HIQA inspection finds overcrowding and long waits at Drogheda ED

Overcrowding in the Emergency Department of Our Lady of Lourdes Hospital in Drogheda with many patients experiencing waits of over nine hours, were among the finding by HIQA during an inspection last June.

Despite the hospital adding an additional 15 beds to its overall capacity following with the opening of a modular build in March 2025, inspectors witnessed overcrowding with 45 per cent of patients waiting in the ED more than nine hours after registration, while one patient had waited over 24 hours. Another 45 per cent of patients had waited over six hours.

A total of 85 patients were registered in the ED, 28 of these patients were admitted and receiving care in

the emergency department and 34 patients were receiving care on trolleys in inpatient wards.

Hospital management told inspectors they had implemented the hospital’s escalation plan in response to overcrowding.

The HIQA report on the inspection noted that while; "the addition of the 15 bed modular unit had increased the beds available, this had little impact on the hospital’s overall capacity and reducing the requirement to accommodate patients in the emergency department. The continued use of the AMAU, ASAU and day ward for admitted patients was impacting on the effectiverunning of these units."

The inspection, which took place on 4th and 5th June last identified risks related to infection prevention and control of healthcare associated infection including insufficient consultant microbiologists for the on call rota as a result of only having two consultant microbiologists.

There was risk to maintaining and sustaining the antimicrobial stewardship programme due to the need for additional antimicrobial pharmacist hours.

Inspectors found that the design and layout of the day ward (surge ward) did not facilitate an environment that promoted effective infection prevention and control practices.

"Inspectors observed cracked paint on walls and ceiling, staining on some patient toilets and sinks. Inspectors also found examples of inappropriate items stored in a store room. This was brought to the attention of the clinical nurse manager to be addressed immediately," according to the report.

Inspectors found limited storage space in Oriel Ground Floor Short Stay ward which was the newly opened 15-bedded modular build. Shelving had yet to be placed in the dirty utility room which resulted in items being stored on the floor which impeded effective cleaning.

Clean linen was also found to be inappropriately stored in a multi-purpose room.

The Inspectors said efforts to maintain dignity and privacy were observed in the emergency department with staff taking patients from corridor trolleys to cubicles for examination.

However, it was not possible to maintain privacy and confidentiality when communicating and interacting with patients being cared for on chairs or trolleys outside cubicles. There was a risk that others (patients, visitors and staff) could overhear patient-clinician conversations and personal information exchanged between patients, medical and nursing staff.

Senior hospital management reported that access to diagnostics for routine investigations such as non-urgent CT and ultrasound was a contributing factor to increases in length of stay for patients. In March 2025, the hospital commenced a ten week trial of providing non-urgent CT and ultrasounds on Saturdays and Sundays from 9am to 5pm. The trial had a positive impact showing a decrease in the number of patients waiting longer than 24 hours, a decrease in the number of patients on trolleys and a decrease in the average time spent in department. The outcome of the trial resulted in the submission of a business case for an additional two senior

radiographers and an additional two basic grade radiographers in order to support the introduction of evening and weekend CT and ultrasound services. At the time of inspection, senior hospital management had yet to receive an update in relation to this service expansion.

The inspection took place on 4th and 5th June and also included inspection of The Cottage Hospital in Drogheda and the Louth County Hospital in Dundalk.

The inspector found the hospitals to be partially compliant with required standards in seven out of 12 categories, substantially compliant in four categories and compliant in one.

Patients who spoke with inspectors in the emergency department in Drogheda acknowledged that

staff were ‘doing the best they can’ and were ‘very kind’ and ‘lovely’. Patients spoken

with also described how they were kept informed of their care plan.

At Louth County Hospital patients were very complimentary about the care received describing the care as

‘exceptional’ .

Patients who spoke with inspectors in The Cottage Hospital were also very complimentary of staff and the care

received .

Formalised and integrated governance arrangements for assuring the delivery of high quality, safe and reliable healthcare across all three hospital sites were in place, according to the inspectors.

"There was evidence of responsive management arrangements in place to address the demand for healthcare services and alleviate overcrowding in the emergency department."

Inspectors found that although some progress had been made with findings from HIQA’s last inspection, the mismatch between availability and demand for inpatient beds continued to impact on the effective management of the emergency department. This resulted in high numbers of admitted patients still being accommodated in the

emergency department while waiting for an inpatient bed.