Study Trip to Sweden, 13-15 August 2024

How is hospital cleaning carried out in Sweden? To answer this, we participated in a three-day study visit to Stockholm and Norrköping Hospital. The study visit included consortium members from Pärnu Hospital Foundation, Narva Hospital Foundation, Viljandi Hospital Foundation, Medicum Healthcare Services AS, Elva Hospital Foundation, Järvamaa Vocational Education Centre, Valga Hospital AS, Tartu Vocational College, Tartu Health Care College, and Tartu University Hospital Foundation. The study trip was supported by Erasmus+ consortium learning mobility projects no. 2023-1-EE01-KA121-VET-000133792 and 2024-1-EE01-KA121-VET-000236654.

The job shadowing was organised by the host organisation Visera AB and Karin Perling, a trainer-consultant specialising in hospital cleaning.

The main themes of the study visit were hospital cleaning, preventing the spread of infections, and the importance of evaluating cleaning quality in a hospital environment. Additionally, participants learned about the possibilities of digital collection of cleaning data, its analysis, and drawing conclusions, based on the experiences of Swedish hospitals. During the training days, Karin thoroughly introduced various principles of hospital cleaning, including how to prevent the spread of infections.

Key facts from the training:

80% of infections are transmitted via hands, which is why hand hygiene is of crucial importance.
In hospitals, it is crucial to know who goes where, and that the same hygiene requirements apply to everyone. It is unacceptable for a technician to move around in the operating room in their own clothes (which actually happens) while different rules apply to doctors and nurses.
Consistent and regular dissemination of information and feedback plays a very important role.
There are no universal cleaning rules. Each room, department, or object has different cleanliness requirements based on its purpose.
Swedish hospitals use stickers that indicate the required cleaning quality level for a room and how many times a week the desired level of cleanliness must be achieved.
Clothing plays a very important role in preventing the spread of infections. Studies conducted in Sweden revealed that disposable clothing releases significantly fewer skin particles carrying infection-causing bacteria, and women, in particular, spread fewer skin particles than men.
We received confirmation of the importance of drying. It is crucial to machine-dry microfiber cloths after washing; otherwise, bacteria in the fabric can begin to multiply, leading to the re-spreading of dirt.
Needs-based cleaning is of key importance. Based on various studies and case studies, it became clear that this is the only way to provide a consistently high level of cleanliness while optimising resource use. Needs-based cleaning can only be achieved through the adoption of digital cleaning solutions.
Fun fact: In the Middle Ages, it took 70 years for the plague to spread around the globe, but only 3 months for SARS-CoV-2 (COVID-19) to spread. This clearly shows that when people travel without implementing preventive measures, diseases and infections spread many times faster.

During the study trip, we were invited to job shadow at Norrköping Hospital as part of a case study, where we observed how hospital cleaning actually works. At Norrköping Hospital, we were welcomed by Bitte, the hospital’s cleaning quality manager. We saw what processes and activities have been developed to prevent the spread of dirt and infections. Every activity and process had its specific purpose. Additionally, we saw what tools and methods they use.

Some interesting facts from the hospital:

The hospital has fully transitioned to using palm-sized microfiber cloths. The main reason is to avoid folding the cloth, as it has been scientifically proven that microbes and infectious bacteria can penetrate through the microfiber cloth’s textile to the clean side, which promotes the spread of dirt and infections.
In the cleaning rooms, clean and dirty zones are separated. Cloths and cleaning trolleys in the dirty zone are cleaned before being moved to the clean zone. Industrial washing machines are double-sided, meaning dirty cloths are put in on the dirty side, and clean cloths are taken out of the washing machine on the clean side, which is on the other side of the wall.
The hospital only uses dampening bottles, as it has been scientifically proven that spray bottles promote the spread of diseases and infections because the nozzle (where the cleaning agent is sprayed out) cannot be cleaned and provides a favorable environment for bacteria to multiply and spread.
Great emphasis has been placed on staff instruction. There are various stands everywhere with instructions detailing which cleaning activities must be performed and in what order.
Author: Aron Alt