Cleanliness is crucial in healthcare settings

Ricky Smith, Truvox International’s UK Field Sales Manager, explains how keeping floors clean in hospitals and other healthcare environments can help reduce the spread of infections.

It’s often stated that nothing in life is certain, except death and taxes. This fatalistic phrase is used to demonstrate that some things are simply unavoidable – and regular or occasional contact with healthcare providers is certainly inevitable for us all. Even if you are blessed with good health and seldom have to visit the doctor, check-ups at the dentist, and visits to friends or family in hospitals or care homes come to us all.

Controlling the spread of infections or viruses is vitally important in many different locations and settings – such as schools, leisure centres and the workplace – but it is even more crucial for healthcare providers. People visiting or receiving treatment in these environments are already vulnerable to the spread of infection, so making sure that effective cleaning regimes are in place for waiting rooms, corridors, reception areas and wards is key. A clean and welcoming environment is also important from an aesthetic point of view, engendering feelings of well-being and trust in people who may be anxious or unwell.

Healthcare-associated infections (HCAIs) is a term that covers a wide range of infections including MRSA, MSSA, E.coli and C.difficile. HCAIs are infections that develop as a direct result of medical or surgical treatment or contact in a healthcare setting. Healthcare providers can help to minimise the risk of cross infection in a number of ways including:

• Having a regular programme of infection control education and training for staff
• Ensuring that infection control practices and standards are being met through a programme of regular checks
• Keeping the environment clean

According to the Department of Health: ‘HCAIs cost the health service around £1 billion per year. In addition, evidence suggests that service users with an MRSA bacteraemium spend on average an additional 10 days in hospital, while those with C.difficile spend an additional 21 days in hospital. Reducing HCAIs helps the NHS make the most of its resources and deliver more for its service users.’

The key to reducing the incidence of HCAIs and cross contamination is to keep caring environments cleaned to a standard as near to ultimate hygiene as possible.

In the Health and Social Care Act 2008: Code of Practice for health and adult social care, the Department of Health gives guidance for compliance with criterion two of the code of practice, which is: ‘Provide and maintain a clean and appropriate environment in managed premises that facilitates the prevention and control of infections’.

According to the guidance, among other things, registered providers should ensure that:

• All parts of the premises from which it provides care are suitable for the purpose, kept clean and maintained in good physical repair and condition
• The cleaning arrangements detail the standards of cleanliness required in each part of its premises and that a schedule of cleaning frequency is available on request

The guidance goes on to say that the arrangements for cleaning should include:

• Clear definition of specific roles and responsibilities for cleaning
• Clear, agreed and available cleaning routines
• Sufficient resources dedicated to keeping the environment clean and fit for purpose
• Consultation with Infection Control Teams (ICTs) or equivalent local expertise on cleaning protocols when internal or external contracts are being prepared
• Details of how staff can request additional cleaning, both urgently and routinely

To attain such standards in high traffic, high risk areas such as A&E and operating theatres, they need to be cleaned rigorously at least once, sometimes several times per day. The amount of traffic in other areas, such as wards, out-patient clinics and bathrooms will influence how frequently they are cleaned.

Given the physical size of most healthcare settings, and the fact that many operate on a 24-7 basis, floor cleaning machines need to be compact and manoeuvrable to reach into tight corners and fit into smaller areas. They must also be as quiet as possible, especially where cleaning has to be carried out near patients, and safe, both for the machine operator and for other staff and patients. Above all, they have to be capable of doing tasks that are particularly important, like being able to clean under beds and furniture.

For carpeted areas vacuum cleaners that also feature HEPA filtration to trap spores and organisms will help with infection control. When it comes to tiled floors healthcare providers need to look for machines that scrub deeply – always ask the supplier the depth to which a scrubber dryer scrubs. Deep scrubbing uses less water and a smaller quantity of chemicals than shallow scrubbing to remove grit and soil.  Machines with cylindrical brushes exert greater pressure on floors and can dig more deeply into tile and grout areas. Less use of chemicals means lower costs; deeper scrubbing means cleaner, more sustainable results.

A vital first step when looking to purchase new floor cleaning machines is to talk to equipment companies that have a good track record in supplying NHS Trusts and other organisations buying for hospital and healthcare cleaning. Once you’ve made your shortlist, ask each one how many hospital and healthcare sales they have made, and ask for the contact details of health service customers who can be contacted for references. This will provide you with a good background before product demonstrations take place, and help to ensure that your ultimate choice will be the best solution for your healthcare setting.

www.truvox.com

Published in the Flooring Magazine – October 2012