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Table 1 Environmental cleaning bundle

From: Researching effective approaches to cleaning in hospitals: protocol of the REACH study, a multi-site stepped-wedge randomised trial

Bundle component

Key activities

Training

- Tailored training activities with environmental services staff at the commencement of the intervention phase, as part of induction for new cleaning staff, and as required throughout the intervention phase

- Content to reflect the trial site context and cleaning roles and responsibilities

Technique

Attention to cleaning technique, including:

- A defined and consistent cleaning sequence

- A focus on cleaning high risk frequent touch points

- The use of sufficient pressure and movement

- Adherence to manufacturers’ instructions for product use

Product

- Disinfectant minimally used for all discharge cleans and for daily cleans of high risk/precautions rooms

- Point of care wipes used for medical equipment

Audit

- Audit activities across the trial site using ultraviolet (UV) marker technology (all trial sites) and adenosine tri-phosphate (ATP) luminosity (3 trial sites)

- Regular audit feedback to cleaning staff

- Summarised audit results provided to clinical governance committees

Communication

- Promotion of a team approach

- Daily contact between cleaners and ward leaders or managers

- Cleaners represented on relevant clinical governance committees