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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