An Audit to Compare the Adherence of Housekeeping Practices to Kayakalp Standards in the Intensive Care Unit of a Tertiary Care Hospital
Hasnah Yasmin Ismail, K. N. Faris HussainAbstract
Background:
Intensive care unit of a hospital is designated as a high-risk area which requires periodic monitoring to check the adherence to infection control practices by maintaining high cleaning standards. Housekeeping services in the unit are entrusted with maintaining proper sanitation and clean and hygienic environment conducive to patient care. To complement this effort, the Ministry of Health and Family Welfare, Government of India, on May 15, 2015, launched “Kayakalp,” an initiative to promote high level of cleanliness, hygiene, and infection control. These guidelines focus on strengthening and streamlining of proper selection and maintenance of infrastructure, development of suitable policies for housekeeping services, selection and training of manpower, development and implementation of suitable cleaning methods in the form of protocols/ standard operating procedure (SOPs), effective supervision, and monitoring by adequate staff. It also aims to create and share sustainable practices related to improved cleanliness in different healthcare settings and to have a positive health outcome.
Methodology:
Plan–Do–Study–Act (PDSA) cycle, supported by root cause analysis through a fishbone diagram, was utilized to identify underlying issues and track improvements during each cycle.
Results:
A marked improvement in staff adherence to cleaning and disinfection practices was observed following the completion of four PDSA cycles, with compliance rates increasing from a baseline of 50% to 68%, then to 87.5%, and ultimately reaching 95%. These findings are consistent with global quality improvement methodologies, such as the Institute for Healthcare Improvement (IHI) Breakthrough Series and the Model for Improvement, which emphasize iterative testing through PDSA cycles, structured protocols, and staff engagement to achieve sustainable change.
Conclusion:
Implementation of structured PDSA cycles significantly improved adherence to housekeeping practices aligned with Kayakalp standards in the ICU. Continuous training, monitoring, and staff engagement played a key role in achieving and sustaining high compliance levels. This approach can be replicated in other hospital areas to strengthen infection control and foster a culture of cleanliness and patient safety.