Rotunda maternity hospital urged to seek improvements for 'outdated' facilities
One of the country's busiest maternity hospitals has been warned that parts of its delivery suite are outdated.
Health watchdogs said they accepted the restrictions facing the Rotunda because of its location in an old, protected building in Dublin city centre but they called on management to keep looking for ways to improve.
An inspection found only two of the nine single delivery rooms in the maternity hospital have en suite toilets and only one has an en suite shower.
The Health Information and Quality Authority (Hiqa) said the delivery suite, which opened in 1993, is not sufficient to meet the demands of a hospital dealing with more than 8,500 births a year.
"Aspects of the delivery suite infrastructure were outdated," the review found.
Hiqa said phased renovation of the delivery suite, due to begin in December, will address some but not all of the deficiencies its inspectors found.
It also raised concern about an operating room which was regularly used for emergency Caesarean sections in the delivery suite.
Inspectors found it was only separated from the main corridor by a single door and there was no protective zone.
They were told that the Rotunda's doctors had no option but to use the room for emergency C-sections if there was an immediate threat to the life of a woman or baby. The alternative was to go to a separate operating room on the floor below.
The inspection also noted that the Rotunda needs to expand its neonatal intensive care unit.
It criticised the use of a resuscitaire machine for babies in an alcove in a corridor in the delivery suite, adding: "This is not an ideal location in which to provide care to a newborn."
The Rotunda is due to be moved to a site beside Connolly Hospital in north-west Dublin but that may take several years, the report noted.
Hiqa said they accepted the restrictions faced by management trying to expand the old and protected structure.
"Given the time it will take to build and open a new hospital, it is recommended that the Rotunda Hospital continues to explore all potential options to improve the current facilities," Hiqa said.
In other areas the hospital was told there was opportunity to improve how point-of-care blood testing equipment was managed.
The Rotunda was praised for its hygiene standards in general and Hiqa said it had an effective system in place for cleaning and associated assurance arrangements in the delivery suite.
Meanwhile, a separate Hiqa inspection of Temple Street Children's Hospital in Dublin in July raised high risk concerns about hygiene standards, including that there were not enough staff to keep one ward clean.
"Cleaning processes in the hospital did not appear to be effectively organised or overseen," the report said.
Hiqa warned that Temple Street had an outdated infrastructure, poor maintenance, very limited space in patient care and ancillary areas, lack of storage space and furnishings which could not be effectively cleaned.
Concerns were so high Hiqa returned within six weeks to find significant improvements in how the cleaning regime was being conducted and managed.
Hiqa said the staff work in a compromised physical environment and deal with a high level of activity and complex cases.
But it said: "Notwithstanding infrastructural deficiencies, hospital environments should be kept clean and proactively maintained to facilitate effective cleaning."