Cleaning protocols for infection prevention

3D virus cells attacking a DNA strand
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Delia Cannings, Chair of the British Cleaning Council, discusses the importance of implementing and respecting robust cleaning protocols across different settings and why the UK Government must do more to make cleaning and hygiene a core part of the national agenda

The British Cleaning Council (BCC) is the authoritative voice of the UK cleaning, hygiene, and waste industry. This sector is worth nearly ÂŁ60bn and employs 1.47 million people, making it one of the ten biggest industries in the country.

The council’s membership consists of 21 trade and membership associations from across the sector. One of our key aims is to fight for recognition of industry staff who perform a skilled and professional frontline role, protecting the safety and wellbeing of others and contributing to the nation’s health and wealth.

A number of infections can spread via surfaces, including flu, hepatitis A, Shiga Toxin-producing Escherichia Coli (STEC), and norovirus. Cleaning, along with other measures such as regular handwashing, is an important tool for helping control these infections.

To be effective, all cleaning staff need to know the differences between cleaning and disinfection, which products they should use and how to measure, dilute and dispose of solutions correctly. Policies, procedures, risk assessment and cleaning schedules must be up to date and reviewed regularly.

Adherence to other key industry standards, such as using colour-coded equipment and the safe and correct use of PPE, is crucial. Documented training and development of cleaning staff is essential, as is refresher training.

Cleaning protocols for different settings

Many people feel they are experts in cleaning because they clean at home; however, professional cleaning is the application of scientific knowledge in a practical capacity. This is reflected by a number of recognised industry qualifications, such as the Level 2 Cleaning Hygiene Operative Apprenticeship, which assesses staff on their knowledge of the correct cleaning protocols to use to prevent the spread of infection. The precise regime to be used depends on the setting and the circumstances. Cleaning protocols in a hospital or the kitchen of a restaurant will need to be more stringent than in a normal workplace setting, for example.

In a typical workplace, regular cleaning with detergent and water is usually all that is needed to prevent infections if carried out correctly by trained operators, as it removes most of the germs that can cause diseases. A comprehensive cleaning regime would specify the frequencies of cleaning and may suggest a disinfection product or the use of steam for weekly and periodic cleaning. Sanitary areas and kitchens in these workplaces usually require the use of a disinfectant since the risk of contamination is higher. However, if there were an outbreak of infection such as norovirus, then an overall stricter cleansing regime would be required, with measures such as more frequent cleaning of key touch points such as door handles.

In healthcare settings, best practice for infection control begins with a robust induction programme for new starters based on the National Standards of Healthcare Cleanliness 2021. Risk categories are determined by functional area, and cleaning frequencies are applied accordingly. Training is essential to ensure the functional risks are known and must be linked to the NHS Trust’s own cleaning protocols and disinfection policy.

Staff across disciplines are encouraged to understand and embrace multidisciplinary links, and the responsibility matrix enables a clear view of who is responsible for what aspects of cleaning.

For example, although it varies across NHS Trusts, patient bed cleaning is often divided between two disciplines: the clinical staff are responsible for the mattress, and the cleaning staff are responsible for the bed frame.

Multi-disciplinary teams must own their cleaning responsibilities to support the best possible outcome on audit. Hospitals are now measured with star ratings, which provide easy, at-a-glance reassurance to users regarding the cleanliness of the environment.

The role of cleaning staff in keeping others healthy, safe, and well was never more evident than during the COVID-19 pandemic. Research has confirmed that the virus could persist on hard surfaces, highlighting the importance of cleaning to prevent transmission. Across the country, enhanced cleaning protocols were introduced in public spaces, and research has shown that the public felt more confident in those spaces when there was evidence that they were hygienically clean.

Despite being on the frontline during the pandemic, cleaning staff did not qualify as key workers. The sector and its staff have been overlooked by the powers that be in other areas.

Driving a national agenda for cleaning and hygiene

The importance of the role of cleaning in protecting people’s health was reflected in the 2022 paper Embedding Effective Hygiene for a Resilient UK. The insightful and excellent report from the sector’s All Party Parliamentary Group made a number of recommendations to the Government that would put cleaning and hygiene at the heart of the national agenda in order to limit the spread of common infections and make sure the UK is better prepared for future public health emergencies.

Despite backing from across the sector and the Royal Society for Public Health (RSPH), I am disappointed to report that the Government has not listened.

The sector has also been hard hit by staff shortages, with many overseas colleagues returning home following Brexit. Changes in immigration status have also had an impact, and this continues to mean cleaning staff are often stretched while trying to cover the gaps and maintain high standards. No help has been forthcoming from the Government on this issue either.

Misinformation about the role of cleaning in controlling infections has, at times, been a significant issue. During the COVID-19 pandemic, unscrupulous traders sprang up offering services such as misting and fogging to tackle the virus, but with limited evidence to support these claims. Con artists sold counterfeit hand sanitisers.

If cleaning and hygiene were put at the centre of national policymaking as it deserves, then it would be easier to prevent this kind of misinformation and probably help save lives in the process.

We are not out of the woods yet. Are we ready to react should another outbreak occur? We have work to do, and we must stand together. Unity is strength.

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