A HOSPITAL that serves patients in East Clare and Galway plans to install a hawk ultrasound, among other measures, to deter birds from excreting on window panes and sills on one of its wards, it emerged this week.
Details of the pest-control efforts were revealed in a Health Information and Quality Authority (HIQA) report, following unannounced inspections at Portiuncula Hospital in Ballinasloe.
HIQA carried out an unannounced inspection in the hospital in March and a re-inspection in April this year, examining the progress made in resolving issues outlined in the hospital’s Quality Improvement Plan (QIP) prepared after a previous unannounced inspection carried out by the authority in May 2014. It also examined improvements in environmental hygiene and the facilities in the oncology day unit.
According to the HIQA report, on visiting St Joseph’s Ward during the March inspection, “an open window on the main corridor alerted inspectors to a large amount of bird excreta present on the exterior of several window panes and some sills of windows on one side of the ward”.
The report said that while this was not deemed to represent an immediate high risk to patients, it still warranted improvements.
“The extent of the problem indicated that there was a pest-control issue, which needed to be addressed as a matter of urgency. The authority was informed that this was an ongoing issue. Accumulation of bird excreta has the potential to increase the risk of transmission of infectious agents to vulnerable patients,” the inspector stated in the report.
Hospitals are responsible for ensuring that there is a pest-control programme or service that is responsible for cleaning and disinfecting areas contaminated by pests, in addition to pest control. The HIQA inspector highlighted the issue to the ward manager and hospital management.
In response, the hospital instigated a sanitising programme to clean the exterior of the hospital and planned to introduce a variety of measures to prevent and control the access of birds to the building, including the hawk ultrasound, as well as “high illumination and netting”.
The authority also found that the isolation facilities in Portiuncula Hospital were inadequate and did not reflect the size, complexity and specialties of the service provided.
The hospital indicated that plans to develop a ward replacement block, which should provide 50 single rooms, was at the design stage. The authority recommended that the deficiencies in isolation facilities should be reviewed as a matter of urgency.
The March inspection identified ‘immediate high-risk findings’ regarding the lack of progress made in resolving issues listed in the hospital’s QIP prepared after the inspection in May last year. Inspectors also spotted high risks relating to poor environmental hygiene and cleaning process on the oncology day ward.
The hospital said it had put immediate measures in place to address the high risks found in the March inspection. The level of progress regarding the high risks were assessed during the inspection on April 21.
Overall, the authority noted that while some progress was made on St John’s and St Joseph’s ward, there were a significant number of issues identified in the 2014 inspection that remained unresolved and stated that further improvement was required.
HIQA was informed by the hospital that a ward replacement block was urgently required, as the hospital infrastructure is quite old, having been built in the 1950s and extended in the 1980s.
The April visit showed that significant progress had been made in St Joseph’s Ward on the maintenance issues identified in 2014 and in March.
With regard to environmental hygiene, the lack of storage space and poor facilities were issues identified on the oncology day unit during the March 2015 inspection.
The March inspection also found “varying unacceptable levels of dust were seen in most areas inspected. The unit was cluttered and there were inadequate storage facilities. Surfaces and finishes in the only patients’ toilet in the unit were worn and not intact and therefore did not facilitate effective cleaning. The floor covering was not flush with the wall and exposed pipe work and unsuitable radiator design made dust control difficult,” the report stated.
The authority was informed that a ‘check clean’ of the oncology day unit was carried out on a daily basis, which included the cleaning of floors and sanitary facilities. Documentation seen showed that a full clean of the unit was only completed every two weeks. Cleaning check-lists viewed by inspectors “demonstrated deficiencies in resources allocated to cleaning, which was symptomatic of the findings relating to hygiene seen during the inspection”.
Significant improvements were observed in the oncology day unit in April and “it was apparent that the hospital had made noteworthy efforts to improve the infrastructure of the unit. Since the March inspection the walls and woodwork have been repainted, which will greatly facilitate effective cleaning.”
Cleaning equipment was shared between the oncology day unit and another ward and was poorly resourced.
“There was only one mop head holder available between the two wards, which was used in isolation rooms and general patient areas. The only vacuum cleaner available between the two wards had been out of order for 12 months, which impacted significantly on dust-control measures. The buffer machine was not working properly and posed a potential health and safety risk to staff.”
These issues were addressed by the April inspection.
The report identified “a lack of local ownership, in addition to a need for more oversight of environmental hygiene by middle and senior management”.
“The oncology day unit provides invasive treatment to patients, where the risk of transmission of infection is increased and is thereby classified as a high infection risk functional area. The cleaning frequencies seen during the inspection did not provide assurances that the level of cleaning was sufficient to mitigate the risk of contamination of the physical environment,” the report stated.
The April inspection showed “significant measures to address environmental issues identified in the March inspection have been taken, an environmental audit completed on St Joseph’s on April 16, 2015 showed 66% compliance. The poor compliance achieved suggests that there are still improvements to be made in environmental hygiene.”
A native of Ennis, Colin McGann has been editor of The Clare Champion since August 2020. Former editor of The Clare People, he is a journalism and communications graduate of Dublin Institute of Technology.