Infection control – in a hurry

THE STATISTICS make for scary reading. Data from NHS Digital show that 15,000 nurses resigned from the health service in the year to March 2022.

More than a quarter of those exiting the profession - around 4000 - cited work-life balance as their reason for making the move.

And the same study revealed that NHS staff in general are in fact now three times more likely to resign from their roles due to work-life balance issues than they were a decade ago. 

The future is looking similarly bleak: one leaked document published in The Guardian indicates that NHS staff shortages in England could exceed 570,000 by 2036. It seems that the global pandemic coupled with the cost-of-living crisis has played havoc with the employment situation in the medical profession.

As a result, hospitals are facing huge pressures due to having fewer staff members who are expected to fulfil a growing number of appointments for an increasingly ageing population.

The need for speed

Speed is always of the essence in healthcare because medical staff will often need to act quickly to treat accident and trauma victims in a timely fashion to ensure positive outcomes. Cleaning teams, too, will be required to work swiftly and efficiently to clean up spills. Bodily fluids always have to be cleaned up rapidly to prevent any potential spread of infections and viruses, while all surfaces need to be wiped down immediately after contamination by an infectious patient.

But speed needs to be balanced with efficacy in healthcare because infection control is of paramount importance in this sector - and should never be compromised.

Healthcare staff have been required to work harder than ever since the COVID-19 pandemic to avoid further outbreaks. Protocols have come under greater scrutiny and cleaning teams have needed to be extra thorough.

Scrupulous hand hygiene is widely regarded to be a pivotal step in reducing the risk of contamination. According to the World Health Organisation (WHO), staff need to routinely perform hand hygiene before touching a patient, before carrying out any aseptic procedure, after any exposure to body fluid, after touching a patient and after touching the patient’s surroundings. 

WHO also states that a healthcare worker’s visibly-soiled hands should be washed with soap and water for between 40 and 60 seconds and then thoroughly dried to ensure a complete clean. If the hands are not visibly soiled, an alcohol gel may be used instead for a period of 20-30 seconds.

So in other words, meticulous surface cleaning and thorough hand hygiene are both crucial if infections are to be avoided in healthcare. But how does a shrinking body of staff manage to achieve these goals without cutting any corners? When healthcare staff are working long shifts and looking after scores of patients, do they actually have the time to wash or sanitise their hands for up to a minute? And is there any way of speeding up the process?

Hand hygiene 

Hand hygiene can never be skimped, according to WHO. However, efforts can be made to make the process easier and more convenient for healthcare workers. 

For example, hand washing and sanitising products can be placed in prominent positions on walking routes, and all dispensers for soap and paper should be designed to be quick and easy to use. It is also crucial that they are kept well stocked at all times and are easy to refill to help speed up the cleaner’s work.

Soap dispensers should have a high capacity and require a low push force to access the soap inside. Paper towel dispensers should provide a long-lasting supply to prevent run-outs and reduce the number of cleaning checks required. Here it is also important to equip wash stations with dispensers that speed up access to the towel inside to save precious time.

For example, dispensers for folded towels that have a low capacity will run out too quickly, forcing the healthcare worker to waste valuable seconds trying to locate a towel elsewhere. Cleaners in charge of refilling these units may decide to compensate for this lower capacity by “over-stuffing” dispensers with more towels than they should hold. This makes it difficult for the user to pull out a single towel from the bottom, causing frustration while also wasting valuable seconds.

Roll towel dispensers tend to offer a higher paper capacity than folded towels, but some models are prone to jamming. For this reason, all hand towel dispensers in a healthcare unit should function efficiently while also being kept constantly topped up and offering a high capacity of towels. 

According to WHO guidelines, hand washing may be replaced with sanitising in situations where the hands are not visibly soiled and where there is no time to wash or where soap and water supplies are not available. 

Busy staff should not have to waste time walking to and from a dispenser, however, so hand rubs should be made available wherever they are needed. And in fact, studies have shown that the number of sanitiser dispensers supplied is less important than where they are positioned. 

According to one study, optimising dispenser placement can increase usage by more than 50 per cent whereas simply increasing the number of dispensers has a much lower impact on usage. Tork has issued a guide to optimum sanitiser dispenser placement at hospital entrances, at nurses’ stations, in a single bed room and on a four-bed ward.

Surface cleaning and training

Surface cleaning is also vitally important in any healthcare setting, but cleaners will work more quickly and effectively if they have been taught how to sanitise all patient areas in the most logical and hygienic way possible. They should understand the order in which surfaces should be cleaned along with the importance of using different cloths for each task to avoid cross-contamination. And all training should be easy to understand, intuitive and take into account the fact that English may not be the trainee’s first language.

Essity’s Tork Interactive Clean Hospital Training takes staff through various real-world cleaning scenarios in a virtual hospital. It incorporates modules on daily cleaning in occupied patient rooms as well as discharge cleaning protocols. 

The cleaner is first reminded to wash their hands and don PPE before entering the room to be cleaned. Each step of the process is then addressed from picking up debris, emptying the bins and wiping down refuse containers before moving on to other tasks. 

Infection control in healthcare environments

There are a number of other ways in which infection control could be made to become more efficient in UK hospitals in the not-too-distant future. Last year it was announced that researchers had created a tool designed to help identify those patients most at risk of developing COVID-19 while in hospital. The AI employed in the tool is trained to identify risk factors such as age, gender, contacts with other infectious patients, where beds were situated and how patients move around the hospital.

In February this year is was announced that the NHS had signed a £20m deal to allow it to better manage the spread of infections with the aid of technology. The contract – awarded to US-based healthcare giant Baxter –will allow NHS trusts to buy a comprehensive infection-control software platform enabling it to collect and process data alongside spreadsheets and paper documents.

And in May this year a new app was launched aimed at helping to tackle the current NHS staffing crisis. Florence for Business allows care homes, NHS trusts and domiciliary care providers to populate staff rotas and schedules via a clear and flexible tool. Managers have access to more than 90,000 workers, carers and support workers and are able to fill shifts directly from the applicant pool.

The infection control conundrum is proving difficult to solve during a major staffing crisis when the NHS is virtually on its knees. But with the aid of technology, innovation, training and practical systems, the issue can be tackled effectively which means outcomes will ultimately improve.

Liam Mynes is sales manager at Tork manufacturer Essity.

For more information visit tork.co.uk/cleancarehealthcare