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Visibility of hospital cleaners affects perceptions of hygiene

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Staff personal hygiene, outsourced cleaning contracts and not knowing where to complain are factors the public considers when asked to rate hospital cleanliness, research has found.

West Midlands strategic health authority commissioned Ipsos Mori to survey patient perception of hospital hygiene.

It wasn’t just ‘I saw some dust under the bed’

The SHA’s programme specialist for healthcare acquired infections Vanessa Whatley presented the findings at the Infection Control 2010 conference.

Ms Whatley told the conference that patients’ assumptions about infection rates were heavily influenced by the visibility of cleaning staff.

“People wanted to see staff remind each other to be vigilant, hear them take infection seriously,” she said.

“They wanted to see the modern matron on the ward having a conversation with the cleaner.

“It wasn’t just ‘I saw some dust under the bed and it didn’t move the whole time I was here’. It was what they saw, smelled, heard and tasted,” she said.

Some findings were contradictory: patients were reassured by the smell of disinfectant but also wanted to smell fresh air.

Other results were surprising. For example, interviewees wanted to see reductions in the size of queues because the sense of a chaotic environment affected their idea of whether it was clean.

Patients were also concerned if they thought the “personal hygiene of patients and health care workers was not a priority”.

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Readers' comments (2)

  • My son had to spend a week in an Italian hospital located in a small coastal town. His sideroom was thoroughly, but discreetly cleaned twice daily by the same cleaner (Mon - Fri) who was seen to frequently liaise with the nursing staff on duty. I was very impressed by the attention given to cleanliness and to the peaceful atmosphere. I've no idea what their infection rates are like as a result of this but I felt very reassured by the very obvious presence of efficeint cleaning staff.

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  • Cleaners entering opposite sex toilet and washing facilities need to follow robust procedures to promote the concepts of privacy & dignity and prevent privacy violations which cause dignitary harm & distress. Knocking/calling out and walking in on patients, staff, visitors performing intimate body functions eg men using urinals causes embarassment and distress and is not acceptable practice.

    Separate toilet facilities are generally provided for men and women presumably on the grounds that they may be used by more than one person and a woman might object to the presence of a man (or vice versa). The use of male cleaner in a female toilet and vice versa without giving users choice and chance to object potentially violates that provision.

    Facility managers need to check and comply with EHRC guidance which advises clear warning signs including times that cleaning/inspection will take place, or asking a same sex (as facility) worker/user to check existing occupancy, so that people may choose to use a toilet with same sex privacy and not have to worry about the discomfort of finding themselves alone with an opposite sex cleaner privvy to their bodily functions. Otherwise cleaners and members of the public are being put in uncomfortable positions which could lead to accusations of inappropriate behaviour/ harassment. This is not safe practice and creates child protection concerns if minors are in single sex enclosures in a state of undress/using a toilet/urinal with an opposite sex worker.
    When an employer, employees or agents are planning what happens to people they are delivering services to, they need to make sure that their decisions, rules or ways of doing things are not:

    • direct discrimination, or

    • indirect discrimination that they cannot objectively justify, or

    • harassment

    It is therefore important to make sure that employees and agents know how equality law applies to what they are doing.

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