Infection risk depletes Rotunda NICU capacity

A cap on admissions in the Rotunda Hospital’s neonatal intensive care unit (NICU) remains in place to mitigate infection risks. A number of dangerous infectious outbreaks have occurred in the NICU in recent years, which the Rotunda has attributed to constrained infrastructure.

Master Prof Fergal Malone confirmed to the hospital’s board in November that a cap on admissions to the NICU remained in place. When 14 out of 19 available beds are exceeded, “the matter is escalated to the HSE and the unit closed to external transfers,” according to meeting minutes.

In 2018, the Medical Independent (MI) reported that an outbreak of methicillin-resistant Staphylococcus aureus in the NICU contributed to the severity of illness in two babies who died due to the complications of prematurity.

In 2019, an outbreak in the NICU of extended-spectrum beta-lactamase-producing Klebsiella led to the unit closing to external admissions and transfer of babies to the other Dublin maternity hospitals, in what was a “major operational crisis” for the hospital.

The Rotunda has developed a strategic assessment report (SAR) and preliminary business case (PBC) for a new critical care wing, which it considers an urgent requirement. “We are following the public spend code (PSC) for all capital projects,” a Rotunda spokesperson told MI.

“The SAR and PBC have been completed and approved by HSE management to complete stage 0 and 1 of PSC. We have sought meetings with HSE senior management in the Acute Division and Estates in order to seek approval and funding to progress to stage 2 and 3, which is a full business case and procurement of design team.”