Association of Healthcare Cleaning Professionals

Recommended “Activity” Related Minimum Cleaning Frequencies

- a best practice document
Edition five March 2005

FOREWORD

This fifth update of the AHCP (Association of Healthcare Cleaning Professionals) Recommended Minimum Cleaning Frequencies has been undertaken as a direct response to the “Towards Cleaner Hospitals” initiatives. It incorporates previous guidance on Frequencies but has been completely re-written by a Team of AHCP members to follow the most recent update of The National Standards for Cleanliness.

We welcome feedback which should be directed to us via any of the normal methods of contact.

INTRODUCTION

The work is intended to serve as a guide. Local practices will dictate how these cleaning frequencies are applied.

The Frequencies indicated should achieve a minimum of

(i). PEAT score of 4

(ii) National Standards of Cleanliness upper quartile

They are intended, as the name states, as an absolute Minimum requirement

This document is intended to be used in conjunction with the Standards for Environmental Cleanliness in Hospitals (AHCP/ICNA) and with subsequent NHS Estates guidance to meet the requirements of:-

• Audit Scotland
• Clean Bill of Health (April 2000)
• NHS Plan (July 2000)
• NHS Plan - Scotland (December 2000)
• NHS Plan - Clean Hospitals (November 2001)
• NHS Scotland CSBS (Scotland) HAI Review (date)
• National Standards for Cleanliness (NHS Estates 2003/4)
• National Cleaning Manual (NHS Estates 2004)
• Towards Cleaner Hospitals (2004)

The Team considers that whether conventional or new technology methods (e.g. Microfibre) are used the same frequencies should apply.

Please note that throughout the document where the word “Trust” appears it also includes/implies “Division”

Best Practice would also normally include a rapid response team approach.

Managers of Mental Health Trusts will have to consider the differentl needs of their environment. For example service users spend as much time in Day Rooms as Wards/ bedrooms and local frequencies will almost certainly be higher. Smoking areas are also a special requirement for this type of unit. Carpet cleaning may also need to be increased.

FUNCTIONAL AREA RISK CATEGORIES

(Ref National Standard of Cleanliness 2004)

Very High Risk

(Includes departments where invasive procedures are performed and would also normally include isolation areas).

Operating Theatres/ Aseptic
ITU/ICU/HDU/SCBU
High Risk Patient
Renal Unit
Transplant Unit

High Risk

Sterile Supplies
Accident & Emergency
Pharmacy
General Wards / CCU/ ECT
Day Hospital
Day Rooms
All Public areas including thoroughfares and toilets

Significant Risk

Laboratory
Out Patients
Radiology
Mortuary
On-Site Laundry
All areas where levels of hygiene and aesthetics are of significant importance

Low Risk

Administrative Offices
Meeting Rooms
Library
Central Stores
Chaplaincy
Retail Areas
Staff Accommodation

DEFINITIONS

Full Clean

A full clean is where all aspects of the element are fully cleaned on each occasion (as indicated in national cleaning manual)

Check Clean

A check clean is where the operative makes an observational check of all aspects of the element. Where they observe aspects of the element that are not up to the required standard they clean those aspects only. The outcome is the same as full clean i.e. the whole element is cleaned to the national standard.

Frequencies

Fundamentally how often you need to clean is governed by how often the element gets dirty i.e. the less dirty (used) it gets the less it needs to be cleaned to maintain an acceptably high standard.

There is a relationship in a healthcare environment between “activity” and the size of the establishment. A simple example:- if you have the same number of people who have to wash their hands and there is either one handwash sink or two handwash sinks, one will need to be cleaned more frequently.

Applying that principle to a whole organisation means that there needs to be an increased cleaning specification for a trust that has a higher “activity” per metre² than a trust that has a lower activity per metre². This does not necessarily mean the bigger the environment the higher the frequency needed.

Three levels of frequencies have been created to support three bands of “activity” per square metre, which are then applied to all elements and risk categories in the following tables.

To identify your organisation’s “activity” level a simple calculation should be carried out as detailed in Calculation 1 and assimilated using Table 1.

With the every changing use of the health care properties, this should be completed at the beginning of every year to ensure the right frequencies apply.

Calculation 1

(BD+OPD+A&E)
OFA

Where:

(BD) Bed days
(OPD) Outpatient attendances
(A&E) Accident and Emergency attendances
(OFA) Occupied Floor Area (m²)

Using this calculation you will arrive at a score of between 2 and 11 which will assign you to a band of “activity” in Table 1.

Table 1

Your score will be Trust wide and you will have to apply your local knowledge to vary this for specific areas (see note on Mental Health above). For example, a ward where patients are primarily in bed will have different needs for cleaning of bathroom/toilet areas than a ward where patients are mobile.

Please now refer to the .pdf Minimum Cleaning Frequencies by selecting from the list below to find the appropriate frequencies for your site.

Very High Risk  

High Risk           

Significant Risk 

Low Risk            

NOTE: Unfamiliar with ? READ THIS FIRST

Further guidance can be sought from

Penny Harrison at AHCP