June 18, 2008

Why Surprise Hospital Hygiene Inspections Are Good for Us All

Public confidence in our hospitals was one concern that came up over and over again during a meeting of the Stormont health committee on the outbreak of a deadly hospital superbug.

As the chief executives of each of Northern Ireland's five health trusts faced tough questions from the committee's politicians back in February, the main fear raised was that their constituents were simply afraid to go into hospital.

The health trust chiefs were called to Stormont to discuss what urgent steps were being taken to tackle hospital-acquired infections after the Northern Health and Social Care Trust declared an official outbreak of Clostridium Difficile -- it continues to this day and has contributed to dozens of deaths since last summer.

News of the superbug outbreak caused shockwaves when it was announced in January, concern which only heightened as the death toll mounted over the months.

The reasons behind the spread of this particular superbug are complex, with the use of antibiotics being a major factor. But there's no doubt the outbreak sparked fear that hygiene standards in the modern day hospital are not what they should be.

As a result of the new policy, the Craigavon Area Hospital was subject to a surprise inspection by an audit team from the Regulation and Quality Improvement Authority (RQIA) on March 7.

The lapses in hygiene levels they found at the hospital were published by the Belfast Telegraph yesterday after this newspaper obtained their report from the Southern Health and Social Care Trust, which has responsibility for Craigavon Area, under Freedom of Information (FoI).

The team's probe highlighted fundamental areas for improvement, such as the safe disposal of used needles and clinical waste, improved cleaning of medical and general equipment, as well as basic health and safety standards.

Hand hygiene in A&E, one of the key areas highlighted by the Health Minister as a way of tackling hospital superbugs, was also found to be a problem. Hand cream dispensers did not appear to be in use and some staff said they had not attended a training course for hand hygiene in the last year.

Also in A&E, two sharps bins, one of which was in the children's emergency unit, were found to have material protruding, while another contained hazardous waste.

It was also noted that while floors were generally clean, the edges and corners were were not free from dust, dirt and grit, while there was also a lack of cleaning in clinical areas in relation to computers, keyboards and attached cables.

The Trust said the majority of the recommendations made as a result of the inspection have already been addressed. It also highlighted that the inspectors did find "areas of excellence".

While the findings are no doubt worrying for Craigavon Area Hospital patients and their families, it is also encouraging to see that unannounced inspections are doing what they should be -- putting a spotlight on hygiene failings and getting them addressed as a matter of urgency.

It will also serve as a warning to other hospitals that any lax hygiene practices will be spotted and criticised should the audit team come their way without warning.

In the long run, this could be a key approach to reassuring the public that hospital hygiene is being tackled effectively.

But perhaps if our health chiefs were really serious about restoring public confidence, they should publish all inspection reports in an open and transparent way, rather than have newspapers such as the Belfast Telegraph pull them into the public domain through FoI requests.

(c) 2008 Belfast Telegraph. Provided by ProQuest Information and Learning. All rights Reserved.