Cleaning is one of the crucial daily activities in the hospital. Enough literature suggests that maintaining hygiene at the hospital environments helps mitigate infection. Hospital hygiene encompasses different levels, starting from the staff, to the hospital floors and surfaces and finally to the hospital environment. Cleaning among many hospitals are classified as a stand-alone activity as it is crucial in infection control. This essay seeks to expound on cleaning as a daily activity in hospitals.
Cleaning of hospital surfaces and floors involves decontamination and sterilization. Cleaning activities take place on a regular basis and can be hourly or daily when surfaces are visibly soiled, presence of spillage, or after a patients discharge (Dancer, 2011). The frequency of cleaning is dependent on established clinical risks, the intensity of people-traffic, patient turnover, and condition of the surfaces. Hospitals maintain a written specification of their cleaning activities on all areas of the hospital.
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The cleaning activities are subject to review by the cleaning supervisors, hospital managers, as well as infection control institutions. The review is vital in providing a safe and clean environment for all. Cleaning of hospital floors and services involves physical removal of visible debris and litter, wiping out of visible dirt, stains smears, and grease by detergent and water. In some instances, cleaning is automated. Automation of cleaning is mainly done as a response to the inadequacy of manual cleaning to thoroughly decontaminate. Automated room disinfection units are characterized by superior decontamination of environmental surfaces and objects (Dancer, 2011).
The systems use various mechanisms such as ultraviolet light, chemicals such as hydrogen peroxide steam or ozone. Cleaning of the hospitals extends beyond the floor to involve door handles, light switches, keyboards, taps, and telephones, among others. Cleaning is largely aimed at surfaces that pose an increased risk of pathogen transmission. Cleanliness among most of the hospital varies depending on the area, which can be a patient area, clinical area, or a non-clinical area. Each of these areas has different cleaning requirements. Cleaning begins with low-risk areas towards high-risk areas. That is, areas which are low touch or slightly soiled are cleaned before high touch areas or those heavily soiled.
Cleaning activities in hospitals are subject to ethical issues. The issue of cleaning non-compliance by HCW is high. Non-compliance by HCWs is attributed to the illusion of invulnerability of some areas as well as understaffing. They are overconfident about these places immunity to germs, ignoring evidence that their position exposes them to more risk and cleaning can help. Cleaning of hospital floors faces issues of whether the same cleaning equipment can be used for all areas — for example, a mop used in cleaning isolation area being used in general areas. Zuberi (2014) has examined the ethical dilemma in cleaning activities in the hospital. The author notes that the prevalence outsourcing of cleaning services in hospitals is disastrous and associates it with an increased risk of HAI.
Administrators can improve their level of social responsibility in the cleaning activities in various ways. They can adopt new technologies as well as train users. Use of technology in cleaning helps improve patient safety as well as to measure and monitor cleaning processes. The administrators should also audit the cleaning activities. Audits are a health service's systematic and ongoing program for monitoring cleaning outcomes. Audits should be performed in all functional areas across all functional area risk categories and result clearly documented. The administrators should prepare a comprehensive mapping of all rooms within the hospital with an accompanying risk profile. This way, the auditing process is simplified. The administrators can also involve both internal and external. Though the accepted level of cleanliness varies, administrators should set high benchmarks prior to the audit. The activities can also be improved by documenting the cleaning technique. Leaning supervisors should ensure that cleaning occurs from low risk to high-risk areas. For example, non-isolation rooms can be cleaned first followed by isolation rooms. The practice helps minimize cross contamination risk of environmental surfaces. Documentation ensures that all staff is familiar with the cleaning techniques. Supervisors should also take it upon themselves to regularly monitor cleaning staff adherence to the procedures. Understaffing presents challenges where the staff is required to clean more square footage. The trend can be solved by introducing technologies such as vacuum cleaners.
Cleaning of rooms and the hospital environments is complemented by evidence-based procedures such as handwashing. Washing hands complements efforts of surfaces cleaned such as doorknobs and staircase rail which most HCW and patients come into contact with. Compliance with handwashing help minimizes the cumulative risk of patients as well as on the doctors (Herbert, 2012). Hospital administrators can improve compliance to handwashing by increasing hand rub dispensers and offering incentives. They can also reposition sinks and install automated ones. Moreover, installing precaution carts can also promote hand washing.
The essay has examined the cleaning as a daily activity. It has looked at the daily activities that surround the clearing obligation. The essay has also expounded on some of the ethical issues surrounding hospital cleaning. Administrators are tasked with implementing the improvements outlined as well as complementary activities such as hand washing.
References
Dancer, S. J. (2011). Hospital cleaning in the 21st century. European Journal of Clinical Microbiology & Infectious Diseases , 30 (12), 1473-1481. doi:10.1007/s10096-011-1250-x
Herbert, W., (2012). Hand Washing: A Deadly Dilemma. Retrieved from https://www.huffpost.com/entry/wash-hands_n_1131614
Zuberi. (2013). Cleaning Up: How Hospital Outsourcing Is Hurting Workers and Endangering Patients . Ithaca, NY: Cornell University Press.
