1. Environmental Infection Control Audit Nottingham CityCare Partnership Marina Otley – Clinical Audit Specialist Jane Clarke – Infection Prevention & Control Matron

2. 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

3. In practice Annual audit of all buildings Buildings excluded if: -No clinical services provided from the building -Temporary site - Or an upgrade is underway

4. 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)

6. 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

7. Initial Findings

13. How our rooms look now

14. 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

15. 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

18. 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

21. 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)

22. 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

23. 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

24. 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

25. Any questions?