Variation in hospital cleaning practice and process in Australian hospitals: a structured mapping exercise

Prof. Brett Mitchell1, Alison Farrington3, Prof Anne Gardner4, Dr Michelle Allen3, Dr Lisa Hall3, Prof Adrian Barnett3, Dr Kate Halton3, Dr Katie Page3, Prof Stephanie Dancer5,6, Prof Thomas Riley7, Prof Christian  Gericke8,9, Prof David Paterson10,11, Prof Nicholas Graves3 Ms Alison Farrington3

1Avondale College Of Higher Education, Wahroonga, Australia,

2Griffith University, , Australia,

3Queensland University of Technology, , Australia,

4Australian Catholic University, , Australia,

5Hairmyres Hospital, , United Kingdom,

6Edinburgh Napier University, , United Kingdom,

7University of Western Australia, , Australia,

8University of Queensland, , Australia,

9James Cook University, , Australia,

10Royal Brisbane and Women’s Hospital, , Australia, 11Wesley Medical Research, , Australia

Background: The purpose of this paper is highlight the variation of cleaning practices and processes in 11 Australian hospitals and to discuss the challenges this variation poses to the implementation of clinical trials and or changes to cleaning practice in hospitals.

 Methods: A cross-sectional study design was used to determine the cleaning practices and processes in hospitals participating in the ‘Researching Effective Approaches to Cleaning in Hospitals’ (REACH) study. A standardised data collection template and approach was used to collect information. Data collection activities included structured on-site discussions, a review of hospital practices and a document review of policy and procedural documents related to cleaning.

 Results: Variation in the auditing process used to evaluate environmental cleanliness, cleaning practices, products use, training and communication pathways available to cleaning staff were identified. There was also variation in workforce structure and responsibilities for cleaning.

 Conclusion: This paper is the first to describe variation in cleaning practices in Australian hospitals. The variation identified presents a number of challenges for the conduct of research and has important implications for both monitoring and standards for cleanliness. These challenges include implementing a practice change or cleaning study where hospitals have different processes, practices and structures.


Professor Brett Mitchell is a Professor of Nursing and Director of the Lifestyle Research Centre at Avondale College. He holds a honorary position at Griffith University and is the Editor-in-Chief of Infection, Disease and Health. Brett has over 100 peer reviewed journal and conference presentations. He is the Chair of an NHMRC committee revising the national infection control guidelines.

Teaching old dogs new tricks: a program to improve staff immunisation rates

Mrs Penelope Guerra1,2, Miss Annelise Plummer2, Mr Jonathan Chrimes2, Ms Lynette Hutchison2, Ms Susan McLellan1,2, Ms Pauline Bass1,2
1Alfred Health Staff Immunisation and Exposure Management Unit, Melbourne, Australia,

2Alfred Health Infection Prevention and Healthcare Epidemiology, Melbourne, Australia

Healthcare workers (HCWs) are at increased risk for acquiring vaccine-preventable diseases (VPDs), and immunisation of clinical staff in healthcare is therefore recommended and endorsed nationally. In 2016, we performed an audit of existing staff to determine vaccination status and inform development of a workforce immunisation program (WIP) at our large tertiary facility. The objective of this study was to determine if there were specific HCW groups with low compliance.

Two nurse immunisers were employed to provide a mobile immunisation service as a catch-up campaign (Jan-Jul 2017) and as an adjunct to an existing WIP. The campaign was developed to assess immunity of HCWs and to offer vaccination where appropriate. NHMRC immunisation guidelines formed the basis of the recommended schedule. Internal organisation targets were 95% and 75% for high- and low-risk departments, respectively.

1279 HCWs were assessed in 16 high-risk clinical departments, with 245 (21%) identified as having an incomplete vaccination record. Of these, 56% were followed up and immunised. 2565 HCWs were assessed in 50 low-risk departments, with 658 (26%) identified as having an incomplete record. Of these, 19% were followed up with immunisations. Those not encountered during the campaign (n=612) included: nursing (55%), medical (29%) and allied health staff (17%) were contacted with a request for review.
A significant proportion of staff spanning all clinical departments do not have complete vaccination records. While a mobile campaign successfully facilitates vaccination, additional methods for engaging non-immunised staff, particularly nursing staff, are also required.

Penny completed her nursing degree in 1999. Following then she worked in cardiothoracic nursing. She later developed an Infection Control interest, completing her Certificate in Sterilisation and Infection Control in 2006. She has been working in Infection Prevention for 11 years, currently employed at The Alfred. Penny is an expert Credentialed Infection Control Practitioner and an Accredited Nurse Immuniser with a special interest in Vaccine Preventable Diseases.

Career highlights include presenting at local and national conferences; co-authorship in a chapter on Infection Control and Asepsis; and the production of ‘Glen’s Story’ a story-telling video on the personal impact of HAI’s.