Environmental Services Recognized As A Key in the Prevention of Healthcare Associated Infections

As hospitals respond to the call to do more with less, the expediency with which patient rooms are turned over is increasing, leading some experts to sound the alarm about compromising patient safety.

"More hospitals are coming to the realization that they cannot rush the processing of a patient room," says John Scherberger, CHESP, REH, founder and president of Healthcare Risk Mitigation and incoming president of the Healthcare Laundry Accreditation Council (HLAC). "When I talk about processing, this includes cleaning and disinfection practices, because healthcare environmental services (EVS) is process-driven, just as surgery and nursing is process-driven. EVS is finally standing up and saying, 'We are process-driven and we cannot cut out parts of our process and expect to get proper results. We must follow our processes, and we require sufficient time to perform the job properly, and if we don't, we risk poor patient outcomes.

Scherberger continues, "Hospitals are realizing there has to be communication, cooperation and collaboration between all of the disciplines, and too often, EVS is being given orders and they haven't been involved in the communication or collaboration components -- they have only been told, 'Get this room done in 10 minutes.' But if you were to tell a surgeon to remove a gall bladder in 10 minutes, he or she would revolt because they can’t do it properly. If we tell a nurse to insert a central line in 5 minutes, the nurse would say "I have standards, I cannot do that.' EVS is finding is voice and saying enough is enough, we have to stand up for our patients."

Scherberger continues, "There is a plethora of studies in the literature that address the role of the environment in infection transmission. For example, Stephanie Dancer showed us that the more time and attention we spend on cleaning, the better the outcomes we can achieve. Other studies by experts such as John Boyce and Philip Carling acknowledge that proper cleaning and monitoring of that cleaning requires adequate time. There are many studies that show the environment has to be tended to properly and in the proper amount of time. We all want the best results for our patients, and people need to see environmental services as an investment in these patient and quality outcomes. They also need to support and invest in the education and training of EVS professionals, getting down to the level of why we are doing this a certain way, or why we are using this specific broad-spectrum disinfectant as opposed to a mere detergent. We must educate people about why it's being done, not just that it has to be done, and that performing proper cleaning takes time -- because it's an integral part of infection prevention."

In recent years the emergence of new microorganisms and the process for removing them from surfaces has required more time and attention, particularly to high-touch surfaces.

Scherberger advocates for the use of protocols and tools such as checklists. "A big problem is that hospitals still refuse to have the checklists that they need. They say 'clean this room,' but how exactly is a person supposed to do that if they don't have a checklist? In surgery we have checklists because the OR team wants to go step by step in the process so they get the proper outcome. With EVS, unless they use a checklist that has been defined for their facility and their unique circumstances, they are not going to know what to do. And EVS managers need to say, 'I will not have my staff process in 10 minutes what should take 40 minutes, according to the checklist. A lot of hospitals say they want a disinfectant that has a dwell time of 3 minutes because they want to decrease the amount of time that staff has to be in the room. They also have also not given EVS staff the proper training on the importance of keeping a surface wet in order to achieve the disinfectant's dwell time. If I am processing a room and do everything the right way, it's going to take more than a few minutes."

Pam Toppel, CHESP, director of Environmental Service – Eastern Region at OSF Saint James - John W. Albrecht Medical Center, Toppel emphasizes the importance of the data calling for proper and rigorous cleaning and disinfection. "Following those recommendations and guidelines we can absolutely impact infection transmission. How can these studies be used to make a case for adequate time to clean? As I mentioned previously, it is our responsibility as environmental services leaders to educate all on what vital team members we are in healthcare. Not only is it a must to be in front of our Administrative Teams, but we also must educate the Environmental Service Technicians.

Please follow the link to read the entire article by Kelly M. Pyrek
References: http://www.infectioncontroltoday.com/articles/2015/09/room-turnover-times-trashanddash-approach-jeopardizes-patient-outcomes.aspx