09.03.11
How clean is your house?
Hospital hygiene is in the news yet again. Health secretary Alan Johnson’s announcement in September shows how seriously the government is taking it: deep-cleaning, new control and reporting mechanisms and even a new regulator. It is an all-pervasive challenge, and one that needs a back-to-basics solution. Money is available, but where best to spend it with a challenge on this scale?
Back in the 1950’s, without the benefit of so many mechanical and chemical-based cleaning aids, our homes and workplaces were generally clean. The stereotype of a housewife scrubbing her front step on her hands and knees was a reality. Keeping dirt at bay is hard physical work, and effective techniques have to be learnt. But 50 years ago people had these skills. They were passed from generation to generation and were an integral part of the body of knowledge. But equally important, people had time to apply this knowledge. Whether in the home or the workplace, time was devoted to teaching these skills and applying them, and they were considered vitally important in both environments.
Cut to the present, and consider the plethora of TV programmes and books showing us traditional ways to keep our homes clean. Most modern lifestyles do not incorporate hard physical effort spent on cleaning, and most people do not have the skills, know-how or the time to deep-clean their homes. The advertisements for cleaning products continue to emphasise how easy it can be and how fragrant the result.
If we take this premise into the healthcare arena, and scale it up for the 1.3 million staff who work for the NHS, we start to see the magnitude of the problem.
New figures from the Health Protection Agency show that the level of Clostridium difficile is increasing, and last year affected some 55,000 elderly people. And there are still nearly 7,000 cases of MRSA reported annually.
The £50 million investment announced in July and the deep-clean programme already underway are, of course, crucial improvements, but we must recognise that they will not have the lasting effect we need unless every member of staff ensures that standards are upheld. Individuals need to know how to keep surfaces and equipment clean, and they must also understand the vital importance of personal hygiene.
The cleanyourhands campaign has been very successful in this regard, both in raising awareness of what standards are required, and also putting practical solutions forward which tackle the problem at source. And the new guidance on clothing, ensuring a “bare below the elbows” culture will further support this focus on personal hygiene.
However, we must not forget that hospitals are not the only problem area. Most healthcare now takes place outside hospitals, and patients are often transferred from one care setting to another during their period of treatment.
Sue Wynne, nurse lead on infection control for Halton PCT, works with the Royal Institute of Public Health (RIPH) to build knowledge and practical understanding of infection control methods in social care settings.
“What you have to understand is that infection control in health care is so much more than just cleaning up our hospitals. There are over 1 million people employed in other areas such as children’s services, residential and nursing homes, private care agencies, and domiciliary care as well as the local authorities, ” she explains.
“Given these figures it’s obvious that the focus must be on these community health settings as well as the NHS, when we consider infection control. We know that health and safety training is mandatory in social care organisations and some have developed partnerships with their local authority for more specialist training. But when it comes to infection control the picture is much more patchy. At best, they may have an informal arrangement with a local PCT or health protection unit. For such an important issue this is just not good enough. Don’t forget that over the past 10 years there has been an explosion in the number of private companies in this field employing staff with little or no knowledge of infections such as MRSA or Clostridium difficile.”
It is to tackle this area of need that the Royal Institute of Public Health has introduced a new qualification aimed at this group of workers. The Award in Decontamination in Health and Social Care Settings reflects national occupational standards requiring an understanding of infections in healthcare settings and how they are spread, enabling care workers to maintain a clean and safe environment.
RIPH believes it is vital that staff who work in the thousands of care homes, GP surgeries and other health and social care settings understand the risks to themselves and the people for whom they care if standards of cleanliness are not properly upheld. And employers in these areas are painfully aware not only of the serious threat to people’s health, but also of the damaging legal action that can result from low standards of cleanliness.
So whether you work with highly trained professionals or less experienced newcomers to the health and social care sector, it is vital to give them the tools for the job. Health and safety legislation makes employers responsible for giving their staff adequate training, and this must now incorporate training in the field of hygiene, decontamination and infection control.
Dr Alan Maryon-Davis, chair of the Royal Institute of Public Health concludes: “This topic is high on everyone’s agenda, but staff are not always aware of the basics regarding cleanliness and hygiene – it has to be taught. And employers need to be assured that their staff have achieved the necessary standards of knowledge and practice. We believe that our new qualification gives employers in health and social care settings a reliable benchmark in maintaining good hygiene and controlling infection.”
Anyone interested in offering this qualification should contact Tony Varey at the Royal Institute of Public Health on 020 7580 2731or visit www.riph.org.uk.
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