Written answers

Thursday, 26 September 2013

Department of Health

Hospitals Inspections

Photo of Seán Ó FearghaílSeán Ó Fearghaíl (Kildare South, Fianna Fail)
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23. To ask the Minister for Health his views on the recent Health Information and Quality Authority hospital hygiene reports; and if he will make a statement on the matter. [39998/13]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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The prevention and control of Health care Associated Infections (HCAIs) is one of my priorities in protecting patient safety. HCAIs represent a major cause of preventable patient harm and increased health care costs.

Established as an independent statutory body under the Health Act 2007, the Health Information and Quality Authority's (HIQA) mandate extends across the quality and safety of the public, private and voluntary sectors. Since late 2012 the Health and Information Quality Authority (HIQA) has been carrying out a monitoring programme against the National Standards for the Prevention and Control of Health care Associated Infections (HCAIs), 41 of which have been completed. Both I and my Department welcome the publication of HIQA’s reports and note the concerns raised in these, and indeed, previous reports about hand hygiene practices particularly among medical staff. With regard to hand hygiene the findings of the Authority suggest that hand hygiene best practice needs to become more operationally embedded at all levels.

Achieving a culture of patient safety in which best practice in hand hygiene is embedded requires actions at all levels. It is the responsibility of management and clinical leadership to make this a priority and ensure that the correct conditions to allow for the improvements in hand hygiene compliance are in place.

It must be emphasised that it is of vital importance that health care workers recognise their personal responsibility to protect patients by maintaining their own good hand hygiene. It is extremely disappointing to note that despite the Health Service Executive’s (HSE) initiatives to develop an organisational culture of hand hygiene, a significant number of health care staff, including doctors, are still not adhering to the basic principles of hand washing.

I very much support the HSE’s ongoing work through its national programme of activity to raise awareness amongst staff, monitor compliance with national standards and to take action to reduce HCAIs in hospitals. A key element of this programme is the HSE’s continuing bi-annual hand hygiene audits which occur in both the acute sector and in the long stay area as well. Additionally, from July of this year it has become mandatory for all staff to receive hand hygiene training as part of staff induction and an education programme every two years is being put in place. The HSE audits have shown an encouraging improvement in hand hygiene compliance with a most recent figure of 84.3% compliance overall (October 2012).

The Director General of the HSE has instructed that all hospitals act immediately on the following:

Ensure that a member of the senior management team is responsible for hygiene. This person must give a report to the facility management team on the facilities performance against the 2006 cleaning manual with a remediation plan and on the facilities performance multimodal hand hygiene plan by the end of 2013.

Ensure that there is a hygiene programme in place by the end of 2013 which clearly demonstrates the hospital’s commitment to hygiene, specifically focusing on patient care equipment, the patient environment and hand hygiene. The programme should be based on the WHO multimodal framework.

Ensure that 100% staff have received hand hygiene education and training by June 2014.

Hospitals are to provide monthly reports on progress to the National Director for Acute Services. The HSE is also working with the main medical professional bodies to address the issue of doctor attitudes and behaviour around hand hygiene.

The Chief Medical Officer (CMO) of the Department of Health has written to the Chair of the Health and Social Regulatory Forum asking that the Forum consider the matter and submit proposals as to how it might adopt a common approach to raise awareness of hand hygiene in particular and support and reinforce compliance with this very important patient safety issue. It has also been agreed that the CMO will meet with the Director General of the HSE to discuss the issue of governance in the control and prevention of HCAIs.

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