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Lack of cleaning services sees nurses disinfecting beds

A cash-strapped hospital trust has been criticised by a leading infection control expert for leaving nurses to take on cleaning duties.

A report into stubbornly high rates of MRSA and Clostridium difficile at Mid Yorkshire Hospitals Foundation Trust found the trust’s Dewsbury and District Hospital did not have a round the clock cleaning service on two days of the week.

This meant nurses were having to “deep clean” bed areas following the discharge or transfer of infectious patients.

The report was written by Janice Stevens, former director of the Department of Health’s Cleaner Hospitals Team and a member of the prime minister’s Nursing Quality and Care Forum, and Brian Duerden, former DH inspector of infection control and microbiology,

They said the trusts cleaning processes were a risk that required “urgent attention”.  

Writing in the report, Professor Duerden said: “Pressure on beds pushes staff to clean more quickly and anecdotal feedback indicates staff believe bed areas are not being cleaned thoroughly at these times.

“Nurse staffing is already ‘tight’ so taking them away to clean must impact on their time for patient care.”

The trust, which has an annual budget of £430m, is planning to make more than £23m of savings this year but despite that is still expected to finish the year with a £26m deficit.

Staff also reported they had been told commodes could not be replaced due to budgetary constraints, which Professor Duerden warned could increase the risk of C difficile.

The report also criticised the trust for using out of date cleaning guidelines in all three of its hospitals.

Professor Stevens told Nursing Times while it was not unusual for nursing staff to do a “standard” or “green” clean, it was best practice to use cleaners where a patient had shown signs of infection and a deep clean was needed, which could involve changing the curtains and cleaning the floor.

She added:  “We base our advice on what we know are good standards.”

Royal College of Nursing infection control adviser Rose Gallagher said nurses had responsibility for ensuring the environment they were caring for patients in was clean, but that did not mean they should be doing the cleaning themselves.

“This is another example of how nurses are under pressure to pick up the slack for services that are not their responsibility,” she told Nursing Times.

In a statement the trust said it did have a 24/7 cleaning service but accepted it was at a “lower level” in the evenings.

A spokesperson said: “In common with other trusts, on occasions members of ward staff may be required to assist with bed space cleaning following the discharge of a patient. This may occur in the evening or overnight and is necessary to ensure that the trust can admit patients requiring emergency admission.

“Our aim is always to discharge patients during the daytime to provide the best possible patient experience.

“The trust is committed to providing hygienic bed spaces and reducing healthcare associated infection rates. We are pleased to report that our infection rates so far this year are equal to, or better than the targets for reduction.”

Readers' comments (39)

  • Where I would we do this after ever patient anyway

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  • oops Where we work we do this after every patient anyway

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  • We have cleaned beds and bed spaces for years now.

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  • yes we clean bed and surrounding areas - but the barrier nursed room/bay is ''deep cleaned'' decontaminated, by cleaning staff. As too time consuming for us nurses.

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  • Anyone in Mid-Yorks done RTTC for this? Releasing Time To Clean........

    I'm here all week, don't forget to tip your waitress :)

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  • Strong rumours in neighbouring Trusts that senior heads are rolling in Mid-Yorkshire. This is the Trust that asked staff to take unpaid leave to reduce the wage bill earlier this year.

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  • Having spent 2 months at the Whittingdon Hospital in North London about 7 years ago with my mother I watched carefully how the 'contract' cleaners didn't clean. they would stand around aimlessly flopping a mop around. for one week I saw the same piece of dried blood in the corner of the lift until I took the pictures to the head of cleaning!! the next day it disappeared. So who is checking? and if they are not doing their jobs properly then get rid of them. Nurses cannot be expected to clean as well as care. Doctors need to do the medical stuff, nurses the caring and cleaners the cleaning. Finally with regard to commodes. I put my mohter on a comode in the same hospital only to find that there was a lump of somebody else's 'stuff' on the seat. The doctor was there at the time and my mother had a bowel infection I pointed this out to the doctor, who was completely disinterested saying "this is the nurses responsibility" not mine......I would love someone to give me a hopsital for a few months and a budget and that hospital would be spanking clean!!!

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  • Since when is it below nurses to do cleaning of beds, even after C Diff patients??? For goodness sake I was a nurse (registered) for years and gladly washed out even suction bottles for re-use before these disposable ones. Nurses are getting above themselves - too busy to clean? Rubbish! If nurses get down to nitty gritty nursing instead of trying to be just managers behind a desk then the service would greatly improve and lower paid staff wouldn't go home totally exhausted and injured as they do. Teamwork let's do it! We are mollycoddling nurses and university teaching is trying to produce managers not nurses.

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  • I do agree also with the last comment about too many nurse managers - but there job should be about caring, sitting by the bed, talking to patients, helping to feed them etc. The problem is that we are too hot on academic achievements rather than the pracitcal side of nursing. A nursing degree is useless if the they do not have a caring personality.

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  • we in our multidisciplinary team always cleaned up after ourselves no matter what as well as after the patients we were looking after, perhaps with the occasional exception of a visiting consultant, although even most of them from our own hospital were fairly well disciplined and often didn't even give us the time to offer. it never occurred to me it should be otherwise. our maid cleaned the ward floors and other surfaces and our HCAs did so when she was not there as she worked 7 am to around 5 pm. their job was not to clean up after others although we would all help each other out in an emergency. even a senior reg. once offered to help me change a very soiled bed of a patient he had been examining when he saw I was on my own. I foolishly declined as I didn't think it was his place and I think I offended him as he humbly said he had also worked as an HCA as a student (I kicked myself afterwards as I also fancied him!).

    When our patients left we disinfected the bed and locker and the maid or an HCA cleaned the surrounding area leaving us free for the rest of our work such as all the discharge admin. etc. The bed was then transported by one of us to the pool for disinfection and sometimes we had to collect them too if we had run out of empty beds but usually the HCAs would fetch clean ones to fill any spaces or exchange clean ones for the ones we had taken to the pool. Corridors were deep cleaned in the early hours of the morning by contract cleaners using industrial machines and any rooms where we had nursed infectious patients were defumigated by the specialists with special equipment and the room was sealed afterwards and out of use for a few hours.

    In a more recent job we had to damp dust all the electric bed frames once a week to prevent or reduce dust allergies. We had about five or six each to do which is quite back breaking work and at 65 and fortunately now retired I just wonder how I would have fared in this job if I had to work until a much later retirement age as even now when I crouch down I have great difficulty getting up again but one could hardly tell colleagues you couldn't do your share of the work.

    An MSc in Healthcare Management didn't prevent me doing this work which was just part of the job I enjoyed,or carrying out basic care and making my patients comfortable, but probable helped me to do it better as I understood the rationale behind everything we did and was able to question what was just ritualistic but had no rational purpose as well. In fact some of it was quite enjoyable as it gave time to think of other things or at the same time observe patients or what was going on or talk to patients or colleagues, something there is often little time for. It seems strange to me that such an issue is being made out of some of the tasks nurses do but to be fair we had enough staff although more recently with rapidly increasing paper work and loss of staff by natural wastage who were not replaced the organisation of our work and attending adequately to our patients needs became more and more difficult.

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  • tinkerbell

    Anonymous | 1-Aug-2012 12:35 pm

    Anyone in Mid-Yorks done RTTC for this? Releasing Time To Clean........

    Exactly, when our managers also asked us to take on washing patients clothes and tumble drying i did ask 'are we releasing time to care or to clean?'.

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  • As if we haven't go enough to do.
    Cleaning the bed and bedspace when a patient leaves, is a part of our job and if done well, shouldn't take too long. But to do deep cleans, is ridiculous. I, for one wouldn't know how to do that.

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  • here, here we haven't the training to use the specialist deep clean equipment - there are intricate procedures involved in the deep clean. Mixing certain chemicals can prove a danger to surrounding patients and a deep clean takes time when done curtain poles, etc as well as bed, floor etc.
    Yes we can clean between patients etc but leave the deep clean to the experts.

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  • I have no problem whatsoever cleaning the beds and the surrounding area, even with my university degree. The turnover on our ward is so high and fast-paced, that if we waited for the cleaning team to do it, we would have patients stacked up to the ceilings!

    Oh, and by the way, we have never had an incident of a patient catching MRSA or c-diff from our area :)

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  • Whilst I am cleaning around the bed area, what happens to my 9 other patients, for example if a patient needs pain relief, or if an ambulance arrives to take a patient home, I have a phone call from a social worker etc etc.
    I have no problem with cleaning but I prioritise my patients needs first.
    I say let the experts do the cleaning and they will do the job properly for the benefit of patients and staff. Then I can do the job I was trained to do.

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  • contrary to a university degree, cleaning demonstrates care and safety for patients and their environment.

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  • I don't consider nurses disinfecting beds as an issue. In fact, I would regard it as a vital nursing proceedure, as it was when I worked in the NHS from 1966 until 1987. As a consequence, in those days, 'cross infection' levels were of a very low occurance rate. Nowadays, it appears all those so called 'non nursing tasks', are left to untrained/qualified people who haven't the awareness of the importance of ensuring a 'sterile' environment. Bring back the matron, and higher nursing standards, that's what I say.

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  • the title of the article leaves one wondering if it is written by a registered nurse as it seems that nurses have always disinfected beds and this is nothing new.

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  • disinfecting beds and the surrounding areas is understandably a nursing job, however doing a deep clean? I didnt go to university for 3 years to clean beds...

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  • Anonymous | 2-Aug-2012 9:11 pm

    Sorry I disagree.

    Why is cleaning "understandably" a part of nursing?

    Does cleaning form part of a nurses job description ?

    By undertaking this task you make yourself part of the problem!

    Trust Management should provide a 24 hour cleaning service staffed by dedicated personnel who are NOT nurses!

    This is another example of Senior Nurse Managers allowing nurses to be abused and patients to be neglected.

    A nurse I would argue can not be providing patient care whilst s/he is mopping the floor!

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