REACH – One Hospital’s Perspective

Mr Paul Simpson1, Ms Alison McKenzie1

1Barwon Health, Geelong, Australia



Barwon Health was one of 11 trial sites undertaking the ‘researching effective approaches to cleaning in hospitals’ (REACH) study. This study aimed to assess the effectiveness of a bundle approach to cleaning. The cleaning bundle incorporated hospital-wide communication, audits, training, cleaning technic and product usage.


Effectiveness of the cleaning bundle was assessed by measuring removal of fluorescent gel markers from frequent touch points. Also the pre-intervention and intervention incidence of Staphylococcus aureus bacteraemia (SAB), Clostridium difficile and Vancomycin-resistant enterococcus (VRE). Finally feedback from cleaning staff was surveyed pre and post intervention.


An increase in the removal of frequent touch point fluorescent gel markers from 39% pre-intervention to 68.7% post intervention. VRE rates decreased from 0.65 per 10,000 occupied bed-days pre-intervention to 0.17 during the intervention. There was a minimal rate reduction for SAB (1.03 to 0.93) and Clostridium difficile (3.59 to 3.03). Feedback from cleaning staff on the benefits of the bundle was deemed very positive post intervention.


Overall, the cleaning bundle demonstrated significant improvements in cleaning thoroughness of frequent touch points. There was a marked reduction in VRE rates during the intervention. Cleaning staff overwhelmingly expressed positive feedback regarding the implementation of the bundle, reporting improved efficiency in cleaning processes. However, consideration is necessary for the longer term resource implications to support a successful ongoing implementation of a cleaning bundle of this nature.


Paul is currently the Manager of the Infection Prevention Service At Barwon Health. Paul has worked in the field of Infection Prevention for over 15 years in both Australia and the UK. Within Australia Paul has worked at Melbourne Health, Hand Hygiene Australia and the Royal Victorian Eye and Ear Hospital. In the dim and dark past Paul served in the British Royal Navy as a Nursing Officer and prior to becoming a nurse spent 6 years in the Royal Navy Submarine Service.

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