Improved hospital hygiene audit results welcomed by HSE

The HSE has today, Monday, December 22, welcomed the Health Information and Quality Authority’s “National Hygiene Services Quality Review 2008” that has confirmed continuing improvement in hygiene in hospitals across the country. Welcoming the report, Dr Paul Kavanagh, HSE Healthcare Quality and Patient Safety, said it “provides clear independent evidence that the HSE is providing care to patients in hospitals that are cleaner, year on year.”

Commenting on the results of the HIQA Hygiene Audit, Ms Ann Doherty, HSE Director of the National Hospitals Office said: “Staff in hospitals which have shown continuing success and improvement are to be congratulated for their hard work.  The public have a right to expect clean hospitals – this is an essential foundation for safe, high quality healthcare.  Ensuring our hospitals achieve excellence in the area of hygiene remains a priority for the HSE.”

Overall, there have been significant improvements in performance.  In total, hospitals demonstrated exceptional compliance for 24.6% of criteria and extensive compliance for 46.0% of criteria.  Exceptional compliance doubled when compared with 2007.  As a result, the number of hospitals receiving a “good” or “very good” award from HIQA rose from 7 in 2007 to 12 in 2008.  

The HSE has further noted the continued success by hospitals in delivering improvements in hygiene services – including hand hygiene, catering, laundry, waste, environment and equipment.

The HSE welcomes this report in the context of the encouraging reduction in MRSA rates reported by the Health Protection Surveillance Centre in October 2008.  MRSA infections for the first six months in 2008 have fallen by 3.5% compared with 2007 and 7% compared with 2006.  While it is still too early to predict if this trend will continue, together with today’s report there is now evidence to show that the HSE is effectively addressing the issues of hygiene and infection in hospitals and is delivering positive results.   

Outlining the measures being taken by the HSE in addressing hygiene and hospital infection, Dr. Kavanagh stated: “The HSE has set itself the challenging target of reducing MRSA rates by 30% over the next five years, with a 20% reduction to be achieved in overall healthcare associated infections.  We have a comprehensive programme of measures aimed at achieving this and we are encouraged that those actions are having an impact.

“Other health systems, notably the NHS in the UK, have shown that with persistent efforts the issue of hospital infection can be addressed.  Although this is an issue that cannot be underestimated, Ireland does have low rates by international standards.  It is very achievable therefore for Ireland to mirror the achievements made in other countries including the UK.”

Having launched the “Say No To Infection” plan in 2007, the HSE continues with the comprehensive programme of work with six local implementation teams across the country, focusing on six areas:

  • Education and Training
  • Hygiene and healthcare associated infection prevent and control
  • Consistent Hospital Standards
  • Focus on antibiotic use
  • Facilities Management
  • Governance

Among the measures introduced by the HSE in recent months are:

  • Public Awareness Campaigns;
  • Development of learning programmes for staff;
  • Enhanced monitoring, including the monitoring of Clostridium difficile (C. diff.)rates in hospitals;
  • Publication of HSE Building Standards to promote cleanliness and reduce infection;
  • Implementation of guidelines in key areas including disclosure of MRSA status to patients;
  • Increase in the number of Antibiotic Pharmacists, infection control nurses and surveillance scientists.
  • Developing of monitoring framework to assure implementation of national strategy at a local level.

The HSE has also welcomed the results of the HIQA Patient Survey that demonstrate that the public awareness campaigns introduced by the HSE over the past year are having an impact. 

Patients were satisfied with the HSE approach to hand hygiene in hospitals and reported positive views on the availability of alcohol hand hygiene, hand washing by staff and hand hygiene signage.  Many patients said they would be happy to ask a member of staff to wash their hands – demonstrating the impact of the HSE campaign. Overall, patients found the physical environment of HSE hospitals clean.

The HSE is continuing to monitor such views, with its own feedback facility available to the public via the “Your Service, Your Say” programme.

The report also highlights a number of additional successes for the HSE including better management arrangements through which hospitals lead, plan, organise and monitor hygiene services to support ongoing improvement. Organisational structures, roles and responsibilities are now much clearer and hospital level hygiene committees are now in place.

However, acknowledging that for a minority of hospitals, issues still remain and their performance did not represent an improvement, Dr Kavanagh explained that “we are very much aware of those hospitals that have yet to demonstrate significant progress. We have been working on targeted intervention for those hospitals.  This plan had been finalised in recent days and we now have the final results of this audit to assist in identifying those hospitals.”

The HSE will be communicating directly with those hospitals and will require them to account for slow progress in implementing change and delivering improvement. According to Dr Kavanagh: “We will be facilitating peer to peer intervention – where successful hospitals will work directly with those experiencing difficulty.  The hospitals receiving assistance will be required to develop rapid improvement plans for implementation with clearly defined deadlines and responsibilities.  The plans will be made public as will the hospitals’ progress. Improvement of performance in hygiene services in these hospitals will be independently assured”.

The HSE today also confirmed that it would welcome the introduction of the National Standards for Healthcare Association Infection Prevention and Control to be published by HIQA in 2009.  The HSE has been actively involved in the development of these standards and believes they will build on the work already underway to tackle hospital infection.

The HIQA National Hygiene Services Quality Review 2008 is the second such report to be carried out by the authority.  It demonstrates that compliance by HSE hospitals (both those operated and funded by the HSE) has improved since the 2007 report – indicating that hospitals are getting cleaner.

The two HIQA reviews follow after two reviews commissioned by the HSE in 2005 and 2006.  Taken together, these reviews demonstrate that hospitals are committed to achieving ongoing improvement and are making sustained progress in this regard.

Click here to read the report

Last updated on: 22 / 12 / 2008