093 Surface cleaning – the reality in a clinical environment

Introduction Studies have shown direct transfer of pathogens between patient and the environment, with patients in intensive treatment units (ITUs) at highest risk to healthcare associated infections (HCAIs). Therefore, frequent and effective cleaning is important in reducing the incidence of HCAIs. While some guidance exists on cleaning, how and when cleaning should occur is not defined. Aim To audit surface cleaning practices undertaken by healthcare staff within patient bed spaces in ITU. Methods Observations were undertaken for 500 hours to audit how non-organic surfaces were cleaned by staff. Observations included different bed spaces, shifts, healthcare staff and routine and post discharge cleaning. Staffs were classified into groups: doctors, nurses, healthcare assistants, housekeepers, cleaners and others. Surfaces were categorised by height as level 0 ( 1.2 m). Observations included the numbers of staff entering a patient bed space, surfaces touched before and after patient contact and cleaning agent and technique used to clean any surface. Findings 17% of staff entering bed spaces undertake some form of surface cleaning. On average, a cleaner would clean 8 surfaces of a possible 56 when entering a bed space, while nurses and doctors on average clean 0.2 and 0 surfaces respectively. Nurses most commonly cleaned the intravenous tray with a wipe, with technique varying significantly. Conclusion Cleaning methods were inconsistent between staff groups. Confusion between cleaning roles was observed, showing a need for a clear division of cleaning responsibilities between staff groups. Wide variabilities in cleaning technique among all staff groups highlights clear gaps in training and a need for a comprehensive training package with defined cleaning roles.