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Winning the fight against HCAIs

01 October 2013

Kay Timms, the UK service delivery manager heading up In Depth’s healthcare division, looks at the importance of using specialised staff and equipment to reduce healthcare-associated infections (HCAIs)

The standard of hygiene and cleanliness in the healthcare sector is under relentless scrutiny. Healthcare-associated infections (HAIs) are estimated by the European Centre for Disease Prevention and Control (ECDC) to occur in nearly 4.1 million patients, and kill nearly 37,000 people in the EU annually. 

Common human pathogens, such as methicillin-resistant Staphylococcus Aureus (MRSA), Clostridium difficile, and noroviruses can survive for prolonged periods on hospital surfaces. The majority of these infections are preventable, particularly through keeping the environment clean and using well-designed infection control methods. Indeed, Office for National Statistics figures show deaths from MRSA fell by 20% from 364 in 2011 to 292 in 2012 and there were 1,646 deaths from C. difficile in 2012, down from 2,053 in the previous year.

Controlling the spread of healthcare-associated infections (HCAIs) is a priority for any healthcare provider, and keeping the environment clean is an essential weapon in the fight to minimise the risk of cross infection. 

Microorganisms that could cause disease are known to survive on inanimate ‘touch’ surfaces for extended periods of time. For example - bedrails, over-the-bed trays, call buttons and bathroom hardware – making it essential for this type of environment to be cleaned by specialist staff who are trained to comply with NHS guidelines on cleaning in healthcare environments. 

Protocols to prevent and control infection 

The Revised Healthcare Cleaning Manual (2009) is aimed at providing guidance on cleaning techniques and best practice advice on defining responsibilities, scheduling work, measuring outcomes, reporting and driving improvements. The regulations are supported by the Code of Practice for the NHS on the Prevention and Control of Healthcare Associated Infections and Related Guidance. Hospitals and healthcare environments need to demonstrate that they provide and maintain a clean and appropriate environment that facilitates the prevention and control of healthcare associated infections.


Cleaning operatives need to be trained to the highest level to meet the daily challenge of infection prevention and control whilst allowing health professionals to focus on delivering excellent patient care. The frequency, method and monitoring of cleaning must take into account the level of potential risk to patient safety posed by infections. Very high-risk areas, such as operating theatres and intensive care units, require an enhanced cleaning service, with specialist equipment and chemicals, operated by a dedicated team.

To prevent cross-contamination, disposable products, including gloves, aprons and mop heads, are recommended in isolation units. There is now a national colour-coding system in place for the NHS for hospital cleaning materials and equipment. This should be followed at all times by cleaners and is aimed at ensuring that these items are not used in multiple areas, therefore reducing the risk of cross-infection. 

Responsible contract cleaning providers who offer services in these types of environment, need to have an excellent knowledge of the regulations and train staff to comply within these guidelines, which will also form the basis of any infection control policies drawn up by the individual clinic or hospital.

We’ve noticed an increase in demand for reliable, expert cleaners in this environment. Having built up considerable expertise in this area over a number of years, we have now launched a dedicated healthcare cleaning division focusing on hospitals, dialysis centres, nursing and care homes, and dental surgeries.