Why green means clean at Mid Essex Hospital Services NHS Trust
Mid Essex Hospital
Gwyneth Wilson, Director of Nursing & Sister Jennifer Bryant
Why green means clean at Mid Essex Hospital Services NHS Trust by Gwyneth Wilson, Director of Nursing Mid Essex Hospital Services NHS Trust and and Clinical Academic Fellow at Anglia Ruskin University, and Sister Jennifer Bryant of Mid Essex Hospital Services NHS Trust
A 'green ribbon' symbolises how serious Mid Essex Hospital Services NHS Trust is about infection prevention.
Between the discharge of one patient and the admission of another, nursing staff thoroughly clean the bed space, including the furniture, and make up the bed. When this has been done, they place a 'green ribbon', or tape across the turned down top sheet on the bed - sealing it and then adding their signature and date of the clean. This procedure is also followed each time a commode is cleaned.
It's very simple, but it gives patients visible reassurance that their bed area and commode has been thoroughly cleaned and disinfected and that rigorous hygiene procedures have been followed,
The idea came from an infection prevention 'brainstorm' on the Trust's Broomfield Hospital B7 vascular ward where the team came up with ideas for improving standards of cleanliness and 'raising the bar' on hygiene. We thought about holidays abroad where hotel room toilets often have a paper seal around them to show they have been cleaned. Our infection prevention team took this idea forward and discovered a product called the Vernaclean Indicator Tape from infection prevention products manufacturer Vernacare.
The Vernaclean indicator, or 'green ribbon' as we call it, was piloted on B7 and was highly successful. The feedback from patients was extremely positive as they felt fully confident that their environment was guaranteed clean and they showed their appreciation by thanking the nursing staff. This helped to reinforce the pride that staff felt in a job well done. Because staff sign the tape to show that they have performed a thorough clean they have more of a sense of ownership and responsibility and that certainly helps to raise standards of cleanliness from good to excellent.
One of the realisations we made during the trial was that the green ribbon was a very good piece of visual management that everybody understood. It meant that there was no scope for confusion between shifts as to whether a bed had been washed down and cleaned, which on previous occasions may have led to wasted effort in the second shift repeating the clean already performed by the first shift.
The new initiative also helped focus everybody's attention on cleaning and hygiene and provided the impetus for new stringent new hygiene protocols, including a daily and weekly cleaning roster and weekly hand hygiene audits.
Since trialling the Vernaclean Indicator 12 months ago, there have been no infection outbreaks on B7 and the ward has always passed hygiene audits with flying colours.
The green ribbon initiative is now being rolled out trust wide across all wards at Broomfield Hospital and sister site St John's Hospital. This started with surgical and medical areas and is gradually being introduced everywhere.
It is part of a hard-hitting and comprehensive cleanliness action plan by the Trust, which over the past 12 months reduced outbreaks of C. Diff by 43% and cut MRSA by 25%. We have recently appointed an infection control consultant nurse and were the first Trust in the UK to introduce pre-operative MRSA screening and are investing £900,000 in cleaning.
Other initiatives include the availability of hand rubs at the point of care and at the entrance to every ward, together with prominent infection prevention noticeboards on each ward which clearly display the results of high impact interventions and set out expectations for hygiene and cleanliness.
Our philosophy is that infection prevention is everybody's business - not just the infection prevention specialist nurses - and that starts at the top with the hospital executive. The Trust's Chief Executive chairs fortnightly infection prevention meetings attended by all directors. Each week the executive do random, unannounced inspections of areas of the hospital and if any issues are identified they do a follow up visit to the area to observe what progress has been made.
This philosophy applied to the green ribbon initiative which was championed by Consultant Vascular Surgeon Tom Browne and such support reinforced the importance that the Trust places on hospital cleanliness and the need to reduce hospital acquired infections. We are determined that everybody shares responsibility for driving MRSA, clostridium difficile and other infections out of our hospitals and our 'green ribbon' is helping to create the cleanliness culture that will ensure we succeed.
It is a simple idea, but it conveys a powerful message that we are serious about creating clean safe hospitals for all our patients. It also builds trust between us and our patients and alleviates any concerns they may have about hospital acquired infections.
