The REACH trial: a real world study of hospital cleaning

Alison Farrington1, on behalf of the REACH study team

1 Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001

 

The Researching Effective Approaches to Cleaning in Hospitals (REACH) project is funded by an NHMRC partnership grant (GNT 1076006). The REACH study used a mixed-methods stepped wedge study design to evaluate the impact of a tailored environmental cleaning bundle in 11 Australian hospitals 2016-2017. Each participating hospital implemented the cleaning bundle with their ward cleaning staff, for a randomised period of between 20 and 50 weeks. Data collected on infection rates, thoroughness of cleaning, knowledge and attitudes of environmental services staff and costs of using the bundle are currently being analysed.

The study used an implementation framework to inform tailoring of the cleaning bundle at each hospital. The study team collected a range of situational and organisational information pre-trial to understand the real world context and the barriers and enablers to practice change at each site. Several challenges to using the cleaning bundle were identified at this stage; other challenges emerged through the implementation phase once hospitals commenced using the bundle. These early learnings included the identification of positive facilitation factors and provide insight into future management of cleaning practice change. Participation in a major research activity also provided some challenges with a need to constantly balance real world and research integrity requirements.