Top management at Waterford Regional Hospital this week went on the offensive regarding the standard of hygiene at the hospital, found to be “fair” by the Health Information and Quality Authority.

As already widely reported, WRH was one of 35 hospitals thus categorised by the HIQA following a hygiene services quality review. Of the other 16 public hospitals reviewed, 7 obtained a “good” rating while 9 were “poor”. Not one was found to be “very good”.

Now WRH General Manager Patricia Sullivan has moved to assure the public of “continued high standards” in relation to service delivery at the hospital. She said the “fair” grading was awarded on foot of the hospital having received one C mark in the criteria for evaluating its human resource recruitment process.

Any C in a core criteria ensures a “fair” grading but, she pointed out, WRH in fact had “more than the required numbers” of A’s and B’s (21.4 p.c. and 51.79 p.c. respectively). C ratings amounted to 26.79 p.c. and there were no D’s (for minor compliance) or E’s (no compliance).

Ms. Sullivan listed a number of favourable observations in the HIQA report regarding WRH. Among them were: there was an excellent approach to the development and improvement of hygiene services; terms and key concepts for hygiene services were implemented; key performance indicators had been established for the contract cleaners and were being monitored; and hygiene standards in high risk areas were very high.

She confirmed also that a review of existing arrangements was underway and a quality improvement plan was being developed to address recommendations of the HIQA report. That would include conducting an in-house patient survey regarding satisfaction with hygiene services, a process for directly including patients and other service users in evaluation of those services, increased monitoring of hand hygiene practices by staff, distribution of an information booklet on hygiene, expansion of key performance indicators for hygiene services and installation of separate hand wash sinks in all sluice rooms.

MRSA

Voicing disappointment at the tenure of statements issued by the MRSA and Families Group in relation to the hospital, Ms. Sullivan maintained it had a high standard of hygiene “as evidenced in several independent reports” and adopted best practice regarding protection against hospital acquired infections.

She said a duty of confidentiality to patients precluded her from commenting upon individual patient’s complaints, all of which were investigated by the hospital through the appropriate complaints procedures.

Commenting on allegations attributed to the MRSA and Families Group, including one of “a wall of silence” from the HSE regarding the role of nurses and the spread of such infection, the General Manager said it was unfair and misleading to suggest. All clinical staff were conscious of the risk of infection to which patients were vulnerable and every effort was made to take appropriate precautions in that regard.

She added: “WRH places the management and delivery of cleaning services high on the corporate management agenda. Extensive facilities for hand washing are provided for staff, patients and visitors in line with national infection control guidelines. Signage, floor displays and audio recordings are used to promote and encourage good hand cleaning practices. All toilets are regularly cleaned with all consumables replenished several times per day. All showers are cleaned daily in accordance with WRH’s cleaning specifications. WRH has a preventative maintenance programme in place to ensure that facilities are maintained to the highest standard and, in addition, is currently upgrading

shower facilities to improve standards”.

A question

Responding, MRSA and Families Group founder member, Teresa Graham from Tramore, posed the question: if hygiene standards were so high at WRH how come it did not do better than “fair” in the HIQA review?

And on the “wall of silence” claim, she said management and people working there were not open about hospital acquired infections; they were not telling patients when they contracted such infections, they were not informing their families, nor were they including reference to the infections on death certificates.

Also, she said, WRH was invited to send a representative to a recent public meeting in Waterford, called by the MRSA and Families Group, but failed to do so. “That does not indicate an open approach”, said Ms. Graham.

She said she regretted to have to report that she and members of the group were still getting complaints about aspects of hygiene at the hospital. She was sad for the staff there – some of whom were excellent – and the people of the region, as well as the patients, because it was their hospital and it was they who were paying for services there.