Key messages

 
  • Health services require a continuous and systemic approach to monitoring cleaning outcomes.
  • Auditing is a part of a health service’s ongoing program to monitor cleaning outcomes.
  • Audits are to be undertaken by qualified or suitably experienced auditors, and auditors may be internal or external to health facility.
 

Audits

Audits are a health service’s ongoing and systemic program for monitoring cleaning outcomes. Audits should be performed in all functional areas across all functional area risk categories, and the results should be clearly documented.

Cleaning audit scores should be equal to, or higher than, the specified AQL for each functional area risk category. The frequency with which any particular functional area should be audited depends on what functional area risk category it falls under.

The table below provides the required frequency of internal auditing and AQL for each risk category.

Functional area risk category

Example of a function area in that category

Required frequency of auditing

 AQL

Very high risk
(category A)

Intensive care unit

Over a period of one month 50 per cent of rooms within a very high risk (category A) functional area should be audited at least once

 90

High risk
(category B)

General ward

Over a period of one month 50 per cent of rooms within a high risk (category B) functional area should be audited at least once

 85

Moderate risk
(category C)

Rehabilitation area

Over a period of three months 50 per cent of rooms within a moderate risk (category C) functional area should be audited at least once

 85

Low risk
(category D)

Administrative building

Over a period of 12 months all rooms within a low risk (category D) functional area should be audited at least once

 85

Internal audits

Internal audits are those audits routinely conducted by a health service.

There is no restriction on who can perform internal cleaning standard audits; however a thorough knowledge of the cleaning standards and an understanding of health facility processes are required.

Non-external  and external audits

Non external audits are conducted by qualified and/or suitably experienced auditors who are either employed by the health service or external auditors contracted by the health service. External audits are conducted by external auditors who are independent from the health service.

There is no difference between an external cleaning audit and a non-external cleaning audit – the auditing processes are the same. The only difference is who conducts the audit.

Non-external and  external cleaning standards audits, should include the examination of a health service’s internal auditing program and the results for all internal audits. 

A health service must be able to demonstrate or produce the following documents:

  • a comprehensive mapping, or catalogue, of all rooms within the health service with accompanying risk profile (this is sometimes referred to as a ‘tree’ or ‘network map’)
  • an auditing frequency schedule, diary or timetable based on the specified frequencies for functional area risk categories
  • reports of all audits undertaken, including variance reports complete with any required rectification and re-auditing of functional areas
  • reporting and feedback processes, including evidence that variance reports are tabled at appropriate meetings, included in quality reports, and that feedback is given to staff of functional areas.

Following Australian standards in sampling procedures for inspection by attributes, an external audit should include approximately one-fifth of the total health facility. 
However, the external audit should include all functional areas in the very high risk functional area (category A) and at least 75 per cent of functional areas in the high risk functional area (category B) and 50 per cent of areas in a medium functional risk area category C. The low risk area category D is not included in an external audit.

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