Posted June 07, 2013

Improve Patient Safety and Increase Quality Care: A Focus on Cleanliness

By Don Dean, BSRT

In the eyes of our patients, a clean hospital is more than just mopping the floors and taking out the trash. It can mean the difference between being discharged early and remaining in the hospital longer due to an infection. Due to the growing number of news reports about hospital acquired infections, our patients are familiar with what is expected and acceptable in our hospitals. And the perception of cleanliness isn't limited to just the patient's room and bathroom. The entire hospital is taken into consideration.

We have the opportunity to bring cleanliness and safety to the attention of our patients. After all, our patients have a lot on their mind when they are in the hospital. They are here because they are sick, hurt, need surgery or maybe they are a family member visiting a loved one. They may be worried about who will feed their pet, how they will pay their bills or how to let their employer know they won't be at work tomorrow. One way can ease those uneasy feelings is to reiterate that their safety is our top concern and we are working to create and keep a clean environment; which may lead to them going home sooner.

The importance and focus on hospital cleanliness and patient safety are not contained to individual patient rooms or just environmental services. Each of us has the opportunity to truly live the values of our organization and the Standards of Behavior. If we see trash in the hallway or a spill on the floor, it's our human responsibility as healthcare workers to take that extra time to clean our hospital. Think from the point of view of our patients. If you arrived to your ER, already sick and scared, and saw overflowing trash cans and dirty hospital floors, would you want to stay to receive care?

When we at Studer Group work with organizations to implement tools and tactics to improve the cleanliness of their hospital, we make sure to start with connecting back to why a clean environment is so important. It's important that our environmental services staff, and really all staff, understand the importance of the work they do. It ties back to patient safety.

One of the main tactics we teach that assists with showing our care and concern is to use AIDET® and Key Words at Key Times. Below is an example of practicing AIDET® (which stands for Acknowledge, Introduce, Duration, Explanation and Thank You) and key words when interacting with patients.

Ask permission to clean. Knock on the door before entering and speak to the patient before you begin cleaning. "Good morning, my name is Ben and I will be cleaning your room and bathroom today. It will take about ten minutes; is now a good time for me to clean? It's important to us that your room and bathroom are always clean."

In less than a minute, Ben was able to Acknowledge the patient, Introduce himself, Explain why he was there and how long it would take (Duration) and reiterate that the patient's safety is the hospitals (and his) top concern. Now as the patient, don't you feel more at ease knowing that you are receiving excellent care and in a safe environment?

Use key words around cleanliness. When conducting Nurse Leader Rounding, we can further reinforce the importance of patient safety by using key words or phrases. "I see that your room and bathroom have been sanitized and cleaned. Is there anything we missed? Your safety is important to us."

Manage up to the patient the things that have been cleaned. Let the patient know, for example, Ben could say, "I just want to let you know your bathroom looks great – I have cleaned your shower and disinfected your toilet, dust mopped your floor and emptied the trash. Is there anything else I can do for you or is there anything I missed before I leave?" By asking this last question, we are able to address any additional needs that may not be apparent. This can help our nursing colleagues to reduce the use of call light. Remember, cleanliness is a partnership between EVS and nursing and we have to work together to make sure the patient's room is clean and we have reduced clutter. Many times, when patient's feel the room is not clean, what they are reacting to is feeling that the room is cluttered. Housekeeping may only come to the patient's room once or twice a day, but our nursing staff is there much more and we need our nursing colleagues engaged in helping to maintain a clean environment of the room.

Cleanliness also expands past what we can see to what we imagine as well, such as and infection from germs. By focusing on the right phrases and words, like clean and sanitized, we can make a difference in our patient's perception of cleanliness.

For more information visit Studer Group’s Value-Based Purchasing resource page. We also recommend The HCAHPS Handbook 2nd Edition available from Fire Stater Publishing.


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