Cleanliness in aged-care environments is essential and requires a detailed approach from the ground up.
Residential and community aged care is already a huge business in Australia and it is estimated that it will grow by 25 per cent annually over the next five years. It is therefore unsurprising that organisations in this sector find themselves in the spotlight when it comes to the quality of service they can provide.
Thankfully, there is a growing awareness in the industry that cleaning is inextricably linked to quality of care and to perceptions of service delivery. Choosing the most appropriate cleaning materials and employing the correct methods is therefore an important part of aged-care management.
What some organisations are yet to realise though, is that cleanliness can also have a huge impact upon the health, well-being and safety of staff. Maintaining a clean environment is therefore not simply a consideration for facilities managers; it also needs to be on the radar of those responsible for occupational health and safety.
Whilst a comprehensive cleaning and maintenance strategy is required to maintain hygiene and safety standards from top to bottom, a good place to start is the floor.
Flooring has to withstand some tough treatment, not just from the constant walking about of workers, visitors and residents, but also from the movement of equipment such as beds and medical apparatus. It must be safe for all, minimising the risk of slips and trips, but at the same time cushioning and protecting from serious injury when accidents do happen. And with staff spending a significant part of often long shifts on their feet, flooring must also be ergonomically responsive, helping to ease repetitive stresses and strains.
To protect organisations’ investment and reputation, flooring in aged care facilities needs to be long-lasting, easy to clean and maintain and able to help prevent the spread of infection. To ensure premises provide a welcoming environment, design qualities are another important consideration.
Design with safety in mind
When designing a new facility, or extending or refurbishing an established site, flooring finishes should be chosen with cleaning in mind, especially if contamination with bodily fluid could cause infection to spread. Infection prevention and control teams can be useful allies; their expertise and knowledge can be tapped into for advice on the most suitable surfaces to install.
Impervious, smooth and seamless surfaces, which are slip and wear resistant, are often recommended, especially in areas where spills are likely to occur frequent. Carpets on the other hand, while providing a more homely feel, are much harder to disinfect. If soiling does occur, they should be cleaned with detergent and warm water, and then steamed. Vacuuming carpets with conventional machines can cause micro-organisms and pathogens to be recirculated back into the atmosphere, so the use of separate ducted systems or High-efficiency particulate absorption (HEPA)-filtered devices is recommended. If carpets are installed over hard floors, a documented local risk assessment should be carried out and a cleaning and maintenance program devised.
The following points should also be kept in mind:
- Coving between the floor and walls prevents accumulation of dust and dirt.
- Joints should be sealed to prevent build-up of dirt and damage due to water.
- Threshold matting placed near all external entrances will help capture excess dirt as people enter.
- Choose slip-resistant surfaces that are easy to clean in zones subject to traffic when wet, such as bathrooms and kitchens.
The importance of infection prevention
Controlling the spread of infection or viruses is vitally important in many areas of business, but it is even more crucial for health and aged care providers. People visiting or receiving treatment in these environments are already vulnerable to infection, so making sure that effective cleaning regimes are in place is essential. The two-fold benefit is that the health of people working in these premises is also safeguarded. This is important, too, because, after all, the organisation cannot function without them.
Keeping aged -care environments clean is a constant battle. There are so many opportunities for contamination and transmission. The threats from hands, surfaces and airborne pathogens mean that cleaning needs to be constant and meticulous. Infectious micro-organisms can enter the air through a variety of routes including sneezing, coughing, skin shedding, patient treatment and activities such as bed-making. Organisms such as MRSA (Methicillin-resistant Staphylococcus aureus), Colstridium difficile spores, VRE (Vancomycin-resistant enterococci) and Acinetobacter can also remain viable for months. Research has shown that improved surface cleaning and disinfection can reduce pathogen transmission.
Guarding against cross contamination
Infection control teams are increasingly requesting that neutral detergents and taurine-based products are used to clean floors – but these need to be applied by a machine to be truly effective. Operatives using conventional mops cannot put enough pressure on the floor to ensure total efficacy, whereas the thoroughness of machine brush agitation ensures neutral detergents work effectively. Brushes should be colour-coded to prevent cross contamination. Those made from materials such as poly-propylene are easy to disinfect and don’t harbour bacteria like natural fibres do. These are all crucial points to consider when selecting cleaning equipment, as are the speed and pressure at which brushes operate. Too much friction can cause burn marks to floors, so this aspect should be thoroughly researched before making purchasing decisions.
As well as ensuring all operatives are fully trained and equipped with the right equipment to clean each specific location, other ‘post-cleaning’ steps can prevent cross contamination. Micro-organisms thrive in warm, moist environments, and dust can enable them to become airborne, so the following advice should be followed for floor cleaning machines:
- After use, ensure all water tanks, both clean and dirty, are emptied
- Clean and rinse through both water tanks, squeegee assembly, blades and hoses
- Leave tanks open to air dry
- Wipe clean all outer surfaces.
Slips, trips and sound
Slip and trip accidents are another great concern in aged-care settings, with their potential to cause injury, generate additional care requirements, create significant extra cost including lost time, and provoke financial claims from those who have been hurt.
Textured, slip-resistant floor coverings should be considered for this reason. A 2011 UK study* found the use of such surfaces does not have an adverse effect on the ability to clean floors to a hygienic standard using conventional cleaning regimes.
By selecting battery-powered cleaning equipment, with no trailing leads, and machines that have the ability to leave floors clean and dry in a single pass, the risk of slips and trips can be further reduced. However, there are other, less obvious safety issues that also need to be considered, namely noise. Cleaning machines that do their job efficiently, safely and quietly are therefore preferable.
It’s clear that aged-care flooring needs to possess a wide range of attributes – but selecting floor materials is just the first step. The correct cleaning and maintenance methods will ensure longevity, maintain hygiene standards and improve service delivery. It will also safeguard the health and safety of an aged care company’s greatest asset – employees.
* Health and Safety Executive RR889 research report: Investigation of slip resistance and the hygienic cleaning of floors in hospital settings.
Fred Esterhuizen is national business development manager of Alphaclean, part of the Alphaline Group.Do you have an idea for a story?
Email [email protected]