More than just cleaning: A qualitative descriptive study of hospital cleaning staff as caregivers

Abstract

Background: Cleaning staff in hospitals can spend an average of 10–20 min per day per patient room. Published literature shows a pattern of interactions between housekeepers and patients, and that they believe themselves to be a part of the patient care team, but to date, no study has framed them as a caregiving population.
 Who is it for? Clinicians, healthcare staff, administrators & faculty
 Involvement & Engagement: Study design was co-created by the principal investigator and co-authors. Two members of the Environmental Services department at UC Davis Health were consulted in developing study aims and an online survey. (Survey data not included in article)
 Objective: To describe the experiences and perceptions of hospital housekeeping staff in relation to patient care.
 Setting: A 625-bed tertiary, academic medical center in the United States.
 Design & Methods: Eight housekeeping staff participated in this qualitative descriptive study. Design, implementation and monitoring was a product of collaboration between co-authors. Participants ranged from 40 to 62 years old, from diverse cultural and ethnic backgrounds, and worked at the study hospital from 4 months to 20 years. Interviews were conducted between September 2020-October 2020. Participants were recruited through flyers, email, and snowball sampling. Data were collected through semi-structured, in-depth interviews lasting 30 – 60 min. Data were analysed through thematic analysis using a 6-step framework that included data familiarization, generation of initial codes, search for themes, review of data, definition and naming of themes, and generation of a written report. Trustworthiness of the data was established through strategies such as reflective journaling, researcher triangulation and member-checking.
 Results: Three themes emerged: 1) “Here to take care of you” 2) Difficulties & Coping: and 3) Perceptions of their role. These three themes provide insight into participants' perceptions of patient interactions and the kind of connections they formed with patients as they went about their duties.
 
 Implications: The potential for cleaning staff providing care to patients opens multiple possibilities for future research. There is little understanding of this phenomenon from the patient perspective, and of the ways in which cleaning staff can support inter-professional care and collaboration. The retention of experienced staff is vital and so wages which reflect the value of their work must not be overlooked. Their contribution can also be recognized by giving them equal access to the same health benefits and paid sick leave, vacation leave as other staff. 
 Study findings suggest that there exists among housekeeping staff a respect for the humanity of patients, a duty to protect people from disease, and a longstanding practice of engaging in therapeutic connections with patients. These results reveal an opportunity to expand our understanding of who we call a caregiver, and to improve how we recognize and support each member of the healthcare team.
 https://www.sciencedirect.com/science/article/pii/S2666142X22000364