‘Dual cleaning and catering duties’ at hospital

WORN and poorly maintained wall paintwork, wood finishes and flooring in the theatre department of Limerick’s maternity hospital do not “facilitate effective cleaning” according to a report by the Health Information and Quality Authority (HIQA).

The report also stated that cleaning staff in the theatre department and labour ward “have dual cleaning and catering duties” and that the cleaning resources allocated to the labour ward “did not provide assurances that the cleanliness of the physical environment can be effectively managed and maintained particularly during surges in activity”.

Hospital management, however, said additional staff recruitment is nearing completion and should rectify these issues.

An unannounced inspection, which took place at the University Maternity Hospital on January 27, found that “overall the environment in the theatre department was generally clean” and had “achieved 95% compliance in the most recent environmental audit carried out”.

However, the HIQA inspectors also identified “a number of infrastructural and maintenance issues which had the potential to impact on infection prevention and control measures.” They also observed that “the theatre department was a thoroughfare for staff en route to the doctor’s residence”.
The report stated, “Traffic in semi-restricted areas such as the theatre reception and corridors must be limited to authorised personnel only”.

The report noted a lack of storage space in the department and “inadequate” male and female staff changing facilities. “In the absence of caesarean section surgical site infection surveillance, the hospital does not have appropriate mechanisms in place to assure itself that infrastructural deficits in the theatre department do not negatively impact on patients from an infection prevention and control perspective,” it found.

HIQA was informed “there were deficiencies in respect of cleaning resources in the theatre department and labour ward, particularly after 5pm”.

“The cleaners allocated to cover the labour ward and theatre department have dual cleaning and catering duties, which further dilutes the cleaning resource and may hinder the effectiveness of cleaning practices,” according to the inspection report.

“The hospital informed HIQA that this is not the operational norm in other areas of the hospital. The reported cleaning resources allocated to the labour ward and theatre department did not provide assurance that the cleanliness of the physical environment can be effectively managed and maintained particularly during surges in activity. HIQA was informed by hospital management that the recruitment of additional cleaning staff was nearing completion and should rectify these deficiencies.”

According to HIQA, the cleaning checklist from a birthing room on the labour ward was viewed and “did not provide assurances that all patient equipment is cleaned on a daily basis in line with best practice”. The report said during the inspection, a staff member was observed leaving the operating theatre “carrying a syringe by hand and proceed to administer to a patient without performing hand hygiene”.

In conclusion, HIQA noted the fabric and infrastructure of University Maternity Hospital, Limerick “presents ongoing challenges to the maintenance and upkeep of the building. The current infrastructure and design of the theatre department does not meet international best practice guidelines for operating theatre infrastructure”.

The report noted the hospital had “demonstrated that it is working towards compliance” with certain infection prevention and control standards and “is committed to improving the management of invasive devices”. HIQA also acknowledged the improvements and progress made by the hospital management and staff since the last unannounced inspection in November 2014.