Patients' health and welfare at a Dublin hospital were put at "serious risk" as a result of poor hygiene practice, a health watchdog has claimed.
A spot check at Beaumont Hospital by the Health Information and Quality Authority (Hiqa) found most doctors failed to wash their hands or change their aprons as they moved from patient to patient.
Inspectors also uncovered a dirty utility room where sterile equipment and hand towels were stored, along with clinical bins that were overflowing with soiled and contaminated linen.
In a report on the unannounced assessment on July 23, Hiqa said preventing the risk of the spread of healthcare-associated infections (HCAIs) was essential to ensure patient safety.
"Hand hygiene is recognised internationally as the single most important preventative measure in the transmission of HCAIs in healthcare services," it said.
"It is essential that a culture of hand hygiene practice is embedded in every service at all levels.
"Hand hygiene practice and standard precautions for prevention and control of HCAI were not operationally embedded, posing a risk to patients in Beaumont Hospital."
A string of failures were identified in the hospital's neurosurgical intensive care unit, such as poor hand hygiene among medical staff.
The report found needles, syringes and intravenous fluids were stored in an unlocked utility room, along with a drugs fridge that was left open allowing unauthorised access.
Bags of clinical waste were left unsecured in the entrance of the unit while awaiting collection, while soiled and infected linen were stored in a waste bin in a utility room.
Inspectors found dust and sticky residues on bed frames, rails and wheels in St Teresa's Ward, the transplant unit.
Containers storing glucometers were stained with a "blood-like substance", while rust was detected around the wheels of some dressing trolleys.
Beaumont's emergency department, which has a catchment area of around 250,000 people, also came under fire in the Hiqa report.
Trolleys and shelving with equipment were found to be dusty, while a bin in a men's toilet was "encrusted with dust and grime".
Bins were overfilled, causing risk of needle-stick injuries, the report said.
Beaumont Hospital was notified of the breaches in writing within a week after the spot check.
Hiqa confirmed it will return to the hospital for another assessment within the next six months.
Meanwhile, four other reports have been released following spot checks at hospitals across the country.
Cleanliness and hygiene levels were generally found to be acceptable, but some areas for improvement were found.
Lourdes Orthopaedic Hospital, Kilcreene, Co Kilkenny, was assessed on July 19. Hiqa's findings included:
:: A protective temporary closure mechanism on two sharps bins was not in place, putting staff at risk of needlestick injury;
:: A cleaners' room, containing potentially hazardous cleaning solutions, was lockable, but ajar and accessible to unauthorised persons;
:: A dirty utility room was unlockable, which is not compliant with the national standards for the prevention and control of HCAIs.
Midwestern Regional Maternity Hospital, Co Limerick, was spot-checked on July 10. Hiqa's findings included:
:: While the hospital had implemented initiatives to improve hand h ygiene, practices were inconsistent with national standards;
:: A culture of hand hygiene is not embedded at an operational level within some of the hospital staff grades.
Merlin Park Hospital, Co Galway, was spot-checked on July 9. Report findings included:
:: Seventeen of 20 hand hygiene opportunities observed during check were taken;
:: All 17 complied with best practice hand hygiene technique. Non-compliance related to failure to take hand hygiene opportunities available.
Midland Regional Hospital, Tullamore, Co Offaly was assessed on May 20. Findings included:
:: Hand hygiene soap, alcohol gel and hand towels were located within easy access to sinks;
:: Signs instructing correct hand hygiene procedures were displayed at sinks designated in the areas assessed;
:: Hand hygiene of staff in the areas assessed was mostly in line with best practice guideline.