Improving environmental cleanliness of a Paediatric Intensive Care Unit (PICU): successful co-creation of a targeted, bespoke educational intervention

Background: A clean healthcare environment is the foundation of both antimicrobial stewardship and delivery of sustainable healthcare. Clinical staff are responsible for cleaning medical equipment and some aspects of the healthcare environment.

Aim: To improve the clinical cleaning on a busy PICU in a tertiary referral hospital in England.

Methods: This was an educational continuous Quality Improvement (QI) project using opportunistic and targeted one to one education and training for clinical staff. Cleaning audits were conducted weekly throughout the study period and the results mapped against monthly bed occupancy data. The PDSA cycle (plan, do, study, act) was used to review actions, outcomes, impact and consider further work every month by the study team.

Results: Key themes emerged for improvement around the training delivered on cleaning, both formally through mandatory study days and informally through the cascade of knowledge to new starters. The cleaning ‘hotspots’ identified via audit, and how these were communicated to the team were also targeted. The multi-mode interventions, delivered by both Infection Prevention link nurse unit staff and a Clinical Auditor/ Educator, were successful in building and maintaining excellent cleaning standards within the ward.

Discussion: Co-creation of cleaning interventions enabled a supportive environment to be developed with staff demonstrating a high level of understanding and commitment to environmental cleanliness. This approach would be scalable across multiple areas of the hospital with the short-term support of a Clinical Educator or Infection Prevention Nurse.