National Hygiene Services Quality Review 2007
Mary Harney TD, Minister for Health and Children, today, 13th November, 2007, welcomed the first report of the Health Information and Quality Authority (HIQA) on hygiene in our hospitals.
The Minister said “the report is the first of its kind and represents a very thorough assessment of how hygiene services are provided and managed in 51 HSE funded acute care hospitals. The method of assessment and criteria used are substantially different to previous audits carried out by the HSE and therefore the results are not comparable. The results do however set a very good benchmark for the future. It is important that our health service provides the highest possible standard of care for patients. Hygiene and infection control are among the essentials that we must get right. That is why this review not only looked at the immediate service delivery elements of hygiene but also examined the critical areas of governance and corporate management.”
“While hospitals generally performed well on hygiene in the service delivery area, the results were poor on governance. This contributed to the disappointing overall results. While improvements have been made and are acknowledged in the report, no hospital achieved a ‘very good’ rating, 7 were categorised as ‘good’, 35 as ‘fair’ and 9 as ‘poor’. Hospital managers and hospital boards have to take hygiene and infection control seriously”
The Minister supports the emphasis by HIQA on a “whole system” approach to hygiene. The report indicates clearly that the review is not, and was never intended, to be an absolute assessment of cleanliness in a given hospital but to provide a detailed assessment of performance across the entire range of areas that impact on hygiene so that individual hospitals can identify areas of strength and areas for improvement.
While the good hygiene practice of front line staff highlighted in the report is vital, real improvement in this whole area also depends heavily on good leadership and a system of governance to ensure that efforts at identifying, managing and reducing infection are sustained and successful over time.
It should be noted that most hospitals achieved either extensive or exceptional compliance with the standard in the service delivery section of the report. The majority of hospitals have a multidisciplinary team in place to oversee hygiene practices but many were very new and roles and responsibilities were not always defined clearly enough. We still have some way to go to embed the culture and practice of measuring, monitoring and improvement. Where risks were identified, these were notified to the individual hospitals and they are receiving attention. A quality improvement plan now needs to be drawn up by all hospitals individually and collectively by the HSE. This will continue to be monitored by HIQA as part of its ongoing quality assurance programme.
HIQA is also currently working with managers and clinicians to develop National Standards for Infection Prevention and Control. When completed, these, along with the national hygiene standards, will provide a comprehensive framework to control infection and improve the quality of our health care.