Infection neonatal unit still hasn't had "formal hygiene inspection" by regulator

Altnagelvin hospital

Altnagelvin hospital

By Niall McCracken

THERE has never been a formal hygiene inspection carried out by the health regulator at the neonatal ward where it was announced last week that three babies had the bloodstream infection MSSA.

In December 2011, a ten-day old prematurely-born baby died at Altnagelvin hospital after contracting the pseudomonas infection in its neonatal unit. A month later a further three babies died of the infection at Belfast’s Royal Jubilee Maternity Ward.

The regional audit tools for neonatal infection prevention in Northern Ireland were only published in February of this year – thirteen months after the pseudomonas outbreak. The Regulation Quality and Improvement Authority (RQIA), who are in charge of inspecting hospital hygiene here, confirmed it could not carry out a full inspection of any of Northern Ireland’s neonatal units in the absence of this audit tool.

RQIA say the date of publication was determined by the Department of Health Social Services and Public Safety (DHSSPS) and not RQIA.

The regional audit tools were developed on behalf of the Minister by a working group chaired by RQIA, with membership from the Public Health Agency, Health and Social Care organisations and DHSSPS.

The Ulster Hospital’s neonatal unit is the only one of Northern Ireland’s five neonatal units to have received a full formal hygiene inspection with the new audit tool to date.

Enquiries by The Detail over the past few weeks have established that Altnagelvin’s neonatal unit has still never had a formal hygiene inspection carried out by the external health watchdog. RQIA confirmed that a formal hygiene inspection is due to take place at the unit at some stage this year but said that as it runs an unannounced inspection programme, it could not provide a specific time frame.

A spokesperson for the RQIA has said that representatives of its infection prevention team had visited all of Northern Ireland’s neonatal units in the aftermath of the pseudomonas infection and as part of a pilot to develop the new methodology for auditing neonatal wards.

RQIA confirmed the purpose of the pilot visits was to ensure regional audit tools were fit for purpose and no formal inspection reports were published.

RQIA says that while the regional audit tools form the basis of all infection prevention/hygiene inspections, the development of a specific neonatal infection prevention programme was only published on February 27 2013, with inspections to commence from April 2013 onwards. The date of publication was set by the Department of Health.

A spokesperson said that any issues around practice and systems that rose during the pilot visits were alerted to the relevant trusts. It added that there were “detailed observations of practice and discussion with clinical staff and infection prevention staff in each of the five neonatal units.”

In a previous story by The Detail in the aftermath of the pseudomonas outbreak, we revealed that RQIA had never inspected any of Northern Ireland’s neonatal units.

A spokesperson for RQIA said that the pseudomonas review, which was commissioned by the Health Minister after the outbreaks, “not only looked at the events in the lead up to the pseudomonas outbreak, but also assessed the governance arrangements in relation to infection prevention/hygiene and their application at that time.”

Altnagelvin’s neonatal unit underwent a deep clean last week after the western trust confirmed a number of babies were diagnosed with the bloodstream infection MSSA (methicillin-sensitive Staphylococcus aureus).

In a statement to The Detail the Western Trust said it would not comment on RQIA’s inspection process as this was a matter for the regulator, but said that the babies who were found to have MSSA last week are in a stable condition and that “robust infection prevention and control measures are in place.”

© The Detail 2013