Janitorial Services of Pak Army Hospitals, a Critical Analysis

Objective: To identify the existing system of janitorial services in the army hospitals, and to give recommendations for standardized policy formulation in military hospitals. Study Design: Cross-sectional study. Place and Duration of Study: Tertiary Care Hospitals, namely Hospital A, B and C, at Rawalpindi Pakistan, from Oct 2019 Jan 2020. Methodology: Responses from 401 Healthcare Administrators (HCAs), Nurses and Janitorial staff were collected through a validated questionnaire, and hospitals' documents/ SOPs, cleaning audit reports, feedback process documents, communication mechanisms and training schedules were reviewed. Results: Out of 401 respondents, the majority were females (54.4%, 5 were HCAs, 143 were Nurses, and 70 were Janitorial staff). The availability of SOPs was associated with cleaning functional areas of hospitals (p=0.001). Awareness of the risk of infection among healthcare workers was associated with Hepatitis B vaccination (p=0.03). Knowledge of hospital areas regarding cleanliness among hospital workers was linked to providing cleanliness training according to job requirements (p=0.001). Conclusion: Hospital A performed admirably in most areas but was found to need more human resources, with staff shortages, high turnover, and a lack of adherence to SOPs. To achieve optimum performance, existing and emerging technology must be integrated with sanitary worker preparation and career development; costs must be reduced.Keywords: Hospital environment, Infection control and disinfectants, Janitorial service, Training