Environmental Infection Control AuditNottingham CityCare Partnership

Marina Otley – Clinical Audit Specialist

Jane Clarke – Infection Prevention & Control Matron

Development• 2005 Infection Prevention Society guidance• 2007 NHS Estates Guidance• 2008/09 Estates Department commits annual

funding to address concerns• Health and Social Care Act (DH 2008)• National Patient Safety Agency (2010)• 2010/11 Health & Safety Alert Bulletin on

choking hazards of blind cords

In practice• Annual audit of all buildings• Buildings excluded if:

-No clinical services provided from the building

-Temporary site

- Or an upgrade is underway

Clinical Audit Tool• Excel audit tool with tabs for each room

type e.g. waiting area, kitchen, consulting rooms

• Three types of criteria – Environmental, Cleanliness, Infection Control Principles

• Total of 241 criteria (average of 24 per room type)

Feedback of findings

• Action plan broken down into Estates, Cleaning & Infection Control issues, with separate reports

• Fed back to Centre Manager & Estates• Responsibilities for actions clearly

identified

Initial Findings

How our rooms look now

Patient safety improvements -Treatment room environments

• Carpets and old flooring replaced with vinyl flooring and coved skirting

• Hand hygiene sinks replaced with integrated plumbing sinks that have sensor operated taps and waterproof splash backs

• Fabric seating replaced

Other environmental improvements

• Light fittings have been replaced • Less open shelving• Sloping tops on cupboards to facilitate

cleaning• Blind cords secured with anti-ligature cords for

safety

Sluices

• Sluices were identified as a priority in 2010• Increase in number of sluices:

2010/11 - 16 sluices across 10 sites (out of 16)

2012/13 - 27 sluices across 14 sites (out of 15)• Improvements of existing sluices

Cleanliness improvements• Couch curtains disposable and documented

that they are changed every 6 months (improvement from 79% in 2010/11 to 100% in 2012/13)

• Shower curtains clean and replaced every 3-6 months (improvement from 33% in 2010/11 to 86% in 2012/13)

Patients Feedback• Jan 2012 survey:

- 99% of public surveyed said they were treated in a clean environment clinical environment.

- 92% said the environment was tidy & uncluttered

Things that have helped the audit run more smoothly for us;

• Combine with audits of GP practices to avoid duplication of effort and minimise impact on the time of Health Centre Managers/G.P Practice managers

• Work closely with the Clinical Audit Specialist• Give plenty of notice of visit and be flexible with

timing

Things that have helped the audit run more smoothly for us;

• Separate criteria into physical environment issues, cleanliness, and infection control practice

• Devise the action plans for each health centre• Agreed standards for devising the action plans for

consistency

Any questions?