ENVI RONMENTAL T RANSMI S S ION
Ward cleanliness
Despite vigorous cleaning procedures being held in higher regard than they have been in previous years, due to recent widespread awareness of the dangers and impact of COVID-19, the above reveals the void of knowledge that is missing regarding the role that environmental contamination plays in the transmission of HCAIs. While it is straightforward to show that infected patients can contaminate hospital settings, it is much harder to prove that in reverse. The UK, therefore, has a tendency to depend on single-measure strategies, while financial constraints means that Trusts do not always prioritise deep cleans. This is exacerbated by the absence of good evidence to suggest a link between increased hospital cleanliness and a decrease in the spread of HCAIs.
What is needed is high-quality epidemiological data so that healthcare authorities can be led by this to produce and develop evidence-based policies. With this in mind, Trusts should also have access to a greater amount of funding – so that the correct deep cleaning procedures can be implemented. This needs to be combined with the effective design, renovation and construction of healthcare facilities to reduce the spread of HCAIs.
In the past, the UK tended to focus
on hand hygiene. However, since 2007, care bundles have been introduced, which take a more comprehensive approach towards hospital cleanliness. This includes patient screening, cohorting of patients and staff, antibiotic stewardship, improved management of ventilated patients, deep cleaning of wards as well as hand hygiene, all contributing towards an overall decrease in HCAIs, demonstrating the importance of having a holistic approach to overall hospital cleanliness. Ultimately, we should not solely depend on environmental technologies, but acknowledge the important role that they can play, alongside other facets, in reducing the spread of HCAIs.
CSJ
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2. Read, J, et al, Hospital-acquired SARS-CoV-2 infection in the UK’s first COVID-19 pandemic wave, The Lancet, August 12, 2021DOI:
3. Tiemersma, E, et al, Staphylococcus aureus Bacteremia, Europe, December 2005, Emerging Infectious Diseases 11(11):1798-9, DOI:10.3201/ eid1111.050524
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4 Stone SP, et al. Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus
aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four-year, prospective, ecological, interrupted time series study. BMJ. 2012 May 3;344:e3005. doi: 10.1136/bmj.e3005. PMID: 22556101; PMCID: PMC3343183.
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About the author
Dave Rudge has been the operations manager at REACT Specialist Cleaning since 2019 and has over 10 years in the Cleaning / FM sector, working alongside a number of industries such as rail, education, NHS / Health and housing.
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