Lapses in infection control found at Cork University Hospital

Multiple syringes of injectable medication were either unlabelled or insufficiently labelled in the intensive care unit at Cork University Hospital, according to an inspection by health watchdogs.

The unannounced Health Information and Quality Authority (Hiqa) inspection also found that the emergency bag located in a medication fridge contained multiple syringes of injectable medication which were either unlabelled or insufficiently labelled.

“The interior surfaces of the bag did not appear to be clean and elastic material within this bag did not facilitate effective cleaning,” the report continued.

The inspection report, published on Tuesday found the acute hospital did not have effective governance arrangements for the prevention and control of healthcare associated infection.

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To reduce the risk of transmission of infection to patients, intravenous medications should be prepared in a clean environment using an aseptic non-touch technique immediately prior to use where possible, inspectors observed.

Hiqa identified a number of gaps in the provision of the infection prevention and control service at Cork University Hospital which were of concern given the size of the hospital and the complexity of services provided.

Specifically, deficiencies were identified by hospital management in respect of consultant microbiologist resources and by the infection prevention and control team in respect of infection control nurse staffing levels.

‘Effective oversight’

Inspectors noted that arrangements at executive management level described in this report did not provide assurance of clear effective oversight of the prevention and control of healthcare-associated infection which was required in a large tertiary referral hospital.

Opportunities for improvement were observed in relation to patient equipment hygiene. A number of items of patient equipment were either stained or dusty and these included three commodes, an electronic thermometer, a blood pressure cuff, a drip stand and a portable suction machine. A patient equipment cleaning logbook reviewed by inspectors showed that cleaning frequencies for some items of patient equipment were not aligned to recommended national guidelines.

Inspectors also found that the cleaning logbook was not consistently completed which does not provide assurance that patient equipment was regularly cleaned. Inspectors were informed that staff responsible for cleaning patient equipment had competing demands on their time such as direct patient care.