was accessible to unauthorised persons. This had the “potential to cause a high risk of transmission of airborne infections”. Other issues included:

  • A procedure, policy or maintenance records for this room were not available;
  • There was no system in place to monitor the pressure in the room when used for the isolation of patients requiring airborne precautions;
  • The door of another room isolating a patient requiring contact precautions was not closed.

August follow-up inspection

The authority was told in August that a previous recruitment drive for an additional locum consult support to the microbiology service had been unsuccessful but a new microbiologist has since been recruited and was due to start this month.

As for the unclean equipment in one of the units, though daily checklists were not available to view at the time of the re-inspection, the cleanliness of the equipment “had improved considerably”. However the authority said that in view of the resources issues highlighted by the July inspection, it recommends that the impact of further reducing resources needs to be examined by the hospital.

Hiqa was told that an audit of commodes, dressing trolleys and drug trolleys was carried out in September 2013. The hospital has secured funding to replace these items throughout the hospital however; the replacement of commodes or drug trolleys was not evidenced at the time of the re-inspection in either of the two areas inspected.

The hospital addressed concerns about the isolation room by issuing a memo encouraging increased vigilance amongst staff. The authority found that the doors of two single rooms on Franks Ward occupied by patients who required isolation were open but this decision was based on a risk assessment of the patient needs. However, the Authority was informed that the risk assessments were not routinely documented.

File Pics Tallaght Hospital CEO denies health of patients under threat. Mark Stedman / Photocall Ireland Mark Stedman / Photocall Ireland / Photocall Ireland

The keys to isolation rooms with engineering controls have been removed from the control switch and given to a designated person on the ward.

However, Hiqa said concerns remain relating to the monitoring of this room when used for the isolation of patients requiring positive or negative pressure as there is no alarm system which can alert staff if the doors are left open or the pressure is not maintained at the required level. On top of this, staff at the ward said they were not educated on the ventilation systems in the room and were unsure of what the required optimal levels were.

The authority recommended that the hospital review the systems, procedures and processes in place to ensure that the risk of transmission of infection is prevented, managed and controlled.

Hygiene

Inspectors also said maintenance tof the patient environment on both wards was also a concern.

  • A blood stain was visible on the floor beside a patient’s bed along with a tourniquet in a six bedded unit.
  • “Unacceptable levels of dust” were present on bed frames, the undercarriages of beds, floor edges, behind lockers and casements over patients beds on some of the areas
  • The floor covering in patient areas in Franks Ward – particularly under hand hygiene sinks – was damaged and beginning to lift
  • A significant area of floor covering was missing beside a patient bed leaving exposed concrete.
  • There was damage to plasterwork and paintwork on walls, door frames and radiators.

The follow-up inspection found a number of rooms had been refurbished, though the same is needed in the other rooms.

Read: Dignity of elderly compromised after being transported down corridors on commodes >

More: HIQA writes to HSE twice over risks to patients in emergency departments >

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11 Comments
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    Mute Bobby
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    Jun 6th 2014, 5:31 PM

    Id say those under 60 are not much better.

    64
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    Mute richardmccarthy
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    Jun 6th 2014, 4:47 PM

    I must be one of the 18%,ever since i stopped smoking 7 years ago i took to cycling excersize with a vengence, clocking up anything from 150/200 km per week on mostly coastal trips,as a form of excersize to help keep the body in shape it is very hard to beat, and would have no hesitation whatever in recommending it,just remember to wear proper hi vis clothing with helmet and a good pair of extra strong sole shoes used just for cycling shoes,and of course a good hibrid bike with strong tyres are a must.

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    Mute Emily Elephant
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    Jun 6th 2014, 5:41 PM

    You do 200k on a hybrid? Is your back made of titanium?

    14
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    Mute richardmccarthy
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    Jun 6th 2014, 7:11 PM

    Well Emily i never had a problem with back strenght,and even hills are not a problem to me now,but as an ex marathon runner back in the eighties i know that regular exersize builds up mental as well as body strenght and things you once thought impossible you take them in your stride, cycling is easy compared to running marathons and of course the fact you enjoy it is a big plus.

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    Mute Emily Elephant
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    Jun 6th 2014, 7:52 PM

    Fair play to you. When my commute went to 11k my back said fook that, and it’s been a road bike ever since. Apparently someone did the Wicklow 200 on a DublinBike last year. Insane.

    6
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    Mute Good News Caravan
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    Jun 6th 2014, 6:43 PM

    Old folk really are lazy. It takes an age to coax my grandma out the back garden for burpees and high intensity interval training.

    I take a carrot and stick approach whereby if she doesn’t go she gets her meals taken from her.

    Fair is fair after all

    35
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    Mute Dee4
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    Jun 6th 2014, 5:16 PM

    no reason not to be physically healthy through to your 70′s, use it lose it.

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    Mute Angelic Lestat
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    Jun 6th 2014, 4:57 PM

    I think the next generation or two will be much more physically active as they age.

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    Mute Marjorie Magee
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    Jun 6th 2014, 10:55 PM

    Some will, but many will be too fat.

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    Mute Hallie Burton
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    Jun 6th 2014, 6:46 PM

    OK then.
    No smoking in the car.
    No giant sized drinks.
    Get yer cervix checked
    Embrace a Gay lifestyle
    Don’t drink the water from a private well
    Make eyer mind up, do you want a fry or a bale of briquettes
    Be careful flying with a certain American Airline
    I think that’s it ,now off for a walk and just hope the TV is not nicked while I’m out. :-)

    15
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    Mute Sheik Yahbouti
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    Jun 6th 2014, 11:42 PM

    Spot on, Hallie, my man:-)

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    Mute Marjorie Magee
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    Jun 6th 2014, 10:54 PM

    Exercise is the key to a healthy old age. I am in my sixties and do a lot more than the recommended amount. I feel the same as I did 40 years ago and have no stiffness and soreness of joints. But you have to like doing it…..

    13
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    Mute Sheik Yahbouti
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    Jun 6th 2014, 11:40 PM

    I’m puzzled. In thread after thread the over sixties are vilified, or at least criticised for consuming health care, for drawing pensions (which they have worked for) and for having paid off their mortgages. Why the sudden interest in extending our lives? I had thought it could only be a couple of years before we received a cyanide pill in the post from Ms Burton and her Department of social protection (try saying that name with a straight face).

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    Mute Catherine Mill
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    Jun 6th 2014, 6:22 PM

    Nanny state.

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    Mute Marc O'Donoghue
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    Jun 6th 2014, 10:54 PM

    Fewer than half, not less than half.

    3
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