Environmental services (ES) professionals recognize that the patient environment plays a significant role in the transmission of health care-associated infections (HAIs).

Unfortunately, not all facilities make the same investment in environmental disinfection. One of the primary methods of disease transmission is via the hands of health care providers and the effect is a contaminated environment.

Millions of dollars have been invested in training nurses, physicians and other clinical staff on the importance of hand hygiene and the fight against HAIs. Yet, only 40 percent of health care workers in the United States adhere to hand-hygiene practices. It should be painfully clear that hand washing and sanitizing alone is not going to bring home the victory.

We must ask the question: "Where do the germs that cause HAIs come from?" This question is too complex to answer with a simple response. We must look at the whole picture: the interaction of the patient (including family and visitors), the provider and the patient's health care environment.

Stephanie Dancer, M.D., in the study titled, "Measuring the Effect of En­hanced Cleaning in a UK Hospital: A Prospective Cross-over Study," clearly demonstrated a direct correlation be­tween the number of ES staff assigned to patient care areas and the time spent tending to their duties. There are other studies that also identify the importance of maintaining an uncontaminated pa­tient environment; yet more than 100,000 patients contract HAIs each year.

Would an informed patient, with the right of informed consent, willingly risk exposure to HAI by occupying a room that the staff was allowed only 12 minutes to clean and decontaminate if they knew that the 10-minute dwell time of the typical hospital-grade disinfectant "dwelled" for only 2 to 3 minutes?

AHE has reaffirmed previously published practice guidance for the minimal time for proper cleaning and surface disinfection of patient rooms. The reaffirmation is due to wide variations in cleaning practices. Over the last several 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."

In its Practice Guidance for Healthcare Environmental Cleaning, AHE states that an occupied patient room cleaning will take approximately 25 to 30 minutes per room. The terminal cleaning of a discharged patient room will take approximately 40 to 45 minutes per room.

However, it takes a collaborative effort by all health care disciplines to overcome the challenges that HAIs and multidrug-resistant organisms present to health care organizations and communities. Health facilities must understand that a clean environment is of utmost importance if we expect good patient outcomes. They must also reinvest in their ES departments.

This month's column was written by John Scherberger, CHESP, CEO of Healthcare Risk Mitigation Inc. and a past AHE board member.

AHE insight

Valuable resources

AHE offers a variety of educational materials. They include the following:

  • 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 for environmental services directors and managers, this book can be used as a resource for implementing proper cleaning techniques and procedures.
  • Contracting: Myths & Realities. This publication covers everything from outsourcing to management pitfalls. It includes sample surveys, budgets and task lists that will assist in making the best contracting decisions for a health care facility's environmental services department. AHE re-released this manual to keep environmental services professionals at the top of their game.
  • Glossary of Healthcare Terms for Environmental Services. This convenient reference tool features hundreds of terms and definitions organized alphabetically, both general and specific to environmental services, housekeeping and textile care.

For information on purchasing these and other valuable industry references, select "AHA Store," then "Environmental Services" click here.