FEATURE


A Working Partnership


David Tucker, Group Director of Infection Prevention at CK Group Services, explores the importance of hygiene and effective cleaning processes to tackle infection in healthcare settings.


The relationship between high standards of cleaning - known as environmental hygiene - and infection prevention and control, has become well established in acute healthcare over the last 15 years or so. This may be surprising given that the relationship between poor standards of cleaning and hygiene, and the risk of infection, had been clearly stated since the times of Florence Nightingale.


Changes were most evident during the 1970s and 1980s when attitudes to the risk of infection relaxed due to advances in antibiotics, and the cost pressures that health services were placed under at that time. As a consequence, the maintenance of facilities, and in particular investment in support services (including


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cleaning), were subject to financial cutbacks. Primarily seen as a problem affecting acute healthcare, it was reflected across all aspects of the care sector.


An Emerging Problem The decline in cleaning standards was related to the emergence of a specific healthcare problem - the increasing incidence of MRSA.


Whilst many clinical interventions were introduced, the state of the care environment came under particular scrutiny with the introduction of inspection teams undertaking PEAT (Patient Environment Action Teams), and subsequently PLACE (Patient-led assessments of the care environment).


Focus on the environment coincided with the introduction of targets


to tackle the incidence of severe infections, particularly MRSA, and latterly Clostridium difficile, a micro-organism that tends to spread from patient to patient through contamination of the environment. The emergence of antibiotic resistant bacteria then gave rise to concerns at the potential inability to treat infections, which has in turn placed renewed emphasis on hygienic practices.


Changing Attitudes The improvement in the state of the care environment, in particular cleanliness, and its recognition by the media is associated with the reduction in the incidence of infections, which whilst related to better clinical management, also has an association with improved hygiene.


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