Today, the Health Information and Quality Authority (HIQA) has published two inspection reports on compliance with infection prevention and control in rehabilitation and community inpatient healthcare services during the COVID-19 pandemic.

In light of the ongoing COVID-19 pandemic, HIQA commenced a monitoring programme to assess compliance with the National Standards for Infection Prevention and Control in Community Services in rehabilitation and community inpatient services. 

Risk-based inspections were carried out between July and August 2020 at: 

• St Joseph’s Hospital, Rehabilitation Unit, Ennis, Co Clare 
•  Clifden District Hospital, Co Galway.

St Joseph’s Hospital, Rehabilitation Unit, Ennis: announced inspection 30 July 2020.

Effective leadership, governance and management arrangements were evident around the prevention and control of healthcare-associated infection at the hospital. Positive and supportive engagement from and within the HSE’s Community Health Organisation (CHO) area 3 was reported. 

Systems were in place to manage and control outbreaks of infection in a timely and effective manner. The hospital had COVID-19 preparedness plans in place. A link-nurse programme supported infection prevention and control practices within the Rehabilitation Unit. The hospital had access to external expertise in infection prevention and control. 

The hospital had systems in place to identify and manage risks in relation to the prevention and control of healthcare-associated infection. A variety of systems were used to ensure that environmental and equipment cleaning standards were met. 

Up-to-date infection prevention and control policies were in place. Infection prevention and control training was delivered to all staff. Hospital management was awaiting a planned move to a newly refurbished unit at the time of this inspection which would further mitigate infection prevention and control risks once operational. 

Clifden District Hospital: announced inspection 13 August 2020.

Leadership, governance and management arrangements were evident around the prevention and control of healthcare-associated infection at the hospital. However, improvement was required in relation to environmental and patient equipment hygiene audits and antimicrobial stewardship at the hospital. 

The hospital had an up-to-date suite of infection prevention and control policies. Infection prevention and control training was delivered to all staff. Two staff were upskilled to support infection prevention and control training in response to the COVID-19 pandemic. Systems were in place to manage and control outbreaks of infection in a timely and effective manner, including COVID-19 preparedness plans. 

Systems to identify and manage risks in relation to the prevention and control of healthcare-associated infection were in place. Longstanding risks related to the infrastructure of the hospital and lack of hand hygiene sinks, escalated to CHO 2, had not been addressed. Reduced occupancy facilitated physical distancing between patient beds. 

The general environment and equipment in the hospital wards inspected were clean. Hospital management stated that staff recruitment was an ongoing challenge. Management within CHO 2 should be assured that sustainable and safe staffing levels are provided within the hospital going forward.

Note to Editor:

• The rehabilitation and community inpatient healthcare services inspection programme monitors compliance against the National Standards for Infection Prevention and Control in Community Services. The focus of inspection is on governance and risk management structures and measures to ensure the prevention and control of healthcare-associated infections during the COVID-19 pandemic.
• HIQA has developed a Guide to HIQA’s targeted monitoring programme against the National Standards for Infection Prevention and Control in Community Services in rehabilitation and community inpatient healthcare services during the COVID-19 pandemic 2020 which can be viewed at www.hiqa.ie