Variation in hospital cleaning practice and process in Australian hospitals: A structured mapping exercise

Highlights • There are variations in the auditing process used to evaluate environmental cleanliness. • Different cleaning practices, product use and training for cleaning staff occur in Australian hospitals. • These variations present a number of challenges for research and monitoring of and standards for cleanliness. Abstract Background The purpose of this paper is to highlight the range of cleaning practices and processes in 11 Australian hospitals and to discuss the challenges this variation poses to the implementation of clinical trials or changes to hospital cleaning practices. Methods A cross-sectional study design was used to determine cleaning practices and processes in hospitals participating in the ‘Researching Effective Approaches to Cleaning in Hospitals’ (REACH) study. A standardised template and approach was used to collect information. Data collection activities included structured on-site discussions, a review of hospital practices and a document review of policy and procedural documents related to cleaning. Results Variations in the auditing process used to evaluate environmental cleanliness, cleaning practices, product use, training and communication pathways available to cleaning staff were identified. There was also variation in workforce structure and responsibilities for cleaning. Conclusion This paper is the first to describe the differences in cleaning practices between Australian hospitals. The variations identified present a number of challenges for the conduct of research and have important implications for both monitoring of and standards for cleanliness. These challenges include implementing a practice change or cleaning study where hospitals have different processes, practices and structures. Keywords Cross infection; Infection control; Hospitals; Health services; Housekeeping; Maintenance; Hospital administration; Translational research; Environmen