Patients at hospital in which Aoife Johnston died still facing 'significant risks' says health watchdog
General views of University Hospital Limerick.
Patients still face “significant risks” at University Hospital Limerick (UHL), according to a new report from the health watchdog.
Despite “slight improvements” in compliance levels in the overwhelmed hospital, the Health Information and Quality Authority (HIQA) found that the time it takes patients to be treated and seen falls “significantly short” of national targets.
It added that this leaves patients in the hospital’s emergency department (ED) at a “higher level of risk of harm for prolonged periods of time”.
READ MORE – ‘Aoife Johnston had no chance – it was a death trap’ recalls consultant as coroner delivers inquest verdict
The report, which was based on an inspection from November 21, 2023, and published on Thursday comes a week after the inquest into the death of 16-year-old Aoife Johnston.
She died in the hospital’s emergency department in December 2022 after waiting 15 hours to receive antibiotics, despite having a letter from her GP that it was suspected she had sepsis.
The report says the hospital is still extremely overcrowded with HIQA giving UHL the worst-rated score for its person-centred care and support.
It said the hospital is “non-compliant” in giving service users’ dignity, privacy and autonomy and explains non-compliant as: “the service has identified one or more findings, which indicate that the relevant national standard has not been met and that this deficiency is such that it represents a significant risk to people using the service.”
The hospital was only partially or non-compliant with three of the four relevant national standards that were assessed by HIQA.
At the inquest into Aoife’s death last week, the Limerick Coroner, John McNamara returned a verdict of medical misadventure in her death from meningitis after she contracted sepsis.
The inquest heard hospitals are required to treat sepsis patients within 10-15 minutes. However, UHL did not triage Aoife for over an hour.
Despite vomiting green liquid, suffering excruciating pain in her leg, and being light-headed and weak, Aoife waited more than 15 hours in total to receive antibiotics, which it was heard would likely have saved her.
The antibiotics she needed were readily available, but because UHL was so short-staffed and overcrowded with patients, staff were delayed in giving them to her.
Dr Jim Gray, who was the only ED consultant on call that weekend, but who was not required to be on-site, told the inquest that not only was the ED a “death trap” on the night, “it is still a death trap”, over a year after Aoife’s death.
Despite being the second busiest ED in the country, with 80,000 people attending in 2022, UHL has the lowest capacity of beds (536) among big hospitals in Ireland.
On the day that HIQA visited the hospital for this inspection report, it found that 32 out of 82 patients in the ED had been admitted but were awaiting a bed.
Nineteen patients were accommodated on trolleys on corridors, which HIQA said “did not support or promote the dignity or privacy for those patients”.
It further noted: “This overcrowding, albeit reduced since the previous inspection, impacted on meaningful promotion of dignity and privacy for patients.”
In 2022, 50.9% of patients presenting to the ED were discharged after six hours, which is 20% lower than the Health Service Executive’s (HSE) national target.
Sinn Féin’s health spokesperson David Cullinane said following the report the Government needs to fast-track 288 additional beds for UHL.
In a statement, he said: “The latest HIQA inspection of University Hospital Limerick has again demonstrated that the hospital is severely constrained by a lack of bed capacity both in the hospital and in the community.
“The hospital is routinely overcrowded, which is degrading, not compliant with a human-rights approach to care, and strips patients of their dignity. The report clearly identifies significant and severe patient safety risks, which are not being effectively managed.”
This comes as the HSE is putting together a support team to ease overcrowding health services in the Midwest.
It said the team will begin work immediately and over the next four weeks to “help devise a number of actions designed in particular to ease overcrowding and pressures in the Emergency Department at University Hospital Limerick”.
The support team will include Grace Rothwell, National Director, Orla Kavanagh, Director of Nursing and Integration at Waterford University Hospital, and retired Emergency Medicine Consultant Dr Fergal Hickey.
In a statement, Health Minister Stephen Donnelly said he was concerned at the pressures on health services in the area.
He said: “We need to provide reassurance to the people of the MidWest region and address the very serious pressures on the services.
“While a number of interventions have been made, I have spoken to the Chief Executive of the need to address this situation immediately. The support team should deliver an improvement for patients quickly.”
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