Unannounced HIQA inspection reveals safety concerns at Irish hospital

The Health Information and Quality Authority (HIQA) said that staffing levels were insufficient to meet the needs of people attending the emergency department at University Hospital Limerick. 

It said this significantly impacted on the “delivery of safe, quality care and on the timely triage and assessment” of people attending the hospital.

The report of the unannounced inspection of the Emergency Department stated that overcrowding and congestion led to patients’ confidentiality being compromised.

Inspectors said patients on trolleys had “little to no privacy or dignity” because of the severe overcrowding.

It said that personal information and diagnoses were shared in areas where others could hear.

Inspectors found 60 patients on the day they visited had been waiting “an especially long time”.

This included one patient waiting 116 hours, a second waiting more than 85 hours and another waiting 71 hours.

Another patient waited 45 hours for an angiogram.

The report of the unannounced inspection of the Emergency Department at University Hospital Limerick against the National Standards for Safer Better Healthcare, was published today (Friday June 17). 

It laid out a number of critical issues in the hospital and recommendations on how to resolve these problems.

The report looked at staffing levels, capacity and patient flow, and respect, dignity and privacy for patients in the emergency department.

Among the issues highlighted, the report noted significant capacity issues with about 40% of patients in the emergency department being treated on trolleys.

The report also highlighted serious staffing issues, with staffing levels described as “insufficient to meet the needs of people attending the department”, leading to a significant impact on safety and safe care.

HIQA said it was also concerned about the number of patients boarding in the emergency department while awaiting an inpatient bed. 

Of the 139 attendees in the emergency department at 11.30am, 60 patients were boarding in the department while awaiting an inpatient bed.

The report stated that the majority of these patients were being accommodated on trolleys in corridors with very limited space between each trolley, which impacted on patients’ privacy and confidentiality.

The Irish Nurses and Midwives Organisation (INMO) said it welcomed the publication of the HIQA report on the emergency department.

The INMO said the report reflected their concerns on overcrowding in the hospital which it said has a “significant impact on the retention of nurses in such unsafe workplaces despite the significant recruitment efforts of nurse managers”.

The INMO also stated it welcomed the quality and workforce review mentioned in the report and that it would be seeking engagement on this over the coming weeks.

Mary Fogarty, INMO assistant director of industrial relations, said: “The report is a fair analysis of the situation our members are facing on the ground.

“However, it needs to be noted that when things are this bad it becomes harder to keep nurses in their jobs, which makes it harder to ensure safe staffing numbers.

“The report shows that nursing staff are doing everything they can in a desperate situation, but that it’s not possible to keep patients safe in these conditions.

“Our members have been drawing attention to these issues for years and we requested that HIQA investigate the situation in UHL and they welcome the publication of the report as a first step, but it’s important that it leads to action.

“It would be wrong to wait for a winter surge or the next healthcare emergency to act on this.

“The report’s recommendations must be implemented urgently or the crisis in the mid-west is only going to get worse.

“Decisions based on patient safety and staff safety must now be made. We will seek to engage urgently with the HSE on this.”