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Lack of resourcing for CPE screening — head of acute services

The HSE’s Director of Acute Operations has informed HIQA that acute services have “clearly indicated” that they need “additional targeted resources” to achieve “sustainable compliance” with the national screening guidance for carbapenem resistant Enterobacteriaceae (CPE).

Mr Liam Woods’s correspondence in April was in response to a letter from Mr Sean Egan, Head of Healthcare Regulation at HIQA, who informed him of a “pattern of regular non-compliance” with national screening guidance on CPE across a number of Hospital Groups, with implementation on the ground “confused or incomplete” in some instances.

Two of the seven hospitals inspected — Portiuncula University Hospital and the Royal Victoria Eye and Ear Hospital, Dublin — were complying with screening guidance. This was “a demonstration that such guidance is implementable”, wrote Mr Egan.

Many hospitals cited a lack of necessary resources in achieving full compliance, noted Mr Egan.

In his response, Mr Woods wrote: “It is intended that the increase in available information on CPE infections, screening levels and application of screening guidelines supported by a comprehensive repository of associated policies and plans will provide details on the measures intended to achieve optimum CPE screening levels in all acute services but will require appropriate financial support from the Department of Health in the context of the service planning and estimates process for 2019.”

Mr Woods stated that he had been “assured” a minimum level of CPE screening for high-risk patient cohorts was in place in all acute hospitals.

Since 31 May, the HSE, with support from the Department of Health, has authorised Hospital Groups to commence recruitment of additional laboratory staff to improve detection of CPE.

“The HSE has also committed resources to enhance reference laboratory services to support tracking of spread of CPE,” said a HSE spokesperson.

To date in 2018, HIQA has conducted 16 inspections in hospitals against the National Standards for the prevention and control of healthcare-associated infection in acute healthcare settings.

“These inspections have found a need for improvement in most hospitals in the implementation of the HSE’s own CPE screening guidelines — a key control measure in dealing with this issue. In each instance, we have escalated this matter within the HSE,” said HIQA’s spokesperson.

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