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Though mostly preventable, healthcare associated infections (HAI) such as Clostridium difficile (C. diff) and Methicillin-resistant Staphylococcus aureus (MRSA) occur in all types of patient and extended care settings. According to the Centers for Disease Control (CDC), on any given day, about 1 in 31 hospital patients has at least one HAI. According to another study published in the American Journal of Infection Control, privacy curtains in hospitals can become breeding grounds for bacteria, including MRSA, posing a threat to patient safety. The 14th day after freshly laundered curtains were hung in patient rooms, 87.5 percent of the curtains tested positive for MRSA. None of the rooms where the curtains were placed were occupied by patients with MRSA.

These studies are just a few examples from an escalating body of research showing that processing the patient environment adequately and effectively is a critical component in reducing preventable HAIs (pHAI). Management at leading healthcare systems understand and recognize the importance of Environmental Services (ES) as part of an enterprise-wide multi-modal intervention plan to combat such infections. As a result, all types of healthcare facilities, from acute care hospitals to assisted living facilities, are adopting programs that elevate the role that the cleaning and disinfecting process plays in patients’ and care givers’ health and safety, with a particular focus on infection prevention. These programs include:

• Nationally recognized training and support programs designed to meet infection prevention standards of excellence

• ES staff recognition to elevate awareness of their importance across the organization

• Best-practice protocols to eliminate cross-contamination (ONEperROOM methodology supported by color-coded products ensures cross contamination is minimized or eliminated)

• High performance textile products

• Aggressive advocacy of enterprise wide multi-modal intervention

The Crucial Role of ES Departments
Texas State University Clinical Microbiologist Rodney E. Rohde, PhD, stated that hygiene specialists are among one of the most important, “behind-the-scenes” professions in combatting HAIs and superbugs in healthcare systems and the community at large. In “A secret weapon for preventing HAIs”, Rohde wrote that ES specialists are the “first-line-of-defense specialists whose training has included learning best practices for effective infection prevention.”

Despite the fact that more and more organizations are recognizing that the human factor is of critical importance in preventing infections, in some US hospitals and long-term care facilities, cleaning is considered healthcare’s lowest-tech activity, carried out by a group of invisible workers on the “bottom rung of the hospital ladder.” In the best healthcare settings, C-suites are beginning to grasp the difference a highly trained ES staff member can make not only in the lives of patients, but also in the facility’s reputation, good will and financial health.

Increasingly, healthcare management is acknowledging and rewarding ES staff that have undergone extensive in-service training in which participants learn best practices for infection prevention and hygiene management in the operating room, patient room and throughout the healthcare facility. Such training programs recognize the science of cleaning and disinfecting that ES performs—both the clinical function of removing and inactivating/killing HAI-producing microbes, and the practical function of cleaning.

As part of the training process, ES staff learn to use separate color-coded wipers and flat mops for the patient room, OR and bathroom, and only use the appropriate items in the specified rooms. Color-coding simplifies training, helps reduce chemical usage, and—most importantly—offers a straightforward and elegant way to eliminate the risk of cross-contamination.

Color-coded products designed and colored for specific tasks might include:
• Gray products for common areas
• Blue products in patient room
• Yellow for intensive care
• Orange products for use in any bathroom
• Green in the operating room

Results
Hospitals that have incorporated Hygiene Specialist training into their multi-modal intervention strategies have recorded significant results. One Kentucky hospital noted a significant reduction in HAIs after providing its ES staff with Hygiene Specialist training. Likewise, a Chicago-area hospital was able to decrease its C. difficile rates by more than 50 percent—which is well below the national average—and significantly improve its national HCAHPS percentile ranking for patient satisfaction with room cleanliness.

The recognition that can come with more advanced Hygiene Specialist training can serve as a great employee morale boost and motivator. Once ES staff complete the training, they are recognized via a senior management-attended event that includes a certificate, pin or other designation, and celebration. Some healthcare providers are even starting to give bonuses to staff who complete the training.

From a broader societal perspective, the World Health Organization (WHO) has indicated that the rise of antimicrobial resistance is a global health crisis. An estimated 700,000 people die every year from drug-resistant infections, according to a recent British commission review. The World Bank further warns that the spread of drug-resistant infections could mean a hit to the global economy that could reach a scope even greater than that of the 2008 financial crisis. Currently, the societal cost of HAIs in acute care hospitals in the US has been estimated to be $147 billion annually.

ES staff serve as the first line of defense in ensuring safe environments in hospitals and long-term care facilities, thereby helping to protect the broader community as well. Those who recognize this by investing in these unsung heroes will improve patient outcomes, boost financial health, increase satisfaction rankings and support the community at large.

By George Clarke, CEO, UMF Corporation

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