Questionnaire for project research

Disclaimer: The information duly collected from you is for academic purpose only.
Name of the hospital:
Location:
No of beds:

Name: Designation:
Contact Number: Email:

Question 1:Under which category does your hospital belong to?

a. Specialty Hospital
b. Multispecialty Hospital
c. Super specialty Hospital

Question 2:Who handles the housekeeping services in your hospital?

a. Hospital housekeeping department
b. Outsourced to third party FMS

Question 4: How many housekeeping operators are involved in cleaning?

a. Less than 50
b. 50 to 100
c. 100 and above

Question 5: Which brand of cleaning tools are you currently using?

a. Unger d. Ecolab
b. Roots e. Diversey
c. 3M f. Others
Question 6: On what basis do you choose a cleaning tool?
a. Durability
b. Quality
c. Price
d. Convenience
e. Performance

Question 7: What are the different floor cleaning methods used in your hospital?
a. Kentucky mop
b. Flat mop
c. Others

Question 8: How much are you willing to spend for the cleaning tools?
a. Below Rs.10000
b. Rs.10000 to Rs.50000
c. Rs.50000 and above

Question 9: How much time is spent on cleaning?

a. Less than 3 hours
b. More than 3 hours

Question 10: Do you experience any cross contamination or bacterial spike or EM Count?
a. Yes
b. No

Question 11:Does your cleaning operators experience any fatigue?

a. Yes
b. No
Question 12:Do you have any absenteeism among your cleaning operators?
a. Yes
b. No

Question13: How much water and chemical do you use per day?

Question 14: How frequently do you clean your hospitals floors and corridors?
a. Once a day
b. Twice a day
c. As and when required

Question 15: How often does your hospital management replace the cleaning tools?
a. Less than a year
b. Based on its usage

Question 16: Does any of the existing suppliers/vendors are giving your operators training
and development?
a. Yes
b. No

Question 17: Does any of your existing suppliers provide 3rd party bacterial validation
certificate?
a. Yes
b. No

Question18: Do you need autoclavable mops, wipes and tools for your sterile areas such as
CSSD, IVF, bone marrow transplant, pediatrics surgery?
a. Yes
b. No
Question 19: Are you aware of pre-prepared cleaning method that stops the spread of
infection from one room to another?
a. Yes
b. No

Question 20: Are you willing to buy the pre-prepared cleaning system which prevents the
spread of infection in your hospital?
a. Yes
b. No

Question 21: Have you faced any difficulties while cleaning?

a. Yes
b. No. (skip question 19)

Question 22: If yes? What are the difficulties?

Question 23: Any recommendation you wish to have in cleaning tools and solutions used in
your hospital?

----------------------Thank you for your time and valuable insights-----------------------