Cavan patients at high risk of superbug

Patients at Cavan General Hospital are at high risk of infection from the Clostridium difficile superbug, partly due to poor hand washing by staff, according to the State health watchdog.

The Health Information and Quality Authority (Hiqa) demanded the hospital take immediate measures to deal with the problem following an unannounced inspection of two wards in the hospital last month.

C.diff is a bacterial infection that commonly affects people who have been treated with antibiotics. It can cause cramping and diarrhoea and can lead to life-threatening complications in serious cases.

Documentation viewed by Hiqa inspectors found a recent increase in the incidence of C.diff-associated disease due to a “possible multitude of contributory factors, one of which was poor hand hygiene”.

On the basis of information provided by the hospital, Hiqa believes the problem relates to “the persistent incidence of isolated, unrelated cases rather than an outbreak of a predominant strain” and said there were no severe cases identified.

The documentation suggests the “pattern and volume of antimicrobial consumption” was a major contributory factor to the C.diff infection rates within the hospital.

“A failure of good hand hygiene practice cannot be ruled out as a contributory factor to the potential cross-transmission between two cases with similarly rare strains or between asymptomatic carriers and more vulnerable patients who subsequently go on to develop C.diff infection.”

Hiqa says the hospital provided a prompt and comprehensive response on the action it would take to address the immediate high risks and to ensure hand hygiene compliance was improved.

The performance of the hospital for hand hygiene was considerably lower than HSE targets, according to documentation viewed by inspectors. They found compliance with the rules for correct hand washing was just 59 per cent.

Inspectors found one of the wards visited was generally clean with some exceptions, while the other required improvement in the maintenance and management of the patient environment.

Specific problems included “varying levels of dust”, dirty equipment and stained mattresses. The cleaning of patient equipment needed to be managed more effectively, the inspectors found.