Hospital at Night housekeeper

Small change, big impact

The Royal Bournemouth and Christchurch NHS Foundation Trust has recently developed a housekeeper role to work with the hospital at night team.

While working across the trust with all specialties and departments, the team is in a unique position to identify organisational wide trends and problems. The trust has shown how a small scale project can have a direct positive impact on achieveing the WTD requirement.

Calling Time spoke to the trust to discuss the process in developing this role.

Rationale

A low ratio of side rooms within the trust meant particular problems with infection outbreaks and the management of patients with MRSA and clostridium difficile. This became especially difficult in trying to keep the rooms available when a barrier clean was required out of hours.

An audit of all side rooms identified a number were being used for non-patient tasks, such as office accommodation. A subsequent report, based on the audit and circulated to the trust board, recommended the repatriation of these rooms to patient use. The board endorsed the recommendation which was fed back through the directorates. Over a period of months, the number of side rooms being used by patients gradually increased.

The team continued to collate information daily to ensure appropriate use of all side rooms and the reason and management of patients who occupy them. This information was shared with infection control and was used to develop a policy on the management of side rooms within the trust.

The information identified cubicles in A&E and side rooms in wards were out of use during the night because they required cleaning/barrier cleaning and so no service was available. This was leading to delays in patient transfers as well as risks in A&E becauses isolation facilities were not available for patients with potential infections - increasing the potential risk of infection to other patients. Patient privacy and dignity was also at risk of being compromised, with the potential to cause distress.

By highlighting these incidents and reporting them back through the risk management and infection control groups, it was agreed that an out of hours cleaning service was needed.

Proposal

It was proposed that a housekeeper should be appointed to support the Hospital at Night team. The housekeeper could undertake barrier cleans and other cleaning as identified by the team. The proposal was supported by the trust board and funding awarded for two whole time equivalents.

Outcome

The role started in September 2007 and currently works between 11pm and 7am. The housekeeper is part of the Hospital at Night team and attends handover at 11pm and is advised of any infection outbreaks.

When the essential cleaning is complete, the housekeeper undertakes general cleaning duties in non patient areas. This has led to improved services to patients and reduced delays in isolating patients with infections. The Royal Bournemouth and Christchurch NHS Trust will review the impact of this role and report back to the trust board in three months.

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