Keeping hospitals clean and safe without breaking the bank

A paper has just been published in ARIC as the first academic output of the Healthcare Cleaning Forum. I blogged earlier this year to relate the inaugural Healthcare Cleaning forum, and this paper expands on the key themes: establishing environmental hygiene as a patient safety initiative, providing an overview of the importance of environmental hygiene in healthcare, exploring the human factors driving the standards of environmental hygiene along with the need for effective education, the possibilities and challenges of automation, and the cost and value of environmental hygiene.

One of the key aims of the forum is to be a champion for environmental hygiene professionals. There’s a famous story of when president JFK visited NASA and asked a janitor who was mopping the floor what they were doing. The answer was simple and profound: “I’m helping to put a man on the moon.” If you asked somebody working in environmental hygiene in your hospital what they were doing, would the response be: “I’m helping to maximise patient safety and prevent healthcare-associated infection.” Probably not. We need to champion the cause of environmental hygiene professionals, who lack professional status, are often not paid enough, and often have limited options for career progression.

Is environmental a treasured investment priority in hospitals?

Related to this is our perception of the cost and value of environmental hygiene in hospitals. Is our level of investment appropriate given the risks associated with inadequate environmental hygiene in hospitals? Would we really find highly valued cleaning and disinfection materials in the metaphorical safe of a hospital manager (see the cartoon above)? Probably not! We need work towards better evidence to understand the value of environmental hygiene in hospitals in the context of other investment priorities.

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The best IPC article of 2018: a blogoff with Brett Mitchell

In honour of Infection Prevention 2018, Brett Mitchell and I are having a blogoff so that you can choose the best IPC article of 2018. This post presents my case, Brett’s post (here) presents his case, and there’s a vote below so that you can choose. The results will be published next Monday morning at Infection Prevention 2018…

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Focusing on the role of nurses in environmental hygiene

I was asked to write a series of articles in the Nursing Times (along with my colleague and co-author Tracey Galletly) on the role of nurses in environmental hygiene*. Et voila:

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I mean cleaning…no, disinfection…no, both. (What you mean is ”environmental hygiene”!)

I’ve been struggling for years to find the best ‘catch-all’ term to describe hospital cleaning or disinfection or both. And, after much thought, I’ve settled on a proposal to share with you, dear reader: “environmental hygiene”.

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Painting the hospital room blue

This recent study from the Donskey group could provide hospital cleaning staff with a powerful visual cue to help assure adequate disinfectant coverage. The addition of a chemical widget to bleach solution gives it a bright blue hue when applied to surfaces, so allowing a cleaner to track their progress visually!

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Does reducing spore contamination on high-touch surfaces reduce C. difficile transmission?

Curtis Donskey’s group recently published a multicentre randomised trial in 16 US hospitals to evaluate the impact of an enhanced cleaning programme (including fluoruescent markers, environmental cultures, and feedback to cleaners) on the transmission of C. difficile. The intervention resulted in an increase in the removal of fluorescent markers, a reduction in environmental contamination with C. difficile, but no reduction in healthcare-associated CDI!

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What do you do to prevent VRE transmission?

What do you do to prevent VRE transmission?

…you are not alone, if the answer to this question is ‘nothing special’, based on survey published in ARIC! Dale Fisher’s team in Singapore put together a simple survey, asking the global IPC community what measures they have in place to prevent the transmission of VRE. There was a huge degree of variability, ranging from ‘nothing special’ to ‘the kitchen sink’!

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