Home' Inclean : INCLEAN May-Jun 2015 Contents 30 INCLEAN May/June 2015
By Francis Cochrane*
Having worked in some of the main hospitals
in Australia over the last 15 years, I have been
privileged to attend many cleaning seminars,
product launches and trade shows. With some
concern I noticed that a key element of what I
term ‘the hospital cleaning equation’ is absent,
which are the hospital executives but more
importantly the nurse unit managers (NUMs).
Hospitals organisation structures have not
evolved over the years and are still operating in an internally focused
and inflexible way. This structure has evolved due to the high amount
of specialisation required. This in turn has led to the operational silos
we are now experiencing and complaining about.
The only way to overcome the increasing isolationist trend is to
ensure that NUMs are part of a cross functional team that is involved
in the shaping of the cleaning process on the wards and the hospital in
general. The reason why the emphasis is more on NUMs rather than
the hospital executive is that the NUMs are at the ‘coal face’ and are
the key link between patient, nursing, cleaning and the executive.
Infection control has been deliberately omitted in this discussion.
The reason is that I have found that each hospital has a different view
with regard to infection control standards as they apply to cleaning. I
presume these standards emanate from either the medical director or
the director of nursing depending to which infection control reports.
In most hospitals the infection control department is small and
therefore needs to devote its resources on clinical issue and outbreaks.
It is however essential that it is a part of the cleaning equation and
therefore needs to be ‘in the loop’.
With the cleaning function moving to other departments, NUMs
have lost touch of what is now a new cleaning approach to hospitals.
The recent rapid changes in specialised cleaning systems, processes and
equipment have further widened the gap between cleaners and nursing.
This causes a lot of conflict resulting in stress between NUMs and the
cleaners that ultimately affects the service to the patient.
This conflict is further fueled with cleaning management increasingly
being put under pressure to lower costs and increase cleaning efficiency.
With new technologies the cleaning of hospitals has greatly
improved in terms of the actual removal dirt, reduced the time
and frequency of cleaning in a patient room, greatly enhanced the
infection control aspect and reduced environmental cost.
It is therefore essential that the NUMs take part in cleaning seminars
to bring them up to speed with the new technologies so that they
become educated and supporters of the changes needed in hospitals.
The benefits would be enormous in two main areas. One, with NUMs
being involved the cleaning industry will become much more focused
on evidence based cleaning systems. This has been lacking in the past as
the cleaning was purely reliant on chemicals and chemical companies
having sufficiently made their case in regard to infection control.
This, however, is no longer acceptable due to the continuous issue with
increased resistance to chemicals and the general environmental impact
of chemical in terms of fumes affecting staff and patients, destruction of
materials due to harsh chemicals and finally, the impact of chemicals on our
environment in general through our wastewater or in landfill. The other
being that NUMs would understand the ‘new’ cleaning methodologies
and trends. With this new-shared knowledge specific cleaning standards for
wards can be developed to meet the needs of the ward.
By working collaboratively together communication will greatly
improve which will greatly reduce conflict. Once the conflict is
removed the patient experience can be addressed and innovative
hospital cleaning technologies and methodology can be accepted.
*Francis Cochrane is a consultant in hospitality and healthcare support services
Nurses and cleaners must collaborate for
hospital cleaning methods to improve
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