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Healthcare – the big reopening

26 April 2021

How will hospitals ensure that their premises are clean and hygienic when out-patients and visitors finally return in large numbers? Liam Mynes poses this question as the healthcare sector works towards reopening for business as usual.

To say that hospitals have had a turbulent year would be an understatement.

The healthcare sector was put on high alert during the first wave of COVID-19 in March 2020. And as case numbers rose throughout the country, wards began to fill up rapidly.

It became extremely difficult for healthcare staff to keep on top of this situation – particularly in intensive care units where demand for beds was high. As a result, many routine and non-urgent appointments were either cancelled or put on hold. And visitors were generally banned from entering hospitals altogether unless it was literally a matter of life or death.

Major obstacles

The healthcare sector has worked extremely hard to facilitate as many routine appointments as possible throughout the various lockdowns and tier systems. But COVID-19 restrictions and social distancing requirements have inevitably proved to be a major obstacle to normal services throughout the pandemic.

According to the Health Foundation, the NHS conducted two million fewer patient appointments in October 2020 compared with the same month the previous year. And there were seven million fewer face-to-face appointments conducted in the same month than there were in October 2019.

Meanwhile, accident and emergency departments fell empty all over the country for a variety of reasons. The fact that there were fewer cars on the road and that pubs and bars were closed meant there were fewer accidents taking place. Many patients also felt nervous about facing the potential infection risks that a crowded A&E department might pose. 

A&E attendances in January 2021 were in fact 38 per cent down on the same month the previous year. While this should have made life easier for staff, COVID-19 brought with it a whole new set of challenges. Infection prevention procedures and testing requirements resulted in patient flow rates being significantly reduced. In fact, only 78 per cent of accident and emergency patients were seen within a four-hour window in January 2021 compared with nearly 82 per cent in the same month the previous year. 

Mounting pressure

The NHS has now launched a series of public information campaigns designed to encourage people back to A&E and to seek help for non-COVID-19 conditions. It has also set targets for hospitals to reduce the backlog of non-urgent treatment. 

However, the disruption caused by the pandemic is likely to take many months to resolve. But people are already starting to trickle back to hospitals either to attend routine appointments, receive A&E treatment or to visit a loved-one.  

So pressure is mounting on hospitals to ensure that their facilities are clean, safe and virus-free. The healthcare environment is a difficult one to control, however. 

The vaccination appears to be taking effect in the UK and we are slowly working our way through the roadmap out of lockdown. But we are still at a critical point in the pandemic which means crucial messages such as the need for hand hygiene and social distancing need to remain front and centre of everyone’s minds.

Hospitals need to carefully manage the situation over the next few months by limiting patient numbers, continuing to enforce social-distancing measures and by putting up clear signage to spell out what is expected of patients. 

People will be asked to arrive exactly on time for their appointments rather than turn up early and wait around where they could compromise social distancing. Patient registration will be managed remotely via smartphones wherever possible to remove the need for paperwork to be handled by multiple people.

Marshalls may be posted at hospital entrances to ensure that all patients and visitors are masked and that they fully understand the protocols inside. And seats in waiting areas are likely to be spaced out to allow for social distancing, while plexiglass screens will be used to help shield the staff from patients and vice-versa. 

A&E departments in particular have to be carefully managed since these tend to be filled with frazzled, distressed patients who may have open wounds or whose immune systems are compromised. This puts them at a higher risk of infection than most.  And while waiting for an appointment, patients will have plenty of opportunities to pick up a virus from the doors, tables, chairs, counters and vending machines. Also the longer they wait, the more items they are likely to touch.

Out-patients and hospital visitors will also be occupying seats, pushing lift buttons and perhaps picking up a coffee from the concession stall. This means that they too will have multiple opportunities for picking up germs.

It is therefore vital that all patients and visitors are advised on the importance of hand hygiene and are given every opportunity to wash or sanitise their hands.

Hand hygiene

Hand hygiene is an important tool for us all – and it is particularly crucial for healthcare staff. According to the World Health Organisation (WHO), hospital staff need to routinely wash their hands before touching a patient, before carrying out any aseptic procedure, after exposure to any bodily fluid, after touching a patient and after touching the patient’s surroundings. 

But it is also important that hospital patients and visitors have ongoing access to hand washing facilities. 

The washrooms play a crucial role in delivering hand hygiene outcomes so these facilities should be accessible, clean, easy to use and kept well stocked with hand hygiene products at all times.

High-capacity systems that naturally reduce consumption will prevent the issue of product run-outs between maintenance checks. A high-capacity soap system such as the Tork Skincare Dispenser is a good solution because it can contain up to 2,500 shots of foam soap, more than double the number in a liquid refill of the same size. Besides ensuring a continuous supply of soap, the system is also particularly easy to use - even for the frail, elderly and patients with low hand strength.

Paper towels are usually provided in healthcare because they avoid the cross-contamination risks of textile towels and dry the hands more rapidly than air dryers. 
A high-capacity hand towel roll will provide a hygienic drying solution while preventing the risk of the product running out during busy periods. The Tork PeakServe® ContinuousTM Hand Towel works well because the unit holds up to 2,100 towels at a time. This means it is highly unlikely to run out between maintenance checks. 

Hospital visitors tend to be on the premises for shorter periods than patients and may not need to use the washroom during their visit. However, their hands will still need to be clean, which means the provision of plentiful hand sanitiser stations is crucial.

Hospital studies have shown that visitors are five times more likely to use a hand sanitiser dispenser when they enter the facility if it is prominently located in the middle of a hospital reception area rather than tucked away to the side. Essity makes recommendations to healthcare facilities on where to position hand sanitiser dispensers to increase usage by staff, patients and visitors. Besides the hospital entrance, these units should be situated on walking routes and in key positions near the entrances to nursing stations. 

Providing hand sanitiser in a unit such as the Tork Sanitiser Stand can further help to improve visitor hand hygiene. This is a highly visible freestanding receptacle that accommodates Tork Alcohol Foam Hand Sanitiser. The Tork Sanitiser Stand provides visitors with easy access to hygiene facilities in hospital reception areas and in other key sites.

Hospital cleaning and training

Hospital cleaning needs to be carried out carefully and methodically to minimise the risk of cross-contamination. Deep cleaning of “hot zone” isolation areas - where suspected coronavirus patients are treated – is already being rolled out in healthcare wards and A&E units. This involves taking down the curtains, dismantling the beds and cupboards and sanitising the entire space. And of course, all high-touch surfaces and washrooms need to be cleaned continuously – and in the right way.

Cleaners need to be schooled in the art of working from high areas to low ones to avoid dislodging any dirt, and they should be taught the science behind the need for starting with the cleanest areas first to avoid the risk of recontamination. At Essity we now offer a training package aimed specifically at healthcare cleaners.

Available in more than 15 languages, Tork Interactive Clean Hospital Training takes operatives through the entire process and incorporates a “train-the-trainer” module. This includes a mini-microbiology school dealing with the dangers posed by micro-organisms in the healthcare environment. 

Deep cleaning, robust training, careful management and a high level of vigilance are all crucial when hospitals reopen to more patients and visitors over the coming months. But these measures should also be backed up with good hand hygiene facilities and prominent signage reminding everyone why hand hygiene and social distancing are so important. Only then can we all experience a safe return to the healthcare environment.

Liam Mynes is sales manager at Essity

For more information visit tork.co.uk/cleancarehealthcare