Implementing a Systematic Process to Improve Environmental Cleanliness in Wards of CPH

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Abstract Summary
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Authors (including presenting author) :
Mui, J. H. C., Wong, R. K. H., Yeung, Y. M., Poon, Y F., Lam, J. Y. Y., & Yuen, C. W.
Affiliation :
Nursing Service Division, Castle Peak Hospital, Hong Kong Hospital Authority
Introduction :
Maintaining environmental cleanliness is an important priority of infection prevention and control, and standard of cleanliness will be seen as a reflection of the services qualities. 2014 accreditation indicated that some wards could improve environmental cleanliness; a ward cleaning program in the in-patient setting was implemented to uphold a hygienic caring environment for both service users and providers.
Objectives :
To evaluate the effectiveness of ward cleaning program in CPH
Methodology :
Taskforce on environmental cleanliness in wards was formed. A focus group was organized to identify root causes and to work out improvement plan. Improvement strategies were carried out, including conducting self-report questionnaire to raise staff awareness, performing ward rounds to alert the improvement areas, intensifying education on roles and responsibilities to frontlines, reinforcing importance of ward cleanliness and supervision through meetings with different ranks and with different disciplines, as well as establishing a communication platform for supporting services to introduce their cleansing services and for frontlines to voice their concerns. Three post intervention surveys were conducted to all wards of CPH in April 2017, February 2018 and March 2019 to evaluate the program performance. A diverse group of representatives was brought together to establish a survey team comprising service users and providers to provide an objective view of cleanliness. The national specifications for cleanliness in the NHS: a framework for setting and measuring performance outcomes was adopted with modifications. The 2017 and 2018 survey results were reflected to frontlines and Supporting Services. Subsequent cleaning arrangement and monitoring, in particular, items and rooms with low cleaning score were discussed. Two award ceremonies were conducted to establish processes for spreading and sustaining improvement over time.
Result & Outcome :
In 2017, 2018 and 2019, 23 wards of CPH had participated in the post intervention surveys. The average cleaning score in 2017 was 87.9130, in 2018 was 92.6261; and that for 2019 cleaning score was 96.1870. Paired t-test was used for analysis and the result of 2017 served as a baseline for comparison. There was significant improvement in cleaning score from 2017 to 2018 (mean= -4.71304, p=0.002), 2017 to 2019 (mean= -8.27391, p=0.000) and 2018 to 2019 (mean= -3.56087, p=0.014). As a whole, 15/23 (65.22 %) wards reported increased in average cleaning score for the year 2017/2018, 2018/2019 and 2017/2019. 25/46 (54.35%) survey items and 11/14 (78.57%) rooms showed improvements in average cleaning score. Results shown that the ward cleaning program is effective in improving environmental cleanliness in wards.

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