The Coombe Women and Infants University Hospital has proposed spending €15 million on renovating “outdated” operating theatres despite plans to move the hospital to a new location within five years.
The hospital revealed its application for funding from the HSE following publication of a report that found its operating theatres posed a safety risk and were not “fit for purpose”.
Inspectors from the Health Information and Quality Authority (Hiqa) identified a number of safety risks during an unannounced visit to the hospital in August. They said the operating theatres did not comply with international or Irish standards and guidelines and were not fit for purpose.
Hiqa said the theatres needed significant capital investment to bring them up to recommended specifications.
Inspectors criticised the open-plan configuration of the theatres and the lack of physical separation. Doctors who have scrubbed up have to walk through one theatre to reach another.
Two of the operating rooms date from 1967, while a further two were added in 1995.
Hiqa said ancillary facilities needed in an operating theatre were absent, making separation of clean and dirty activities difficult to achieve.
Scrub-up areas
There are plans for the Coombe to move to a new site beside the proposed national children’s hospital in St James’s Hospital but Hiqa said improvements would have to be made in the interim.
Some of the risks to patients can be resolved without any major capital investment, it said.
These include open windows and doors that allow unfiltered air to circulate during surgery, a lack of bedpan washers and macerators in the department and inappropriate storing of sterile supplies and equipment.
The department’s design meant that operating rooms, preparation and scrub-up areas were not physically separated and surfaces, blinds, light fixtures and floor coverings “did not facilitate effective cleaning,” according to the Hiqa report.
There was a substantial amount of exposed pipework and electrical wiring on ceilings and along walls, it said.
The hospital said that since the inspection was carried out, the HSE has approved funding for an extension and upgrade of the operating theatres.
In a statement, the Coombe said it accepted the conclusions reached by Hiqa but said the risks in operating theatres could not be addressed without “major” capital development.
Extra vigilant
It said it was waiting to hear from the HSE on when approved funding would be made available to redevelop the operating theatres.
Sharon Sheehan, master of the hospital, said it had sought €15 million to build two new operating theatres and to refurbish four others. She said a rebuild of facilities was necessary. Staff and management, who knew a problem existed, were extra vigilant in monitoring and keeping areas clean.
A separate Hiqa report on Our Lady’s Children’s Hospital in Crumlin found the intensive care unit and St Peter’s Ward were clean and well-maintained.
