Published Tuesday, 30 June 2009
"There is significant room for improvement," said Glenn Houston, RQIA chief executive.
The message was hammered home as the authority published details of unannounced hygiene inspections on five hospitals - one in each health trust area.
Particular concern was highlighted about cleanliness and best practice in accident and emergency and outpatient departments.
Wards
The hospitals visited included The Mater in Belfast; the Lagan Valley in Lisburn, Co Antrim; Mid Ulster in Magherafelt, Co Londonderry; Daisy Hill in Newry, Co Down; and Tyrone County in Omagh.
A total of 19 wards and areas were inspected. In 11 there was partial or full compliance, but eight were below the minimum level expected, despite the health minister and his department making control of infections a priority.
Mr Houston said: "Clean wards and robust infection control practices are crucial in the fight against health care associated infections. These help to reassure patients that the care they receive is safe."
The inspections carried out between January and March focused on indicators of good practice, including hand hygiene, the environment, clinical practice and patient equipment.
Mr Houston said: "The standards of performance varied across the 19 areas inspected and there was also a marked variation in performance between wards within each of the five hospitals.
"In particular, concerns were noted in some Accident and Emergency and Outpatient departments where there was significant room for improvement."
He said the current focus on hand hygiene had resulted in significant improvement when compared to previous inspections, but he added "further work is necessary in this area."
At the Mater Hospital both the A&E and outpatients departments failed to meet even the minimum compliance standard. It was the same story at the Daisy Hill and in A&E at the Lagan Valley.
The Tyrone County was below standard in its outpatients and urgent care unit as well as ward 7, which was picked at random. Only its renal unit scraped through with a partial compliance rating.
By contrast the Mid Ulster Hospital sailed through with full compliance in outpatients and both wards inspected. Its A&E department was at the upper end of the partial compliance band.
Authority chairman Dr Ian Carson said there was "no excuse" for a lack of cleanliness in hospitals.
Blaming the age of buildings was not an excuse either, he said, pointing to the successes of the Mid Ulster which had the oldest buildings of the five visited.
'Dirt'
He said the big message they were trying to reinforce was that cleanliness was paramount and had to be embedded in hospital practices.
Dr Carson said: "There is no doubt our programme of inspections is an important driver in making hospitals safe and an aid to lowering the rate of health care acquired infection.
"There is evidence of infection rates falling both here and across the water. But we do need to maintain cleanliness if we are to improve further and get more reductions in health care infections."
Among examples of concerns highlighted in the reports was ward E in the Mater Hospital. Its report said: "A number of lockers were soiled with a build up of dirt and bed frames were soiled with what appeared to be blood and crumbs."
It also said there was no soap in dispensers in both the male and female toilets in the A&E department. It reported dirty utility areas in both A&E and Outpatients.
At the Daisy Hill inspectors expressed concerns about a syringe with medication in it left unattended in a resuscitation area. When after 10 minutes it was still there and a member of staff was informed by inspectors, the medication was incorrectly disposed of in a piece of paper towel.
Health Minister Michael McGimpsey said he would be taking further action to tackle poor standards of cleanliness and hygiene in hospitals.