Nurses left to fill gaps in cleaning
More than half of nurses believe cleaning services at their organisation are inadequate, with around a third saying they have cleaned toilets or mopped the floor during the past year.
Over 1,000 nurses and healthcare assistants responded to our survey on cleaning practices and attitudes.
It follows criticism of Mid Yorkshire Hospitals Foundation Trust for leaving nurses to “deep clean” bed areas following the discharge or transfer of infectious patients.
A fifth of survey respondents said their trust had cut cleaning services in the last year, while 37% said their trust would not close a bed if it had not been cleaned properly.
Two fifths said they had cleaned a bed area or single room following the discharge of an infectious patient, and 81% had cleaned up after the discharge of a non-infectious patient.
However, almost three quarters had not received training on how to do so.
Rose Gallagher, the Royal College of Nursing’s adviser on infection prevention and control, said lack of training was a patient safety risk.
“This is not about saying nurses are too posh to wash… Cleaning in hospitals is not the same as cleaning your own home,” she said.
It is best practice for acute trusts to have 24/7 cleaning services. However, only 60% of respondents working in acute trusts knew their hospital had one.
Ms Gallagher said it was important nurses made sure they knew what level of cleaning support they were supposed to be getting.
Of those respondents that said they did have a 24/7 service, 51% said there were not always enough cleaners and they had to carry out extra cleaning duties at nights and weekends, However, 30% said they were required to provide cleaning support at all times of the day or night.
Nurses reported cleaning corridors, computers, nursing stations, offices and waiting areas.
Andrew Jones, president of the Association of Healthcare Cleaning Professionals, told Nursing Times he would not expect these jobs to fall to nurses, but it was “inevitable” nurses would end up doing some cleaning of patient areas during out of hour periods.
He said a number of hospital trusts had looked at having dedicated cleaning teams to do all discharge cleaning, but could not make it work logistically because most patients were discharged at around the same time.
Mr Jones said best practice required a ward to have a dedicated cleaner who could become part of the team.
“When that happens we get better cleanliness standards and a better motivated workforce,” he said. “Some of the [survey] responses would suggest that’s not the case as often as we would want.”
A new specification on cleaning in hospitals was published last year by the Department of Health, National Patient Safety Agency and the British Standards Institution. However, it does not specify what is appropriate and not appropriate for nurses to do. Instead it stresses the importance of being clear about responsibilities.
Respondents to our survey had a mixed attitude towards how much cleaning nurses could expect to do, with 16% saying nurses should not do any cleaning.
Tracey Cooper, president of the Infection Prevention Society, questioned whether it was the best use of resources to use registered nurses to clean, but said not doing any at all was unacceptable.
She said the most important thing was that everybody knew who was responsible for different cleaning duties.
“Nurses are the guardians of the standards of their wards… Cleaning has always been an integral part of what nurses do,” she said. “The risk comes when there is a lack of clarity about process and who is responsible because then you get things that nobody cleans.”