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Matrons face a challenge

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VOL: 98, ISSUE: 23, PAGE NO: 45

Kathryn Little

The Department of Health recently published Modern Matrons in the NHS: A Progress Report (DoH, 2002). The document suggests that matrons should have clear links with infection control teams (ICTs) and that, by setting and monitoring standards, they can make sure that wards are clean, cleaning specifications are met and infection control measures are properly applied by all staff. We can all be forgiven for the sharp intake of breath that comes with the recognition of the enormity of the task to address poor hospital hygiene and infection control practice along with the other aspects of the modern matron role. Yes, the remit is huge - and what power will the modern matron be able to wield to ensure that these lofty targets are met? Any? Some? None?

The Department of Health recently published Modern Matrons in the NHS: A Progress Report (DoH, 2002). The document suggests that matrons should have clear links with infection control teams (ICTs) and that, by setting and monitoring standards, they can make sure that wards are clean, cleaning specifications are met and infection control measures are properly applied by all staff. We can all be forgiven for the sharp intake of breath that comes with the recognition of the enormity of the task to address poor hospital hygiene and infection control practice along with the other aspects of the modern matron role. Yes, the remit is huge - and what power will the modern matron be able to wield to ensure that these lofty targets are met? Any? Some? None?

Investment in a nationwide hospital clean-up programme has seen a measure of success - all hospitals in England provide a patient environment that is good or acceptable. However, modern matrons will have to prove that they are able to sustain these improving standards when their budgets are not boosted by a government wanting to be seen to do the right thing.

The ICTs, which already audit wards and departments against standards, have a lot of knowledge on which modern matrons can build. Areas where the fabric of the ward can be altered to aid cleaning can be highlighted, equipment which can be easily and safely decontaminated installed, and a plan for implementing appropriate cleaning and monitoring schedules developed.

Many issues raised by the public regarding hospital hygiene do not necessarily pose increased infection risks, but are a question of aesthetics. A clean hospital engenders confidence in the environment, the people who work there and the care we receive. It is therefore imperative from a clinical governance point of view.

The task is huge and there has been much discussion about how effective such a post-holder can be. Accusations that matrons are powerless figureheads are as yet unsubstantiated, and perhaps underestimate the commitment of senior nurses to make a difference. The source of power for modern matrons to make a difference may be in their collaborations with other senior nurses, some of whom will be members of the ICT. Both need to participate in the negotiation of tenders to provide cleaning services when contracts are due. If we do not get it right at this stage, we will find standards difficult to maintain in the long term when there are no further injections of cash.

There is plenty to do in the interim and the modern matron can be at the forefront, setting standards which successful tenderers must meet. League tables suggest that hospitals are getting cleaner; the progress report states that 2,000 modern matrons already in post are making a difference and, with another 500 promised by 2004, things can get even better. They must be careful they don't spread themselves too thinly. Making sure infection control measures are properly applied by all staff is another tall order.

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