The Australian Council on Healthcare Standards (ACHS) is a not-for-profit organisation that is dedicated to quality healthcare across Australia. The National Safety and Quality Health Service (HSQHS) Standards give a consistent statement on the expected level of care from the health services in Australia.
In order for facilities to be accredited by these organisations, there are standards that must be met, and cleaning and hygiene play a large role in these. Cleanliness has a direct and immediate impact on patient safety in terms of infection control and, therefore, on your audit outcomes as a healthcare provider.
In a healthcare environment, there must be precision, specialised processes and strict documentation surrounding healthcare. Matthews Cleaning Company is well-positioned to partner with medical centres seeking compliant cleaning practices for the benefit of their patients and to ensure accreditation.
Core Cleaning Requirements for the National Safety and Quality Health Service (NSQHS) Standards
Particularly pertinent to us as a contract cleaning provider is NSQHS Standard 3 – Preventing and Controlling Infections. This requires medical facilities to ensure their systems prevent and control healthcare-associated infections by maintaining a hygienic environment.
Cleaning staff must have a strong understanding of evidence-based cleaning protocols, including hand hygiene, appropriate use of PPE and correct disposal of waste in order to break the chain of infection and protect all stakeholders (patients, staff and visitors to the facility).
In order to meet the standards set by the NSQHS, there is a requirement for the use of cleaning methods based on rigorous evidence. This includes the use of disinfectants approved by the Therapeutic Goods Administration (TGA) and recorded as hospital-grade. These provide the very highest level of hygiene, essential in healthcare settings.
Cleaning teams have clear roles and responsibilities set out by the NSQHS, and there is a requirement for this to be integrated with clear clinical governance. The physical act of maintaining a clean environment is important, of course, but there must be an accompanying paper trail. Administration of cleaning is vital to staying compliant with NSQHS standards, which is why at Matthews Cleaning Company, we adhere strictly to procedures aligned with criteria from the NSQHS and ACHS.
High-Touch Point and Terminal Cleaning Protocols in Medical Centres
High-touch points in healthcare settings include:
- Door handles.
- Stair rails.
- Reception counters.
- Chairs in treatment and waiting areas.
- Surfaces for clinical equipment.
It is expected that in certain zones of a healthcare setting, these will be cleaned multiple times daily, with each time recorded (see previous section for the importance of cleaning administration).
Terminal cleaning is a specific set of steps for disinfection after a patient has left an area, to prevent the spread of infection. There are mandated steps to follow after contact with a confirmed-infectious patient and at the end of clinical days.
Cross-contamination is a key issue in healthcare, so it is important that staff are all aware of colour-coding systems for cleaning equipment, the need for equipment segregation (especially in different zones of infection or at peak times of year for specific infections, e.g. norovirus) and the essential nature of PPE.
Infection Control: Disinfectant Selection and Dwell Time
In healthcare settings, there is a big difference between cleaning, sanitising and disinfecting. While all three matter, they are not the same and should not be seen as such.
- Cleaning physically removes the visible signs of dirt. It reduces the germ count on a surface but does not kill them. It is the vital first step before sanitising or disinfecting.
- Sanitising reduces the bacteria on a surface to a safe level – it is generally the level of cleaning required of a surface to be considered food-safe, but it may not kill viruses, making it only a mid-step for healthcare surfaces.
- Disinfecting kills bacteria, viruses and fungi (which covers most illness-causing germs). It is essential for high-touch surfaces in healthcare settings.
Disinfectants in healthcare settings must be chosen based on the type of pathogens they remove, meaning that different disinfectants will be required in different areas of the hospital due to the presence of different viruses, bacteria or bloodborne pathogens, for example. As previously mentioned, it is important for disinfectants to be sanctioned by the TGA in order to be used in healthcare.
Cleaning products come with vital considerations for the safety of staff and patients:
- Dwell Time: How long must the product sit on a surface in order to fulfil its full level of cleaning, sanitisation or disinfection? Timing products incorrectly results in ineffective cleaning and could lead to the spread of infection in a setting.
- Ventilation: If a product can only be used in a well-ventilated area, it may not be appropriate for use during the day on high-touch surfaces and may only be used as part of routine deep-cleans.
- PPE: What must cleaning staff wear to protect themselves from the chemicals present in their cleaning products?
- Dilution Control: Are all staff aware of safe ratios of product to use in different areas?
At Matthews Cleaning Company, we pride ourselves on our rigorous selection of chemical cleaning products for healthcare settings, and on ensuring that our staff are trained to ensure good knowledge of appropriate product application.
Documenting Cleaning Audits for Healthcare Compliance
We have already touched on the importance of documentation for accreditation and patient safety. Typically, a healthcare cleaning audit will comprise checklists, verification logs of cleaning routines, photographs of areas and records of corrective actions taken since the last audit. Essentially, every cleaning action in the setting must be traceable: there must be a record of tasks undertaken to prove that every area and surface within it is clean.
Matthews Cleaning Company uses audit-ready documentation processes that aim to support our healthcare clients through the process of ACHS audits, streamlining the process of recording and reporting to show complete transparency to auditors.
Conclusion
Cleaning in the healthcare sector is specialised and necessarily governed by strict processes and standards to ensure patient safety. In order to succeed under NSQHS Standards and ACHS audits, your setting must have thorough and evidence-based cleaning practices as well as rigorous and transparent reports of its regular undertaking.
At Matthews Cleaning Company, we are a trusted partner to many healthcare settings, supporting them to deliver their services and meet the exacting standards necessary in their sector. Contact us to review your current practices and see how Matthews could support your needs for your next audit.