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‘Take control of hygiene’

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Gail Smith on why hospital cleaning has gone backwards in the past 30 years

When I first came to work in the NHS some 30 years ago, I was introduced to weekend cleaning and checking and, of course, the cleaning and checking book.

This was a little notebook with a list of mundane tasks to be completed each weekend. Cupboards in the sluice and storage areas were cleaned and sorted. Drug trolleys were tidied and equipment was checked.

Funnily enough, I am now back working in the same hospital, having moved in a full circle via the rest of South Wales, London and Jeddah. There are many changes – not all good I’m afraid.

Weekend cleaning and sorting appear to have become things of the past and lists of what needs to be done no longer exist. Everyone works much, much harder now, with minimal overlapping of shifts.

There is no slackening of the pace at weekends, especially in acute medicine. Beds are fully occupied at all times. The hospital has an official occupancy rate of 98%.
As a result, there is little spare time available in which nurse-initiated cleaning and sorting can take place. The only slack in the system is often between about 2.30am and 5am.

With minimal staff numbers at night and the fact that humans are not naturally nocturnal creatures, it is not surprising that one does not feel enthusiastic for sorting out and cleaning cupboards at 3am.

Sending teams of cleaners into hospitals to clean patient areas will have little effect if sluices and treatment rooms are not clean and orderly. To my mind the worst offence is having a smelly sluice – a bad odour really does give a poor impression of hygiene standards.

How does anyone know when the sluice was last cleaned or what is involved in cleaning the sluice properly? Are commodes being thoroughly decontaminated between each patient use? When were the cupboards last washed out?

Moving to the treatment room, when was the drug storage fridge last cleaned? When were the racks holding the intravenous fluids removed from the shelf and the shelf cleaned? When was the drug cupboard sorted and washed out? The list is endless.

How do we get around the problem? I cannot truly say that bringing back a checklist will answer the question, much as I wish it would. In the present economic climate, it would be unrealistic to expect more staff.

However, unless nurses realise their accountability in ensuring good housekeeping in their clinical areas, I can see no way forward.

Gail Smith is a staff nurse in Cardiff

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