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    Everything you ever wanted to know about hospital housekeeping

    May 1st, 2007

    by Nick Jacobs

    As a first time hospital president, it was clear to me that I could not tolerate a business as usual environment. My background had included visits to plenty of hospitals that allowed me to see blood on the walls in the patient’s rooms, filthy corners, stairwells, and waiting areas with waste baskets running over, cigarette butts at the entrance ways and infection rates raging at around 10% or above. For the most part, it was not because of a lack of pride. It was because of accepted standards, history, and tradition. It was about mediocrity. It was about doing it the way it had always been done.

    When you enter many hospitals, you feel fortunate if you are overwhelmed by the smells of disinfectants. At least it smells as if someone is trying to clean the place. You feel lucky if you don’t see fluids on the curtains or walls, and, if you don’t get an infection.

    What do you look for in clean hospital? What questions can you ask? Well, here’s the drill. There are several very important extra steps that can take place. The first thing in the morning, the public bathrooms are thoroughly cleaned. This gives the patients time to eat breakfast before the housekeeping staff begins to clean their rooms. Having said this, however, since they are the focus of the entire hospital, the patient rooms and operating rooms are the priority for the staff.

    The patient rooms are done every single day; the window, windowsills, floors, tables, telephones, telephone cords, restrooms, end tables and bed trays are sanitized. The staff uses disposable wipes for each room so that the tools used to wipe up and clean up one patient room are used only once. This ensures that each room is getting it’s own cleaning equipment. It’s more expensive, but much safer for the patients this way.

    The water in the staff’s cleaning bucket is changed for every room. To ensure cleanliness and to protect from infection, any blood or bathroom accidents are handled as soon as the staff is made aware of it. If any rooms need any type of maintenance or work performed, the housekeeping staff will contact the maintenance department immediately to get the problem fixed.

    Staff is always on the lookout for exposed needles in patient areas to ensure everyone’s safety. They also check out the floors for paperclips because these little organizational tools can cause slips and falls on the floor. Further, they are very careful that any hazardous waste material is disposed of properly every time to ensure safety from infection.

    Most importantly, when possible, they also have an important roll in taking care of the patients themselves. If they are doing their cleaning, and the patient needs a pillow, wants propped up in bed, needs a drink, or whatever non-medical request they might have, the housekeeping staff will do all that they can to help.

    If it’s a medical task; they will find the person who can help the patient. Some of these requests may seem beyond the realm of a typical job duty, but if the request is valid, they will go far beyond the norm. For example, if the patient has spilled some food or drink on their personal items, the housekeepers will even wash those items for the patient. Further, they will then return it to them pressed and cleaned. (Obviously, to avoid spread of infection, any blood borne pathogens are not included in this extra service.)

    Comments, Pingbacks:

    Comment from: Geoff Teed [Visitor] · http://www.mdparadigm.com
    Nick,
    I like that you make housekeeping a priority. It also appears that you involve your staff in the patient experience. I wonder if some issues with cleanliness in hospitals and increases in infection rates have anything to do with the metrics by which housekeeping is measured?
    1)appearance - does the hospital look clean?
    2)frequency - do they clean daily?
    3)congeneality - were they polite?
    4)responsiveness - room turnover time
    These are all seemingly important unless it means spending less time on surface cleaning (much of the source of MRSA) to meet aggressive/unrealistic response times -as a result of headcount reductions - which can cause an increase in infection rates.
    In some hospitals the overnight housekeeping staff is assigned to burnishing the floors b/c shiny floors give the impression of cleanliness.
    Permalink 05/02/07 @ 15:06
    Comment from: Nick Jacobs [Visitor] · http://windberblog.typepad.com
    Dear Geoff,

    All I can tell you is that, in a country that averages 9 percent infection rates, for over seven years, our infection levels have averaged 1 percent or below. The secret is? Pride, commitment, experience, and the fact that many of our housekeepers are related to, friends with or know many of the patients. Consequently, they don't want them to get sick because of anything that they personally do.
    Permalink 05/03/07 @ 01:20
    Comment from: Geoff Teed [Visitor] · http://www.mdparadigm.com
    The realtionship between job performance and infection rate isn't always communicated unfortunately.
    I can see you are an enlightened CEO. What % of hospital CEOs do you believe have your passion for patient-centeric care and what % do you feel could benefit from imitating many ofthe simple fixes you've already addressed?
    As a Planetree hospital you have probably seen the clinical, financial and operational benefit of delivering clinical excellence. Do you have an estimate of the cost and LOS difference between 1% & 9% infection rate?
    Imagine if all hospitals could boast an infection rate of below 1%.
    I agree also that professional pride plays a part but I also believe you provide a culture of excellence which educates and supports your caregivers.
    Congratulations to you on your impressive performance.
    Permalink 05/07/07 @ 15:43
    Comment from: CJ [Visitor]
    What is an exceptable hospital bed clean time? In other words, how long should it take for a housekeeper to clean a Med/Surg room?
    Permalink 08/13/07 @ 18:17
    Comment from: steve krautscheid [Visitor] · http://tuality.org
    The question came up again regarding whether or not the small paper recycling bins at the desk need to be UL approved. Does anyone know?
    Permalink 09/17/07 @ 18:56
    Comment from: K [Visitor]
    I begin work at a hospital soon and I am looking for more information as to how standards are in housekeeping. I really look forward to the job I will be performing but I want to make sure I can do everything I can to prevent the spread of infection. Please email me If you Believe you may have important insight for me. blue_belle1986@yahoo.com
    Permalink 09/25/07 @ 14:54
    Comment from: Kent L. Miller, CHESP [Visitor] · http://www.mercycare.org
    Excellent display of knowledge on healthcare important of the housekeeping departments strategic role in patient safety. Our infection rates are real low as well. I educate our EVS staff in how they are involved in the Qaulity of the hospital through their significant work here. Our patient satisfaction has increased to 98% with the HAI rates low.

    We expect our staff to spend 30-35 minutes cleaning a discharged patient room. A lot of this is based on cleaning the bed from top to bottom, walls, glass, cabinets, bathrooms total cleaning, etc.
    Permalink 10/05/07 @ 22:55
    Comment from: linda y ward [Visitor] · http://housekeeping
    just wanted to let you know from 9thfloor psrs what a great job linda did on sat 10-23-99. we have a lot of housekeepung that do a good job. but none compare to linda. she just kept on moving. we gave her a free dinner to show our appreciation. yet..we also wanted to let you know,what a great employee you have under your belt. she knows her job well and does a magnificant effort ti get things done. she certaintly made our day easier with all of her help ...thanke... 1-517-541-0553
    Permalink 04/21/08 @ 14:15
    Comment from: Mike Gunderson [Visitor] · http://www.negaardenterprises.com
    Dear Nick,

    Great information about the importance of cleanliness in hospitals. I hope people are seeing this.

    A big area of importance that my customers express is floors. Floor care can have a big impact on the impression people have of your facilities cleanliness. In addition, ensuring that contaminants are not transferred from one room to another during the cleaning process is extremely important.

    Floor care is costly and it can take away from a hospital staff's focus on cleaning. Just keeping up with floors is a challenge for most facilities where it is often very difficult to get into patient rooms, O.R.s and emergency rooms to properly maintain the floors.

    Ultra-durable, water-based urethane is a great alternative to traditional acrylic wax finishes. The product I offer to my customers gives them a durable, high-gloss finish that does not require routine buffing or burnishing, is highly resistant to stains and abrasion, and is easy to clean with often no more than a clean, wet microfiber mop that can simply be changed from room to room.

    Water-based urethane minimizes a facility's use of water and reduces or eliminates the need for chemicals used for cleaning and stripping floor finish which improves your environmental stewardship.

    If you or your readers have any interest in taking the pain out of floor care, reducing your long-term costs and being a better steward of the environment, visit www.negaardenterprises.com for more information or call 800-722-2998.

    I look forward to reading more.
    Permalink 05/20/08 @ 00:39

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