Cleaning the grey zones of hospitals: A prospective, crossover, interventional study

Semret, Makeda; Dyachenko, Alina; Ramman-Haddad, Leila; Belzile, Éric; McCusker, Jane

doi:10.1016/j.ajic.2016.04.234

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…Variations in product use and cleaning practices [ 21 , 24 , 25 ], information transfer and communication pathways [ [26] , [27] , [28] ], and organisational culture [ 20 ], can all influence cleaning outcomes. Improving staff knowledge around product use, communication, training, audit and utilising an implementation framework have been shown to improve cleaning outcomes, reduce risks for patients and are cost-effective [ 12 , 17 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

Mitchell

Russo

Kiernan

et al. 2021

Infection, Disease & Health

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Background: As frontline providers of care, nurses and midwives play a critical role in controlling infections such as COVID-19, influenza, multi-drug resistant organisms and health care associated infections. Improved cleaning can reduce the incidence of infection and is cost effective but relies on healthcare personnel to correctly apply cleaning measures. As nurses and midwives have the most contact with patients and as an important first step in improving compliance, this study sought to explore nurses' and midwives' knowledge on the role of the environment in infection prevention and control and identify challenges in maintaining clean patient environments. Methods: Cross-sectional online survey of 96 nurses (RN/EN) and midwives (RW) employed in clinical settings (e.g. hospital, aged care, medical centre, clinic) in Australia. Results: Nurses and midwives broadly stated that they understood the importance of cleaning. However, cleaning responsibilities varied and there was confusion regarding the application of different disinfectants when cleaning after patients with a suspected or diagnosed infection post-discharge. Most would not be confident being placed in a room where a previous patient had a diagnosed infection such as multi-drug resistant organism. Conclusion: Greater organisational support and improving applied knowledge about infection control procedures is needed. This includes correct use of disinfectants, which disinfectant to use for various situations, and cleaning effectively following discharge of a patient with known infection. The cleanliness of shared medical equipment may also pose current risk due to lack of cleaning.

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Section: Discussionmentioning

confidence: 99%

Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

Mitchell

Russo

Kiernan

et al. 2021

Infection, Disease & Health

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“…Once inside the hospital, inadequate cleaning/disinfection and lax biosecurity/prevention protocols were the most probable factors contributing to the dissemination of MRSA across the veterinary facility. This hypothesis is based on facts discussed in previous studies, where the implementation of appropriate and targeted cleaning and disinfection protocols can effectively reduce MRSA environmental contamination (Rampling et al 2001 , Boyce et al 2009 , Jinadatha et al 2015 , Yuen et al 2015 , Semret et al 2016 ).…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Multidrug-Resistant Community-Acquired Methicillin-Resistant Staphylococcus aureus at the Largest Veterinary Teaching Hospital in Costa Rica

Rojas

Barquero-Calvo

Balen

et al. 2017

Vector-Borne and Zoonotic Diseases

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Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen associated with severe infections in companion animals present in the community, and it is diagnosed in animals admitted to veterinary hospitals. However, reports that describe the circulation of MRSA in animal populations and veterinary settings in Latin America are scarce. Therefore, the objective of this study was to determine the prevalence and investigate the molecular epidemiology of MRSA in the environment of the largest veterinary teaching hospital in Costa Rica. Preselected contact surfaces were sampled twice within a 6-week period. Antimicrobial resistance, SCCmec type, Panton-Valentine leukocidin screening, USA type, and clonality were assessed in all recovered isolates. Overall, MRSA was isolated from 26.5% (27/102) of the surfaces sampled, with doors, desks, and examination tables most frequently contaminated. Molecular analysis demonstrated a variety of surfaces from different sections of the hospital contaminated by three highly related clones/pulsotypes. All, but one of the isolates were characterized as multidrug-resistant SCCmec type IV-USA700, a strain sporadically described in other countries and often classified as community acquired. The detection and frequency of this unique strain in this veterinary setting suggest Costa Rica has a distinctive MRSA ecology when compared with other countries/regions. The high level of environmental contamination highlights the necessity to establish and enforce standard cleaning and disinfection protocols to minimize further spread of this pathogen and reduce the risk of nosocomial and/or occupational transmission of MRSA.

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“…This study also emphasised how the lack of cleaning products, PPE supplies and medical equipment, combined with outdated IPC guidelines, impacted on nurses' and midwives' ability to practice optimal hygiene, comply with IPC policies, or work in COVID-19 safe ways 4,[18][19][20] . This variation in process, supplies and equipment with respect to cleaning, has also been identified for other occupations in hospitals 21,22 . Risk therefore became real and very personal; something few nurses had encountered.…”

Section: Discussionmentioning

confidence: 57%

Environmental hygiene, knowledge and cleaning practice: a phenomenological study of nurses and midwives during COVID-19

Curryer

Russo

Kiernan

et al. 2021

American Journal of Infection Control

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Background Environmental cleanliness is a fundamental tenet in nursing and midwifery but often overshadowed in practice. This study explored nurses’ and midwives’ knowledge and experiences of infection prevention and control (IPC) processes and cleaning, and perceptions about workplace risk-management during COVID-19. Methods Six registered and enrolled nurses (one with dual midwife qualifications) were recruited. In-depth telephone interviews were analysed using Colaizzi's phenomenological method. Results Four major themes were identified: Striving towards environmental cleanliness; Knowledge and learning feeds good practice; There's always doubt in the back of your mind; and COVID has cracked it wide open. These articulate the nurses’ and midwives’ experiences and knowledge of IPC, particularly during COVID-19. Discussion The findings emphasise the dynamic, interdependent nature of clinical (time, staff knowledge and compliance, work processes, hospital design) and organisational contexts and environmental cleanliness, which must be constantly maintained. COVID-19 opened up critical insights regarding poor past practices and lack of IPC compliance. Conclusion COVID-19 has highlighted the criticality of environmental cleanliness within clinical and community settings. Evidence-based, experiential learning is important for nurses and midwives at all career stages, but provides only one solution. Clinician-led hospital design may also reduce the spread of infection; thus promoting better patient care.

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Cleaning the grey zones of hospitals: A prospective, crossover, interventional study

Cited by 7 publications

References 18 publications

Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

Nurses' and midwives’ cleaning knowledge, attitudes and practices: An Australian study

High Prevalence of Multidrug-Resistant Community-Acquired Methicillin-Resistant Staphylococcus aureus at the Largest Veterinary Teaching Hospital in Costa Rica

Environmental hygiene, knowledge and cleaning practice: a phenomenological study of nurses and midwives during COVID-19

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