Sask. auditor finds shortcomings in hospital hand hygiene, surgical biopsy waits

Sask. auditor finds shortcomings in hospital hand hygiene, surgical biopsy waits
Saskatchewan’s provincial auditor found some hospital units had a 60 to 70 per cent decline in hand hygiene among employees during a blind audit.



Saskatchewan’s provincial auditor found hand hygiene practices are falling short in her review of hospital acquired infections.

Judy Ferguson examined the Regina General Hospital and Pasqua Hospital over a 12 month period ending Aug, 31, 2018.

Overall, Ferguson found there were generally good hygiene practices in place, but hand hygiene and general cleaning were falling short.

The Ministry of Health target for hand hygiene compliance is 100 per cent, but Ferguson said compliance rates may actually be lower than reported, fluctuating between 80 and 85 per cent.

In May 2017 a blind audit was conducted, so employees were not aware they were being monitored.

The auditor found some units had a 60 to 70 per cent decline in hand hygiene compliance rates compared to the June 2017 direct observation audit.

Ministry of Health guidelines recommend a blind audit in order to provide a better representation of hand-hygiene practices.

Ferguson noted the importance of proper hand-hygiene procedures, reporting this is one of the primary ways to prevent hospital-acquired infections.

According to the report, these infections result in one third of unexpected hospital deaths.

“The Saskatchewan Health Authority (SHA) should rethink its approach to monitoring compliance with hand-hygiene policies to collect more accurate data on its hand-hygiene compliance rates,” Ferguson said.

“Without accurate information on hand-hygiene practices, the authority cannot properly identify which units or hospitals need additional assistance to improve their hand-hygiene compliance.”

The hospital hand-hygiene compliance policy states hands should be sanitized before entering or leaving any facility or unit, before client/client environment contact, after client contact, before aseptic tasks (e.g. sterilizing equipment), and after bodily fluid exposure risk.

The audit found new employees receive about an hour of hand-hygiene training when they start their jobs, and further training is “ad hoc.”

“Up to 70 per cent of hospital-acquired infections are preventable; hospital acquired infections can unnecessarily extend a patient’s hospital stay, and lead to increased complications and costs,” Ferguson said.

Surgical biopsies

Ferguson also found labs in Regina and Saskatoon took considerably longer than good practice to analyze surgical biopsies. At the end of September 2018 there were around 1,300 backlogged biopsies.

Surgical biopsies are tissues removed from a patient to help provide a diagnosis for a variety of health problems, including cancer.

In 2017-18 the average wait for a surgical biopsy report out of Saskatoon was 12.1 days, and 18.7 days in Regina.

Ferguson said good practices suggest routine biopsies take five business days, with more complex biopsies taking six to 15 business days.

She also found shortcomings in the in the tracking process, noting neither city’s labs tracked biopsies through the entire process.

Saskatoon plans to introduce better tracking through a new IT system expected to be in place this month. The Regina lab did not have similar plans.

“A formal assessment of the surgical biopsy process and IT tracking system could help the SHA to identify factors affecting delays in patient diagnosis,” Ferguson said.
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