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Last Updated: Wednesday, 13 July, 2005, 18:08 GMT 19:08 UK
Nursing standards
As part of the effort to improve cleanliness in hospitals, the government has tried to invigorate chains of command and responsibility for cleanliness in hospitals. There was a sense that cleaners worked to their own management and were very much separate from the nursing staff who ran the wards.

The Matron's charter, published in October 2004, is central to correcting this. Hospitals are expected to use the advice in this document to improve their standards of cleanliness.

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A recent parliamentary report which welcomed the charter suggested that its' implementation by trusts should be evaluated in an annual survey.

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In his foreword to the charter, the then secretary of state for health, John Reid makes it clear that cleanliness is a nurse's responsibility as well as a cleaners:

"...in patient areas, it is nurses and midwives - and particularly matrons - who the public look to, to set and uphold standards including cleanliness."

Matrons on each ward are asked in this document to take control of infection control and cleanliness on their wards. They are given the power to advise that payment for cleaning services is withheld when services persistently fail to meet local standards.

Part of the problem is that matrons and nurses may feel they have too much on their plate to keep watch on cleaning services as well. A Royal College of Nurses' study, asking matrons what they had spent most time on in the two weeks prior to the study, found only 9% listed addressing concerns about food or cleanliness ' not because they weren't important but because there wasn't time to get to them'.

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