Immediate risks to the health and welfare of hospital patients were uncovered during an inspection, a report has revealed.
The health watchdog made an unannounced monitoring assessment at Waterford Regional Hospital on June 25, where inspectors noticed nursing and medical staff in the emergency department did not clean their hands before or after touching patients.
One patient with a suspected communicable infection was also in a bay in the main area of the department despite isolation rooms being available, the Health Information Quality Authority (Hiqa) said.
The report stated: "During the course of the monitoring assessment, the authority identified specific issues that they believed may have presented immediate serious risks to the health and welfare of patients receiving care at Waterford Regional Hospital.
"These issues were brought to the attention of the hospital manager during the monitoring assessment who agreed to put in place the actions necessary to mitigate immediate serious risks."
The report was one of five published on different hospital inspections by Hiqa.
Inspectors at Waterford found that the environment and equipment in areas assessed - the emergency department, Surgical Seven Ward and Medical Two Ward - were generally unclean, placing patients at significant risk of healthcare associated infections.
There were also poor waste management practices.
The contents of a resuscitation trolley, including emergency supplies of needles, syringes and medications were unsecured and located on the main corridor of the ward.
A medication fridge containing insulin and antibiotic solutions, and a cupboard containing medicated sprays, were unlocked.
A disposable kidney dish containing used surgical instruments and a used disposable tracheotomy tube were stored on top of one of two large trays containing disinfectant fluid. But there was no indication what the solution was, when it was constituted or when it should be discarded.
And pieces of equipment were soaking in a hand washing sink.
A toilet and sink for a patient were also heavily soiled with a mould-like substance and a shower-chair unclean and bedside oxygen administration tubing was uncovered and on the floor.
Elsewhere access along the emergency department corridor was hindered due to cluttering with trolleys, items of patient medical equipment, bed tables, waste collection bins and chairs, Hiqa added.
Other unannounced inspections were carried out at Portiuncula Hospital in Ballinasloe, Our Lady's Hospital in Navan, Louth county Hospital in Dundalk and St Michael's in Dun Laoghaire.
There were no immediate risk to the health and welfare of hospital patients at any of the facilities, but Hiqa said further improvements are needed at Portiuncula.
The physical environment, waste management and cleanliness of patient equipment were still not effectively managed and maintained to protect service users and reduce the spread of infections, it found.
In Navan the emergency department, and to a lesser extent the female medical ward, were not effectively managed and maintained to protect patients and reduce the spread of infections.
Inspectors visiting Louth said there was much evidence of practice that was not compliant with national standards for the prevention and control of infections.
Hand hygiene was also not up to standard, which posed a clear risk to patients of contracting an infection.
Meanwhile in St Michael's the emergency department was generally clean but a male ward was generally cluttered.
There was also a lack of appropriate storage for equipment in both areas assessed, and unsecured chemical storage, clinical waste and sterile equipment.
Elsewhere hand hygiene practices in St Michael's Hospital were inconsistent with the national standards.
"It is essential that a culture of hand hygiene practice is embedded in every service at all levels," Hiqa added.