Infection prevention – a frontline perspective

Neil Nixon speaks with Yvonne Spencer, the clinical lead for integrated facility management at Sodexo Healthcare, who shares her perspectives on infection prevention and how it’s evolved over the course of the pandemic. Yvonne has over 15 years’ experience in nursing and before joining Sodexo was a ward manager at Royal Manchester Children’s Hospital.

Over the last 18 months, cleaning and infection prevention (IP) in hospitals has been a much talked about topic. What are your reflections and how are teams starting to think about IP in the longer term? A big milestone for us now is the new National Standards of Healthcare Cleanliness 2021. These were about to be rolled out early last year but then the pandemic hit plans were put on hold across the country. Now we’re really looking forward to delivering against them. I’m hopeful that we’ll start to see a reduction in overall HCAIs as a result.

I think a lot of IP teams are changing their thinking and the way they manage infections in a healthcare setting. For example, it’s important to create strategies and policies to deal with COVID-19 as a continuum and not an isolated incident anymore. We must make sure that managing this becomes integrated with how we control all pathogens, becoming part of our standard operating procedures and a measure that we consistently report on.

We’re taking learnings from COVID-19 and applying them to how we deal with other super bugs. I’m hopeful that we’ll be able to develop our IP processes and technologies, alongside implementation of the new national standards, to evolve how we keep healthcare spaces clean and safe.

What strategies do you think deliver the most impact when it comes to effective infection prevention and control? For me, it’s all about the implementation of change. You really need to engage all stakeholders and make sure everyone is aligned before you get going, making sure you have the right frameworks in place to enable collaborative, connected working.

With any new standards or policies, it’s super important to firstly put yourself in the shoes of the patient and think about what they’ll be experiencing because of the changes that you make. Listening to service users and patients in any development or design can really be invaluable. Taking on board those interesting insights and ideas means what you eventually roll out has been created with your key users in mind, which has huge benefit to NHS staff and patients alike.

Working in infection prevention, part of my role is to help service users, patients and their families to know what we’re doing, why we’re doing it and how it’s keeping them safe. By communicating effectively and informing people about cleaning and control, we can

empower people to be part of how we break the chain of infection. If people understand the reasons behind what we’re asking them to do, we’re able to improve that experience for them, and help them see that we just want to keep everyone safe. Making sure that you’re thinking about these things as part of your IP strategy can be transformational.

How has patient perception of hospital cleanliness changed in the last 18 months? The major change is that patients are now really empowered to challenge if someone isn’t living up to the cleanliness standards that we expect. If a member of staff isn’t washing their hands or wearing a face mask, we find that patients will call it out and ask them to do something differently.

We want to feel safe when we’re at our most vulnerable, and our environment plays a massive part in this. I think patients are much more aware of their surroundings and how they’re being managed. In our hospitals we have communications boards which tell patients what they will see and how we keep our spaces clean and safe for them. For example, we’ll tell them that they might not see us cleaning in the daytime, simply because we do it out of hours. Or we use a UV-machine in certain circumstances.

I believe that if you know what’s going on, you feel more in control, and having good information is a key factor in that.

How has that impacted the people working in cleaning and infection prevention? The pandemic has really put the spotlight on the amazing work that our teams do for the NHS. It’s more than simply cleaning, it’s a job that makes a real difference to people’s lives.

Before an airplane takes off, the cleaning and maintenance staff will ensure that the environment is safe, secure and clean, ready for example, Tork Extra Mild Foam Soap is allergyfriendly and certified by the European Centre for Allergy Research Foundation, while Tork Xpress Extra Soft Multifold Hand Towels are soft, absorbent and gentle on the skin. A fragrance-free conditioning cream such as Tork Non-perfumed Hand & Body Lotion will help to prevent chapping and soreness when used after hand washing.

Before an airplane takes off, the cleaning and maintenance staff will ensure that the environment is safe, secure and clean, ready for the passengers to get on board. This includes making sure everyone has a life jacket that is accessible and fit for purpose. That plane won’t take off until the pilot has had the go ahead from his team. Similarly, our cleaning and infection prevention teams make sure that an operating theatre is spotless before an operation takes place. It’s the same level of rigor and dedication that goes into making sure an operation can go ahead on time, so clinical teams can treat and care for as many patients as possible.

What new ideas and innovations are you excited about and why? I think the recent work at Gateshead Hospital to adapt the electronic patient record system to map who has been in contact with a patient has been fantastic. It links into a bed mapping system which staff can access via handheld devices, to add and monitor a range of metrics and clinical observations. This is a smart way to manage the spread of infection, not just for COVID-19 but for a wide range of pathogens.

The team also recognised the importance of communicating what they are doing to patients and visitors, otherwise people may assume that the nurse is just on their phone at the end of their bed, and not using a handheld device for clinical reasons. Telling people what the device is, how it’s used and why it keeps them safe is important. That kind of patient first approach makes me excited and is something we should all really embed in our training and development practices, so it becomes first nature to staff.

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