A HIQA inspection of Ennis General Hospital has found that infrastructural issues at the Medical Assessment Unit presented risks to patient privacy and infection control.
The announced visit of the Health Information and Quality Authority took place between the 17th and 18th of May.
The inspection team led by Danielle Bracken, supported by Denise Lawler and Aoife O’Brien visited the Medical Assessment Unit, the Local Injury Unit and the Burren General Medical ward.
At the Burren Ward Inspectors noted “a person centred approach to care,” while patients on the ward who were interviewed for the report described the nursing staff as “excellent”.
A total of 42 patients attended the LIU on the first day of inspection, with 2.4% of those attending requiring inpatient admission to UHL.
The average patient experience time in the LIU was 1 hour 35 minutes, well within Ennis Hospital’s target of patients admitted or discharged within two hours.
Inspectors noted that the rate of incident reporting from Ennis General Hospital for 2022 was low, when compared to other Model 2 hospitals, which HIQA says “may indicate a culture of underreporting.”
In 2022 there were a total of 375 clinical patient-safety incidents reported, 37% of which were slips, trips and falls, however 205 of the incidents reported resulted in no injury.
Monthly environmental hygiene audit results reviewed by inspectors showed that in April of 2023, the LIU had a compliance rate of 89%, the Burren ward 74%, while the MAU scored just 40%.
The team also noted that the MAU had consistently scored below the required standard in the preceding months before HIQA’s inspection.
The MAU, which is located in an older part of the hospital and had infrastructure issues such as wear and tear on flooring, walls and woodwork.
Notwithstanding the efforts of staff, which inspectors acknowledged, these issues were said to present a risk in terms of infection prevention and control and compromised privacy and confidentiality.
Since January 2023, Ennis Hospital received 68 patients under the new Medical Assessment Unit Pathway project; 46 of those were then admitted to an inpatient bed in the main hospital.
Had this arrangement not been in place, these patients would have most likely attended for care in UHL.
On the first day of inspection, HIQA found that 91% of patients presenting to the MAU were admitted or discharged within six hours of registration, which was above the target set by the HSE of 75%.
On average, those attending MAU were admitted or discharged in under three hours, well below the HSE target of six hours.
There was no dedicated infection prevention and control team or nurse for Ennis Hospital, but Inspectors were satisfied that the control measures in place were sufficient to mitigate against this risk.
Staff at Ennis Hospital are supported by a visit from a designated infection prevention and control nurse manager from UHL visiting the hospital once a week.
In conclusion, Ennis General Hospital was found to be substantially compliant in eight areas of assessment, fully compliant in two and partially compliant in two.
In a compliance plan submitted by Ennis General, the Hospital has committed to increasing patient safety in the MAU by installing protection barriers on the corridor walls and to replace the flooring in the unit by February of 2024.
You can read the full report here.
