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Properly Cleaning Health Care Facilities

By Beatrix Babcock

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It was first discovered in 1847 that hand washing could help stop the spread of infection, but it wasn't until the 1960s that hospitals began monitoring and developing their own infection control programs, which your facility is required to have in place today.  Despite current widespread awareness for the need for infection control, it is estimated that on any given day about one in 25 hospital patients has at least one healthcare-associated infection1

The impact of these infections are high: Healthcare - Acquired Infection or Healthcare Associated Infections (HAI) are a leading cause of death in the United States2 and HAI in hospitals alone result in up to $33 billion in excess medical costs every year3.

Simple Tips

With heightened awareness of the impact and increased monitoring of infectious diseases, from MRSA to Clostridium difficille to Ebola, your facility likely has strategies for surveillance, prevention, and control of HAI in place. There are also simple tips that your staff can keep in mind as they keep infection prevention a top priority to protect patients from HAI that can lead to serious health conditions.

Educate and Train Staff

Provide routine formal trainings to educate staff on the difference between cleaning and disinfecting and how these processes impact the spread of infection. Cleaning is the process of removing soil from a surface as soil can harbor germs, such as influenza. Disinfecting is the process of killing the germs. Cleaning should be done first in order to allow disinfecting agents to be effective.

Set Cleaning Frequencies and Follow Current Best Practices

Every item, room, and unit in your facility should be cleaned not only according to current best practices, but also as frequently as the area requires. For example, the ED should be cleaned on a continual basis while offices may be cleaned only once a week. The area’s risk of infections determines how frequently and how it is cleaned.

  • Multipurpose Products

    To simplify cleaning and disinfecting tasks while increasing efficiencies, use EPA-registered multipurpose products designed to clean a broad range of task areas and disinfect in one step. Product labels should indicate what bacteria and viruses a multipurpose product or stand alone disinfectant is effective against. Train staff to follow label instructions for proper usage and dwell times. Cleaning and disinfecting with one product can help save labor time and money and simplify cleaning and disinfecting procedures, which aids in getting the job done right the first time and reduces the need for rework.
  • Clean High-Touch Areas

    Germs are pervasive in our environment and are easily spread through surfaces and contact with others.  Pay added attention to high-touch surfaces that are often missed, such as door handles, sink faucets, food trays, countertops, chairs, tables, light switches, toilet handles, handrails and elevator buttons.Consistently clean and disinfect these areas throughout the day to help get rid of germs. Additionally, staff should clean and sanitize mops and other cleaning tools to prevent cross contamination.Look for multipurpose products that are virucidal and bactericidal,and refer to label instructions for proper usage and dwell times.
  • Promote Hand Washing

    Hand washing is one of the most important steps that staff can take to help fight the spread of germs, bacteria and disease. Create and enforce proper hand washing protocol to reduce germs and keep staff accountable. Post hand washing reminders throughout the facility for staff, residents, patients and visitors to follow.

Stock Supplies

Facility managers should ensure that there are ample supplies in all areas where staff, patients and visitors are sanitizing their hands. Stock and clean all soap, hand sanitizer and paper towel dispensers frequently throughout the day.  Keep hand sanitizers and soap replenished and regularly empty trash cans.

Impact on Staff, Patients and Facilities

While there is a great responsibility on staff and the facility to maintain and control infections, the consequence of not meeting this responsibility is greater.  Staff are affected by HAI in a number of ways, including:

  • Increased time for care, diagnosis and treatment of a patient when an infection is acquired.

  • Increased infections can lead to nurse burnout, while studies also show that increased nurse burnout, leads to an increase in infections.4

Impact of HAI on Patients:

Patients obviously suffer if they acquire an infection in your facility and some of that impact includes:

  • Leading cause of transfer to a hospital (from a non-acute facility)

  • Loss of function

  • Pain and suffering

  • Increase in falls and pressure sores

  • Sense of isolation

  • Further weakens the immune system

  • Death

Impact on Facilities:

Facilities are impacted by HAI on a number of levels, including the impact on staff and patients, and this impact is growing as more healthcare is delivered in non-hospital settings, such as long-term care facilities, ambulatory surgical centers, and private doctors’ offices.According to the CDC, “on any given day, about 1 in 25 hospital patients has at least one healthcare-associated infection. There were an estimated 722,000 HAI in U.S acute care hospitals in 2011. About 75,000 hospital patients with HAI died during their hospitalizations. More than half of all HAI occurred outside of the intensive care unit.”5

While the CDC says that the burden of HAI outside acute care settings is largely unknown and based on few estimates, they do note that there are approximately 1.7 million long-term care beds in which 1.6-3.8 million infections are estimated to occur per year on a national basis. Based on these estimates, infections in long-term care residents may account for between 23,100 to 70,000 deaths per year in the United States.6

While it's difficult to truly define the impact, we know that facilities dealing with HAI can experience:

  • Increase of direct and indirect costs from increased care and administration costs.

  • Higher costs to third-party players for extended care resulting from a HAI.

  • Dissatisfaction from the families, patients and/or residents when loved ones enter a hospital to receive treatment and end up with a new infection.

Facility managers should always be vigilant in their cleaning efforts. By promoting good hand washing practices, identifying high frequency areas and high-touch surfaces and regularly cleaning and disinfecting, facility managers can help keep healthcare environments clean and hygienic. This, in turn, can help curb outbreaks and illnesses in facilities.

About Beatrix Babcock

Beatrix Babcock, MS-HSA, LPN, owns HCI Consulting Group and currently serves on the P&G Professional Advisory Council. To help hospitals increase the quality of cleaning, protect patients’ health and increase their satisfaction, Babcock works with housekeeping and infection control staff to set cleaning standards, identify and assign risks, and train staff on proper cleaning techniques tailored for health care environments.

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