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Improving environmental cleanliness of a paediatric intensive care unit (PICU): Successful co-creation of a targeted,
1Faculty of Health, Science, Social Care and Education, Kingston University, London, UK.
Insights
Implementing targeted education and audits improved clinical cleaning standards in a pediatric intensive care unit (PICU). This quality improvement project fostered staff commitment to environmental cleanliness, demonstrating a scalable approach for healthcare settings.
Area of Science:
- Healthcare-associated infection prevention
- Clinical quality improvement methodologies
- Antimicrobial stewardship
Background:
- A clean healthcare environment is crucial for antimicrobial stewardship and sustainable healthcare delivery.
- Clinical staff play a vital role in maintaining environmental and medical equipment cleanliness.
Purpose of the Study:
- To enhance clinical cleaning practices within a high-acuity pediatric intensive care unit (PICU) at a tertiary referral hospital.
- To implement and evaluate an educational quality improvement (QI) initiative focused on environmental hygiene.
Main Methods:
- An educational QI project utilized opportunistic and targeted one-to-one training for clinical staff.
- Weekly cleaning audits were performed and correlated with monthly bed occupancy data.
- The Plan-Do-Study-Act (PDSA) cycle guided monthly reviews of interventions, outcomes, and impact.
Main Results:
- Key improvements were identified in formal and informal cleaning training delivery, including knowledge transfer to new staff.
- Audits pinpointed specific cleaning 'hotspots,' which were then addressed through targeted interventions.
- Multi-modal interventions, delivered by Infection Prevention link nurses and a Clinical Auditor/Educator, successfully established and sustained high ward cleaning standards.
Conclusions:
- Co-creating cleaning interventions fostered a supportive environment, leading to high staff understanding and commitment to environmental cleanliness.
- The implemented approach is scalable to other hospital areas with appropriate support from Clinical Educators or Infection Prevention Nurses.
Background:
A clean healthcare environment is the foundation of both antimicrobial stewardship and delivery of sustainable healthcare. Clinical staff are responsible for cleaning medical equipment and some aspects of the healthcare environment.
Aim:
To improve the clinical cleaning on a busy PICU in a tertiary referral hospital in England.
Methods:
This was an educational continuous Quality Improvement (QI) project using opportunistic and targeted one-to-one education and training for clinical staff. Cleaning audits were conducted weekly throughout the study period and the results mapped against monthly bed occupancy data. The PDSA cycle (plan, do, study, act) was used to review actions, outcomes, and impact and consider further work every month by the study team.
Results:
Key themes emerged for improvement around the training delivered on cleaning, both formally through mandatory study days and informally through the cascade of knowledge to new starters. The cleaning 'hotspots' identified via audit and how these were communicated to the team were also targeted. The multi-mode interventions, delivered by both Infection Prevention link nurse unit staff and a Clinical Auditor/ Educator, were successful in building and maintaining excellent cleaning standards within the ward.
Discussion:
Co-creation of cleaning interventions enabled a supportive environment to be developed with staff demonstrating a high level of understanding and commitment to environmental cleanliness. This approach would be scalable across multiple areas of the hospital with the short-term support of a Clinical Educator or Infection Prevention Nurse.
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