Hospital hygiene has always been a matter of concern. Experts continue to stress on the importance of maintaining the highest standard of hygiene within a healthcare setting primarily because of the greater risk of contamination. That being said, the common touch points inside a hospital (such as elevator buttons, door handles, hospital beds, etc) remain a matter of concern. Due to the current outbreak of COVID-19, the need to identify critical hospital touchpoints and disinfect them has become more important than ever.
Denise Hanson, Head of Technical Services at The British Institute of Cleaning Science (BICSc), outlines the measures that the hospital housekeeping department needs to put in place.
Due to the current outbreak of COVID-19, it is important to understand what cleaning operatives can do to help prevent the spread of infection whilst also protecting themselves. Standard precautionary measures need to be applied in order to help prevent the risk of spread of any infection. Cleaning operatives can help and contribute to the prevention and reduce the risk by applying good standard precautionary practices such as the following:
• Achieving good hand hygiene.
• Correct use, including donning and doffing procedures, of personal protective equipment (PPE) such as gloves, aprons, masks, etc.
• Disposing of waste appropriately.
• Managing spillages of blood and body fluids.
• Achieving and maintaining a clean environment.
Here are some digestible guidance that will help keep you, your team and your clients feeling safe:
CONSIDER how much additional time and resource will now be required to meet the needs of the clients and contract delivery, which make all involved feel secure and safe?
IDENTIFY is there has been an actual outbreak on the sites your operatives are working in. If so, follow decontamination/ disinfection procedures and protocols.
THINK if you are cleaning, decontaminating or disinfecting? There are differences.
FOLLOW manufacturer’s guidelines on products and machinery. Use the correct dilution rates, incorrect dilution causes shortages and will stop the product working correctly.
BE AWARE of the key touch points.
• Door furniture
• Reception areas
• Lift control panels
• Washrooms – door handles, toilet seats, flush mechanisms, taps, soap dispensers and waste bin lids.
UP THE FREQUENCY of cleaning and disinfecting especially in washrooms and heavy footfall areas.
ALWAYS wash and dry your hands thoroughly, even when you arrive at your place of work, and before and after each task.
In addition to this, cleaning operatives must:
• Ensure up to date risk assessments and method statements are in place (this should include social distancing measures)
• Consider if they are trained in the control of crosscontamination? This will ensure the spread of any infection is minimised.
• Follow the BICSc recommended colourcoding guidelines. This will ensure there is no crosscontamination.
• Follow the ‘clean to dirty’ path – clean from the cleanest areas to the dirtiest to minimise cross-contamination
• Use systematic overlapping passes so that all the surface area is efficiently and effectively cleaned
BICSc has also announced the launch of a selection of healthcarecompliant cleaning skills, which have been adapted from the Institute’s long-established Cleaning Professional’s Skills Suite. The selected skills are compliant with both PAS 5748:2014, and the draft ‘NHS National standards of healthcare cleanliness manual’.
A HOSPITAL’S PERSPECTIVE
To get a deeper insight into the hospital touchpoint challenge, we speak to Remya Venugopalan, General Manager - Operations & Quality, International Modern Hospital, Dubai.
According to her, the major touch points in a hospital from a hygiene point of view include the hospital entrance (temperature checking), hand sanitizers, lifts, biometric attendance, receptions, cashiers, outpatient clinics, pharmacy, cafeteria and rest rooms.
These touch points are cleaned very often with Virex II 256 disinfectant. In fact, International Modern Hospital has deployed permanent housekeeping staff in the lifts and at the receptions for cleaning after every person touches to avoid cross infection. Additionally, they have developed a schedule for deep cleaning of these touch points by their well trained housekeeping staff.
In addition to this, they have implemented touchless technologies such as thermal screening of patients at the hospital door, sensor based auto cut tissue dispensers, sensor based hand sanitizers at few areas, sensor based doors/ lights at few areas etc. The reason for selection of these technologies is to prevent cross infection by touch.
Some of the challenges in maintaining hygiene include frequent movement of people and making sure individuals maintain hand hygiene after each touch.
“We identified that the best way to overcome these challenges is to make hand hygiene and disinfection a habit by awareness. So, we have put up educational posters and videos at multiple points in the hospital asking patients and staff to disinfect their hands after each touch. Dedicated staff have been deployed for refilling hand sanitizers. Continuous training and education of the hospital staff on infection control have helped too. Rigorous monitoring of the staff and disinfections by the infection control team have successfully prevented the spread of infections. The task was effectively led by Mr. Farooq, Housekeeping-in-Charge who continuously supported the staff to overcome the challenges faced,” says Venugopalan.
The pandemic has changed the way we look at infection control in the hospital. These touch points have become vital for us to prevent the spreading of coronavirus. Speaking of International Modern Hospital, they have increased the number of hand sanitizers across the hospital and especially at these touch points. Also, the frequency of cleaning of these touch points and in some areas like lifts and main reception have been increased since they have deployed dedicated staff for cleaning and disinfecting after each touch.
The cleaning staff go through a rigorous training, which includes classroom training with video demonstrations and role plays. Apart from this, there is direct observation by the housekeeping supervisors of the staff. Following this training, competency assessment of the staff is done at periodic intervals. Monitoring hand hygiene compliance and HAI rates in the hospital help the staff to evaluate the effectiveness of the training imparted.
Needless to say, hospitals are sensitive places. We all know they have been doing everything they can to eliminate germs from their environment. They have infection control protocols, staff dedicated just to reducing infection, and involve every member of the staff, from housekeeping to the executives, in taking steps to protect visitors, staff, and most importantly, the vulnerable patients in their care. Despite this, the pandemic has changed the way hospitals now see hygiene. Like every other facility, they too have had to adapt to the protocols of the new normal.