Terence Flanagan (Dublin North East, Independent)
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276. To ask the Minister for Health the position regarding hygiene in hospitals (details supplied); and if he will make a statement on the matter. [16435/15]

Leo Varadkar (Dublin West, Fine Gael)
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Patient safety is a priority for my Department and the delivery of Ireland's health services. Increased emphasis on patient safety in policy reform, legislative changes and development of standards of care driven by quality improvement initiatives underpin the Health Service Executive's (HSE's) Service Planning process and specific measures focused on quality and patient safety including Healthcare Associated Infections (HCAIs) in both the hospital and community setting.

The HSE has implemented a number of national initiatives in the control and prevention of HCAIs over many years including, SARI 2001-2010 (The Strategy for the Control of Antimicrobial Resistance in Ireland) and the HSE's "Say No to Infection" which focused on both HCAIs and Antimicrobial Resistance (AMR) launched in 2007.

The most recent HSE Healthcare Associated Infection (HCAI) and Antimicrobial Resistance (AMR) Clinical Programme was established in 2010. The Programme, based within the HSE Quality Improvement Division, has targeted three key areas relating to HCAI/AMR.

1. Hand Hygiene: achievements include provision of online hand hygiene resources (www.hse.ie/go/handhygiene), updating of national hand hygiene guidelines, national specification for alcohol hand gel, and a monthly Key Performance Indicator (KPI) on hand hygiene training for hospital staff.

2. Prudent use of antibiotics ('Antimicrobial Stewardship'): achievements include development of public website for self-care for common infections (www.undertheweather.ie ), guidelines for antibiotic use in primary care and residential care settings (www.antibioticprescribing.ie), annual promotional and educational activities around European Antibiotic Awareness Day, public information campaigns (www.hse.ie/antibiotics),collaborative project to promote safe use of gentamicin (www.rcpi.ie), and antibiotic care bundles ('Start smart then focus' and 'Right drug, right time, right duration').

3. Medical device-related infections: achievements include update of 2009 National Guidelines for the prevention of intravascular (IV) catheter-associated infection, and guidelines and care bundles for prevention of urinary catheter-associated infections (www.hpsc.ie).

Other activities and achievements include the introduction of new monthly indicators (hospital acquired S. aureus bloodstream infection and C. difficile infection), guidelines for prevention and control of multiple drug-resistant organisms (www.hpsc.ie), and development of infection prevention and control guidelines for primary care (www.icgp.ie).

In addition, the Health Information and Quality Authority (HIQA) carries out unannounced inspections in public acute hospitals to monitor compliance with the National Standards for the Prevention and Control of Healthcare Associated Infections. It focuses in particular on Standard 3: Environmental and Facilities Management and Standard 6: Hand Hygiene with the purpose of assessing hygiene as experienced by patients at any given time. Other Standards may be observed and reported on if concerns arise during the course of an inspection. The monitoring inspections commenced in November 2012 and over 100 inspections, including some re-inspections have been carried out to date. Hospitals must revise and amend their Quality Improvement Plans (QIPs) after monitoring to prioritise the improvements necessary to fully comply with the Standards; the Authority continues to monitor the hospital's progress in implementing its recommendations.

I am advised by the HSE that Hospital Groups will continue to achieve full implementation of the local Quality Improvement Plans developed following each HIQA visit which will be managed and monitored to ensure hospitals achieve and sustain high standards of hygiene and improved compliance with infection prevention and control standards.

To further support patient care HIQA is also monitoring compliance against the National Standards for Safer, Better Healthcare with a particular focus in 2015 on antimicrobial stewardship and nutrition and hydration of patients.