A lack of cleaning of shared equipment in public hospitals is causing infections that would lead to complications and deaths, a prominent Lake Macquarie academic says.
Professor Brett Mitchell oversaw a study, published in The Lancet Infectious Diseases journal this week, that found "strong evidence that cleaning can save lives".
The study - named CLEEN - found 35 per cent less infections in patients using cleaned equipment.
"We had about 100 more infections in patients who didn't use cleaned equipment," said Professor Mitchell, of Avondale University's School of Nursing and Health at Cooranbong.
"A proportion of these would have had major complications resulting from their infection, including death."
Professor Mitchell's research has previously shown that about 165,000 infections occur in Australian public hospitals each year.
Now his team has evidence that a significant number of infections are caused by a lack of cleaning of shared hospital equipment.
The team conducted a randomised controlled trial in 10 wards of Gosford Hospital on the Central Coast over nine months last year.
The study engaged dedicated cleaners, rather than healthcare workers, to do three hours of cleaning a day in each ward.
They cleaned shared equipment such as commodes, drip stands and walking aids.
The study included about 5000 patients.
In the control group of 2497 patients, there were 433 "health-care-associated infections".
In the intervention group of 2508 patients, there were 301 of these infections.
Professor Mitchell said this amounted to a "pretty huge" 35 per cent reduction in infections.
The study showed that cleaning shared medical equipment with a disinfectant wipe at least once a day can save lives by reducing infections.
To measure cleanliness, the researchers placed fluorescent marker gel dots on the surface of equipment.
When the dots dried, they became visible only under special light. They could be removed only by a thorough clean.
Professor Mitchell said the study provided "strong evidence that cleaning services must be maintained and enhanced within hospitals".
A NSW Health spokesperson said the study findings highlighted "the importance of cleaning protocols in infection prevention".
"They have potential positive impacts across the wider health system," the spokesperson said.
NSW Health said its Environmental Cleaning Standard Operating Procedures "provide detailed best practice guidelines for all aspects of environmental cleaning in NSW Health facilities".
"All local health districts have robust processes in place to ensure all reusable shared patient equipment is cleaned and disinfected in between use."
NSW Nurses and Midwives' Association general secretary Shaye Candish said when nurses and midwives "attend non-clinical duties like cleaning hospital equipment", patients receive less direct care.
"Workload issues for nurses and midwives are exacerbated by having to pick up non-clinical duties like cleaning due to staffing shortages," Ms Candish said.
Professor Mitchell said hospitals across the world faced the problem of "who's responsible for cleaning shared equipment".
"Often it's not documented in hospital policy or guidelines," he said.
"Usually it's healthcare workers who should clean equipment between patients.
"But we know in hospitals across the world, it just doesn't happen."
Professor Mitchell said this was "not being critical of clinical staff".
"Cleaning takes time. If they're cleaning, then they're not providing clinical care."
He and his team are working on another study that is set to show that cleaning hospital equipment saves money.
"Not investing in cleaning is a false economy. It means patients are having worse outcomes and we're wasting healthcare resources," he said.
He highlighted the problems of hospitals cutting back on cleaning and seeking cheaper cleaning products.
"When health budgets are under pressure, one of the first things that gets looked at is cleaning," he said.
However, patients that get infections "have to stay in hospital longer, which means there's less beds available for others".
"So there's an opportunity cost to the community here," he said.
This compounded the problems of crowded emergency departments, ambulance ramping, bed block and long elective surgery waitlists.
"We can free up beds by investing in cleaning services," he said.
"We need a better way to clean equipment to make it safer for patients."
