When I interview candidates for open staff positions and during departmental meetings, I stress that environmental services (ES) is part of the health care organization for three primary reasons: to clean, to disinfect and to provide excellent customer service. All three of these are important; however, if the ES department cannot assist in reducing health care-associated infections (HAIs), the ultimate cost to the organization can be exorbitant.
How much do you work with your infection control preventionist (ICP)? I ask because I helped staff the AHE booth at the Association for Professionals in Infection Control and Epidemiology conference last spring, and many ICPs came by to discuss how they were or weren't working with their ES directors. Astonishingly, several did not even know their ES director!
I meet with our organization's ICP every other week to discuss any issues or upcoming projects. If you are looking at changing chemicals, in particular disinfectants, do you come to consensus with your ICP? Have you worked on any projects with your ICP to help reduce HAIs? Are you on your institution's infection control committee?
Chemicals are necessary for cleaning and disinfecting. You need to make sure staff are aware of the disinfectant that is used daily. Do they know the vendor's dwell time? If you use other products, such as sodium hypochlorite, staff members also need to be aware of their proper uses.
One area that has been a constant in infection prevention is hand hygiene. And, ironically, this seems to be an area in which ES staff can fall short. One area of hand hygiene is well within our area of responsibility and often is overlooked: When you audit your staff during daily rounds, do you check to make sure that hand sanitizing stations and hand soap dispensers are being replenished?
We also need to show that we are monitoring cleanliness within the health care organization. Browse the Centers for Disease Control and Prevention (CDC) website at www.cdc.gov/HAI/toolkits/Evaluating-Environmental-Cleaning.html#a1. The CDC requires that health facilities maintain auditing processes for cleaning, and it also provides toolkits for evaluating cleanliness.
In working with our staff on wearing proper personal protective equipment (PPE), we also can help reduce HAIs. It is important to follow proper PPE requirements for each isolation room (i.e, contact isolation, droplet isolation and airborne isolation). Some organizations add another requirement related to Clostridium difficile to be sure that staff use bleach for disinfecting and soap and water for hand washing.
Another important infection prevention is making sure staff take advantage of the full spectrum of vaccinations our health care organizations provide.
The ES department has a significant role in preventing HAIs and improving patient outcomes. Make sure your department is doing all it can.
This month's column was written by Kent L. Miller, CHESP, director of environmental services at Jackson Hospital and Clinic, Montgomery, Ala., and AHE president.
AHE offers a variety of educational materials. They include the following valuable references:
- Practice Guidance for Healthcare Environmental Cleaning. This publication, prepared by AHE and edited by infection control professionals, contains requirements for environmental cleaning in health care facilities. Targeted to environmental services managers, this book can be used as a resource for implementing cleaning procedures.
- Contracting: Myths & Realities. This publication covers everything from outsourcing to management pitfalls. It includes sample surveys, budgets and task lists to assist environmental services departments in making the best contracting decisions.
- Glossary of Healthcare Terms for Environmental Services. This tool features hundreds of terms and definitions organized alphabetically, both general and specific to environmental services.
AHE Recommended Practice Series: Integrated Pest Management, 2nd Edition. This is a how-to guide to implementing and maintaining an effective integrated pest management program.
Click here for information on purchasing these and other valuable industry references, select "AHA Store," then "Environmental Services".