Fighting against
 cross-infection with colours

This has been underlined and clarified by the British Institute of Cleaning Science (BICSc).

According to a report published by the Health Protection Agency (HPA) earlier this year, over 6 per cent of hospital patients, both NHS and private, acquire some form of infection during their stay at a hospital. The report from the HPA confirmed that although the successful infection-control measures rolled out throughout the UK, such as hand-washing and swab-testing had caused cases of MRSA and C.Difficile to fall by over 4 per cent since 2006. However, the report also highlighted that other infections with organisms such as E.Coli and Salmonella are
increasing; in particular infections were most prevalent within
intensive care units and surgical words.

So how can we continue to fight cross-infection within hospital environments to ensure the safety of patients, staff and the general public? The HPA provided recommendations surrounding hand washing, use of personal protective equipment (PPE), and regular cleaning to prevent the build-up of organisms. However simply increasing the frequency of cleaning is not enough to prevent the spread of infections; it could in fact cause further issues and cross-infection if cleaning operatives are not properly trained to an accredited standard.

Different areas
Why would increased cleaning cause more infection you ask? Well let’s set the scene, as a cleaning operative within a hospital I may be responsible for a number of different areas, such as bathrooms, wards and isolation areas. If a cleaning operative works within all of these areas and uses the same materials and equipments within each area, they may spread an infection from an isolation ward to a bathroom which may be accessed by other patients, staff or the general public. Alternatively, a hospital which employs both in-house and contracted staff may have received different training on which materials and equipment to use; in-house staff may have been trained to use red materials in bathrooms, while the contractors have been trained to use red in isolation areas. As you can imagine, confusion and cross-infection is likely to occur.

The British Institute of Cleaning Science (BICSc) first began to develop a universal colour code for the cleaning industry back in the late 1990s, and over the years have reviewed their recommendations to align with the recommendations from organisations such as the National Patient Safety Agency. A national standard colour coding chart for the cleaning and hygiene industry prevents materials and equipment being used in multiple areas, thus reducing the risk of cross-infection. This includes all materials and equipment, including cloths, mops, buckets, aprons, and gloves. As a result, all materials within a janitorial/housekeeping cupboard within a hospital should be colour coded in accordance with the area in which they are used and following organisational policy, to avoid the spread of infection. 

The National Patient Safety Agency recommends the use of four key colours to cover the different hospital cleaning zones; Red for general washrooms; Blue for general areas, including wards, departments, offices and basins in public areas; Green for catering departments and ward kitchen areas; and, yellow for clinical areas. The British Institute of Cleaning Science has broken these categories down further to ensure maximum protection from cross-infection across all sectors of the cleaning industry.

It is worth noting that the above colour coding standards (see chart) are only for the cleaning and hygiene industry and not for the catering and food production industry as the Food Standards Agency state that red is for the preparation of red meat. Additionally, the BICSc Colour Code identifies that it is necessary, especially within a hospital environment, to have a designated colour (white) for high risk facility specific areas; these materials are designated for one off cleaning, and are disposed off immediately after use. The British Institute of Cleaning Science also recommends that general basins within a public area pose a higher risk of cross-infection than general areas such as departments, therefore these should be cleaned with red materials and equipment rather than blue.

Minimising cross infection risk
Patient safety is the responsibility of everyone, therefore through the implementation of the recommended colour coding into the cleaning process, cleaning operatives and hospital staff alike will help to minimise cross-infection risks by using the correct materials and equipment within the correct designated areas, thus protecting the patient, staff, the general public and themselves! This is especially important within isolation areas where there may already be a higher risk of infection. We can minimise the risk of spreading infection by ensuring the cleaning materials and equipment used within an isolation area are not used elsewhere within the building. E 
E Today we live in a more flexible society, where it is common practice for individuals to move between jobs and organisations; this is also true for cleaning operatives who can often be found to move between jobs or to be contracted to multiple organisations. Therefore to avoid confusion and inconsistency it would make senses that all organisations adhere to a national colour coding system.

It is also the responsibility of the employer to ensure all cleaning operatives are fully trained in their role, to an accredited level and that they are introduced to the colour code during their initial training. The British Institute of Cleaning Science recommends that all cleaning operatives should receive training to ensure they are competent in their role to ensure the safety of the operative and the users of the building. The Cleaning Professional Skills Suite (CPSS) has three mandatory units which ensure chemical competence, equipment safe use and care and the safe storage of equipment and material. Additionally, through the BICSc training, operatives are trained to clean ‘from clean to dirty’ to further minimise the risk of cross-infection. Upon completion of the CPSS mandatory units, operatives receive a BICSc Mandatory Unit card which is their License to Practice, which recognises the operative as competent by current and future employers. 

Finally, through implementing the colour code into the cleaning process, employers can ensure the safety of their cleaning operatives. As Stan Atkins, group ceo for The British Institute of Cleaning Science, explains: “It is undoubtable that patient safety is a priority within a hospital environment, however it is also the responsibility of the cleaning industry to ensure that cleaning operatives are protected from harm while working. Through the implementation of the colour code system, cleaning operatives are empowered to protect themselves while working in high risk areas.”

Through the provision of a safe working environment for cleaning operatives, employers can positively impact job satisfaction, which in turn will improve retention levels. Ultimately, reducing the money and efforts spent on recruitment, which we cannot ignore while the economy is still struggling and budgets are being stretched further than ever before.

Therefore, through the colour coding system cleaning operatives can improve the safety of hospital and healthcare premises, and help maintain a clean and comfortable environment for patients, staff and the general public. So next time that you place an order for new cleaning equipment or materials, take a moment to remember the colour code.

Further information
To find out more information about colour coding or the training of cleaning operatives please visit www.bics.org.uk