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High Performance Filtration
By Greg Whiteley*
The importance of cleaning staff's role in
preventing healthcare associated infections
(HAIs) is massively underrated. The
core function of cleaning is to remove
microorganisms that can cause disease,
illness and even death. Getting rid of
dangerous microbes is a primary infection
This is made clear in the National
Safety and Quality Health Service Standards for Australia, but this
recognition of the importance of cleaning, often does not translate
into effective action within the wards of Australian hospitals -- and
that is a disgrace.
Australia still does not have a national public reporting mechanism
of the frequency of HAIs that is both transparent and up to date.
The U.S. Government forced this onto the healthcare sector in the
United States in 2011. But in Australia the bad bugs spread around
inside hospitals due to a range of hygiene and infection prevention
failures and no one is held accountable.
Hand hygiene is reported to be compliant through the auditing
approach accepted by the Clinical Excellence Commission
of NSW and through Hand Hygiene Australia. But there is a
growing body of evidence that the flawed audit approach is
hiding the true level of non-compliance. Independent studies often
rate the real hand hygiene compliance for doctors as frequently
around 30 per cent.
Here is the risk for patients. The acceptable rate for hand hygiene
compliance is only 70 per cent (Hand Hygiene Australia guidelines),
so then it is apparently ok for doctors to touch patients on three out
of 10 occasions where they have not washed their hands.
If the last item or surface touched -- prior to touching the patient --
was contaminated with a Multi-Resistant Organism (MRO/the bad
bugs), then the bad bugs have jumped from that surface to the hands
of the healthcare worker and then onto the vulnerable patient. As
easy as that there is infection.
A recent Australian study showed that most of the bad bugs in
a busy Intensive Care Unit (ICU) were in and around the clinical
workstation. So, the healthcare workers who often do not wash their
hands pick up the bad bugs and move from the clinical staff area
back to the patient area without any interference.
What is the solution? Let's get rid of the bad bugs. Quickly, call
It is the role of the cleaning staff to clean away the bad bugs. If
Cleaners are final defence against HAIs...
but cost cutting creates inefficiencies
"So the staff areas where the
bad bugs are hiding don't
actually get cleaned because we
don't have enough cleaning staff
to clean all of the surfaces that
the extra doctors touch."
there is not sufficient cleaning staff and they are not allowed to do
all of the cleaning that should be done, then the bad bugs easily
become residents within the hospital.
But it gets worse, because cleaning is apparently too expensive
and so cleaning staff numbers get reduced. Meanwhile, we are told
that we need more doctors (who don't wash their hands sufficiently
often). So the staff areas where the bad bugs are hiding don't
actually get cleaned because we don't have enough cleaning staff to
clean all of the surfaces that the extra doctors touch.
Well, maybe the cleaning is done once a month, or even once a
year, or whenever the hospital can afford to get the cleaning staff
involved in doing the cleaning that removes the bad bugs that cause
these infections. But mostly, the cleaning is insufficient.
We have an excess of infections, and a shortage of cleaning staff
in hospitals around Australia. No wonder we still have an HAI
problem. Washing hands and cleaning surfaces might just be the
answer, so quickly, call the cleaner...
*Greg Whiteley is director of Whiteley Corporation,
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