An unannounced inspection at St Luke's General Hospital in Kilkenny has found not all essential elements of an infection prevention and control programme were in place at the hospital.

The HIQA inspection took place on May 25th.

It found implementation of a comprehensive infection prevention programme was "limited by the daily need to address the placement of patients requiring isolation in a frequently overcrowded hospital with poor inpatient accommodation infrastructure and a lack of isolation facilities".

The report says: "Governance and management arrangements around the prevention and control of healthcare-associated infection at St Luke's General Hospital were not aligned to the current Ireland East Hospital Group governance structure.

"These arrangements should be reviewed and addressed by the hospital."

But HIQA says some of the elements cannot be sufficiently mitigated at local hospital management level.

"Mitigation of these risks will require support at senior HSE and hospital group level to address the infrastructural deficiencies and capacity," it says.

Since 2015, the hospital has consistently achieved the required HSE national hand hygiene compliance target of 90%.

"Notwithstanding the identified areas for improvement found during this inspection, inspectors found that the infrastructure of some facilities for people attending the hospital had been recently significantly improved", HIQA adds.

It says the opening of a newly-built Emergency Department and day and out-patient facilities "is a welcome development."

Coombe inspection

A similar unannounced inspection was carried out at the Coombe Women and Infants University Hospital in Dublin.

HIQA found the hospital had an established infection prevention and control team and committee, who were supported by effective governance and oversight.

"The hospital had up-to-date policies, procedures and guidelines in relation to the prevention and control of infection and had implemented a number of measures to promote education and training of clinical staff which represented a commitment to promoting safer patient care."

"Overall, patient equipment and the patient environment in the areas visited on the day of inspection were generally clean.

"There was good ownership in relation to hospital hygiene and evidence of clear processes and responsibilities from clinical areas to executive management."

However HIQA also found that risks associated with outdated infrastructure identified in a previous inspection in 2016, which could not be adequately eliminated locally, had been escalated through the Health Service Executive (HSE) hospital group structure.

But HIQA acknowledged that risks in relation to hospital infrastructure cannot be mitigated until building works are complete.

"Overall, this inspection found that the hospital was committed to implementing evidence-based practice in relation to infection prevention and control and to producing relevant information to inform improvements needed."

Read the reports in full here