Winston Churchill said,

"To every man there comes
in his lifetime that special moment when he is
figuratively tapped on the shoulder and offered a
chance to do a very special thing, unique to him and
fitted to his talents. What a tragedy if that moment
finds him unprepared or unqualified for the work which
would be his finest hour.”

Don’t expect luck to present you with your finest
hour. Remember, luck is when preparation meets
opportunity. What three things are you doing right
now to prepare for greater opportunity this year –
and to perhaps experience your "finest hour?" The
best person to predict your future is you.

Portrait artist James Whistler decided to paint his
mother when the person who had scheduled an
appointment with him failed to show up. (Don’t wait
on perfect conditions for success to happen; just go
ahead and do something.)

Finish is too Sticky or Tacky

Cause

Solution

Not enough drying time between coats.
Under normal conditions, finishes dry in 20-30 minutes. High humidity extends drying time.

Restorer not properly diluted or applied too frequently.
Follow label instructions. Overuse can leave a sticky residue.

Restorer/maintainer not burnished soon enough after application.
When dry, restorer/maintainer will continue to soften finish if not burnished

Floor not properly rinsed before application of finish.
Thoroughly rinse and neutralize floor after stripping. Use neutral cleaner in proper dilution.

Improper use of disinfectants.
Measure carefully and follow label directions.

Separation of finish.
Finish may have been exposed to prolonged heat or cold. Shake or stir before using.

Alkaline or detergent contaminated tile.
Make sure to rinse floor until pick-up water remains clear. When recoating, make sure no cleaner residue remains on floor – rinse with clean water to prevent problem.

Finish is applied too thick.
Apply thin coats and allow each coat to dry before applying the next coat.

There’s really no such thing as knowing too much about what you’re doing. The reason’s I joined ASHES, ASHE, The American College of Healthcare Executives, IEHA and APIC are many but all focus on one thing, staying informed.

Staying informed is a daily task, and challenge, considering how quickly our world is moving. But not keeping up is like agreeing to check out – please don’t do that. Plug in and learn everything you can. You never know when information will come in handy.

If I hadn’t studied,  I wouldn’t have been able to see the great opportunity that led to my first big success.

Resolve to move forward and to learn as much as you can – today and every day.

How to Develop Charisma: Twelve Key Moves

Those who study the phenomenon of charisma say while some people are innately more charismatic than others, there are certain things everyone can do to boost their charisma quotient. Debra Benton, author of Executive Charisma: Six Steps to Mastering the Art of Leadership offers the following pointers:

Expect acceptance.
Regardless of rank, expect to be treated as an equal. If you expect acceptance, you just might get it. If you don’t expect it, you definitely won’t get it.

Control your attitude.
Success in business is based more on mental attitude than on mental capabilities. Be optimistic toward yourself, others and life. Walk in to a room with a spring in your step and a smile on your face.

Perfect your posture.
Pull your ribcage away from your pelvis, roll your shoulders back and down, pull your stomach in and tuck your bottom toward your spine. Breathe deeply. You’ll not only look better, but feel more energized, alert and in control.

Think before you talk.
Think fast, pause, then speak purposefully. One CEO practices saying everything to himself before he says it out loud so that he will hear how it sounds and can change it if he needs to.

Slow down.
Speed in speaking, moving, gesturing and walking looks nervous and scared. Scared people get passed over, not hired or promoted. Learn to speak in a comfortable, easygoing and welcoming way. Don’t waste time, but do speak as if you have all the time in the world for those you are speaking to.

Shoot straight.
Everything you say or write can be done in a simple, straightforward manner. Just do it.

Be a good storyteller.
People understand you better, remember what you say longer, and find you smarter and more interesting if you use anecdotes to make your points.

Be aware of your style.
Clothes don’t make the man but they do make a difference. Wear well-tailored, good quality clothes that make you look like you are in charge. But remember, it isn’t as much about your look as how you look at things and what people see when they look at you.

Admit your mistakes.
If you are error-free, you’re likely effort-free.

Don’t be bullied.
If you are unjustly criticized, don’t take the bait and get into an argument. Instead calmly ask: "Why do you think that?" "What do you mean?" or "What’s that based on?"

Be flexible.
Be able to stand out while still fitting in with the crowd.

Be at ease with yourself and others.
Look others straight in the eye, eliminate any defensiveness and take the edge off your voice. Never let them see you sweat!

Debra Benton is a best-selling author and internationally acclaimed speaker and coach who specializes in helping executives do a better job of presenting themselves. Her clients span 17 countries and include NASA, Hewlett-Packard, IBM and Pepsi. Debra can be reached at: www.topspeaker.com.

Training

·   Verbally explain

·    Physically demonstrate

·    Use visual aids and include written instruction in employment policies and as envelope stuffers with payroll.

·   Use daily checklist to assist troubleshooting and accountability.

Then repeat everything.

Scrubbing (frictional cleaning) is the best way to physically remove dirt, debris and
microorganisms.

Cleaning is required prior to any disinfection process because dirt, debris and other
materials can decrease the effectiveness of many chemical disinfectants.

Cleaning products should be selected on the basis of their use, efficacy, safety and
cost.

Cleaning should always progress from the least soiled areas to the most soiled areas
and from high to low areas, so that the dirtiest areas and debris that fall on the floor
will be cleaned up last.

Dry sweeping, mopping and dusting should be avoided to prevent dust, debris and
microorganisms from getting into the air and landing on clean surfaces. Airborne
fungal spores are especially important as they can cause fatal infections in
immunosuppressed patients.

Mixing (dilution) instructions should be followed when using disinfectants. (Too
much or too little water may reduce the effectiveness of disinfectants.)

Cleaning methods and written cleaning schedules should be based on the type of
surface, amount and type of soil present and the purpose of the area.

Routine cleaning is necessary to maintain a standard of cleanliness. Schedules and
procedures should be consistent and posted.

A little late, here are some suggested training topics for October:

1. Customer satisfaction surveys; HCAHPS, Press Ganey, Picker or your favorite. Don’t forget to add internal surveys and patient rounding results.
2. Department team building. Always very important.
3. Hazardous waste; transportation, handling and storage.

What waste is it

Questions often asked at facilities are” “Is this a waste?” and “Is the waste a hazardous waste?”

The answer depends on the issue of point of generation (POG). A material becomes a waste when the owner or operator decides that it cannot be used for its original intended purpose. A good example would be a can of paint. As long as there is a legitimate use for the paint and the paint is still usable as a paint, it is not a waste. So if you can find some one to use the paint in a legitmate manner, you won’t have to worry about it.  But if you decide that you want to dispose of it, it becomes a waste. Another example would be a jar of pure chemical on your laboratory shelf. If the shell life of that chemical has been exceeded (it cannot be used for its original intended purpose), it becomes a waste.

Another example: You may have a hazardous chemical in a machine that is operating on your site. You do not have a waste as long as that hazardous chemical stays inside the machine. But once you take that hazardous chemical out of the machine and you have no further use for it, you will have generated a waste at that point. That’s you POG.

Once you have a waste, then you have to determine if it is hazardous. Does it exhibit any of the four hazardous waste characteristics (ignitability, corrosivity, reactivity and toxicity)? Has the waste been listed by EPA?

Here Betco Corporation offers a video overview of how and why we clean critical areas. This is a good video for regular review.

Paul Tarrant, Site Coordinator at Community Hospital North gives an overview explaining how Environmental Services cleans at this Indiana hospital.

Highlighting common scenarios from hand hygiene and glove use to properly cleaning patient rooms, this video will illustrate the type of precautions that housekeeping staff should take to protect themselves and patients from germs and infections that could make them sick.

What is MRSA?

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that causes serious infections that are resistant to many of the strongest antibiotics, including methicillin and other more commonly used antibiotics (including penicillin and amoxicillin). (1)

MRSA occurs most frequently among patients who undergo invasive medical procedures or who have weakened immune systems and are being treated in hospitals and healthcare facilities. (2) These healthcare-associated infections (HAIs) include surgical wound infections, urinary tract infections, bloodstream infections and pneumonia. (3) People who have been hospitalized or had surgery within the past year or who are receiving treatments like dialysis are at increased risk for infections with MRSA. (4)

MRSA infections have risen sharply in recent years. In 1972, MRSA accounted for only two percent of all Staphylococcus aureus HAIs reported to the Centers for Disease Control and Prevention (CDC) in the U.S. (5) Recent data show that MRSA now accounts for 50 to 70 percent of Staphylococcus aureus infections. (6)

Staphylococcus aureus (“staph”) organisms are common bacteria that can live on the skin and are one of the most common causes of skin infections in the U.S. (7) The bacteria also live harmlessly in the nasal passages of roughly 30 percent of the U.S. population. These people are sometimes called “staph carriers” or persons who are “colonized” with staph organisms. Staph organisms can cause infection when they enter the skin through a cut or sore. Infection can also occur when the bacteria move inside the body through a catheter or breathing tube. The infection can be minor and local (for example, a pimple) or more serious. (8)

Though MRSA is generally associated with healthcare institutions, it can also occur in persons who have had no contact with a healthcare facility. These types of MRSA infections are classified as community-acquired MRSA (CA-MRSA) and are presenting to hospital emergency departments and outpatient clinics in increasing numbers. In addition, patients with CA-MRSA who are admitted to a healthcare facility can be the source for organisms that can be spread to other hospitalized patients, and such spread has been well documented. Many such infections have also occurred among athletes who share equipment or personal items (such as towels or razors) and among children in daycare facilities who are in very close contact with one another throughout the day. (9) By some estimates, more than half of all skin infections now treated in emergency rooms are caused by MRSA. (10)

How does someone contract MRSA?
MRSA is most often contracted while a patient is in the hospital. Transmission of MRSA organisms can occur from skin-to-skin contact with someone who has MRSA on their skin, by hands of healthcare personnel who pick up organisms on their hands from a colonized patient and then care for another patient without washing their hands between the tasks, by contact with items such as computer keyboards or surfaces such as bedrails that have the
organisms on them, and through insertion of devices such as catheters or breathing tubes that bypass the body’s natural defenses.

The risk for the spread of CA-MRSA is highest where people with poor hygiene are associating in close quarters such as prisons, homeless shelters, locker rooms and daycare centers.

How do we clean rooms used by MRSA infected patients?
Using a EPA registered disinfectant with a MRSA rating clean thoroughly using friction, all surfaces in the patient room, paying particular attention to high touch  surfaces. Be sure to follow contact precautions in addition to universal precautions, and wash hands thoroughly, when you finish cleaning.

References:

1 www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
2 http://www.cdc.gov/ncidod/dhqp/ar_MRSA_spotlight_2006.html
3 http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html
4http://www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
5 www.cdc.gov/od/oc/media/pressrel/r061019.htm
6 Siegel JD, Rhineheart E, Jackson M, Linda C; Healthcare Infection Control Practices Advisory Committee.
“Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006.” Available at

http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf.

7 http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html
8 http://www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
9 http://www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
10 Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, Talan DA; Emergency ID Net Study Group. (2006). Methicillin-Resistant S. aureus Infections among Patients in the Emergency Department, New England Journal of Medicine, 355,666-674.

Suggestions for Infection control procedures for free-standing imaging centers and hospital radiology departments

The cleanliness of free-standing imaging centers and hospital radiology departments is crucial for reducing the spread of MRSA and other acquired infections. The following are 11 simple procedures to implement that can prevent the spread of these infections.

1. Have a written infectious control policy to include MRI cleaning procedures as well as the cleaning schedule and have it posted throughout the center.

2. Implement a mandatory hand washing / hand sanitizing procedure between patient exams for technologists and any others who come into contact with patients.

3. Clean the MRI tables, inside the bore of the magnet and any other items that come into contact with a patient. Infection control experts recommend this be done between each patient.

4. Clean all pads and positioners with an approved disinfectant. Infection control experts recommend cleaning after each patient.

5. Periodically inspect the pads with a magnifying glass, particularly at the seams, to identify fraying or tearing. If present, the pads should be replaced.

6. Regularly check all padding material with an ultraviolet (black) light and make sure that any biological material detected on the pads can be removed.

7. Replace damaged or contaminated pads with new pads incorporating permanent antimicrobial agents.

8. Use pillows with a waterproof covering that is designed to be surface wiped. Replace pillows when their barrier is compromised.

9. Promptly remove body fluids, and then surface disinfect all contaminated areas.

10. If a patient has an open wound or any history of MRSA/other infection:

a. Gloves and gowns should be worn by all staff coming in contact with the patient. These barriers must be removed before touching other areas not coming in contact with the patient, i.e. door knobs, scanner console, computer terminals, etc.

b. The table and all the pads should be completely cleaned with disinfectant before the next patient is scanned, if it is not already being performed between every patient. For patients with any known infectious process add 10-15 minutes onto the scheduled scan time to assure there is enough time to thoroughly clean the room and all the pads.

11. All furniture should be periodically cleaned. Ideal surfaces are those that are waterproof and wipeable. Infection control experts recommend this be done between each patient.

1. Never mix chemicals.
2. Always wear gloves.
3. Always wear protective eye wear or glasses when pouring chemicals or working overhead.
4. Always wash your hands after chemical use and before eating.
5. If a potentially harmful chemical comes in contact with your skin or eyes, flush with water immediately and call your supervisor.
6. If n doubt about proper use, always ask your lead, supervisor or manager.
7. Chemicals should always be dispensed in the safest manner possible from a flip top cap. The only exceptions are glass cleaners and deodorizers, which can be dispensed by trigger sprayers.
8. Any chemical on a cleaning cart or in a storage closet must be labeled with the correct name of the contents in the bottle, the specific hazard warnings, and the target organs affected by exposure to the chemical. In other words, a pre-printed label. Don’t just write the name on a bottle.
9. For any question concerning makeup or compounds, please refer to the MSDS or your hazard communication manual.

The most important staff related task we have in Environmental Services is training. Almost every challenge or difficulty we face can be reduced or eliminated with great training. I’m going to list steps that will help you conduct successful training. This is not meant to be a perfect or complete list, just use this as your starting point and customize it for your needs.

ACTION STEPS:

1. Organize the Approach for Training

a. Decide the amount of skill you expect the trainee to acquire and by what dates.
b. Prepare a schedule to follow

1. Have the employee ready for training.
2. Decide what area will be used for training.
3. Decide items to be covered in each training session.

2. Organize the Work

a. Decide how the area to be covered will be separated into segments that can be learned.
b. Arrange for the proper supplies.
c. Be sure the necessary equipment is available and in good condition.

3. Orient the Employee

a. Put the person at ease.  Make them feel comfortable with you.
b. Explain the task to be learned and find out how much the employee knows about it.
c. Stress the importance of the task, the reason it must be done, and the results of doing it well.  The employee must become interested in learning the work.
d. Explain and show the employee each step of the task, one step at a time.  Don’t go too fast, look for understanding.
e. Stress each step clearly, completely, and with patience to make sure the employee understands.

4. Hands on Training

a. Have the employee attempt the task, and correct any errors while he or she does the task.
b. Have the employee do the task again, and explain each step as the employee does the tasks.
c. Repeat the procedure until you are certain that the task is being done properly and the employee fully understands.

5. Follow Up

a. Allow the employee to perform the task on their own.  Be sure they know that they should contact their supervisor if assistance is needed.
b. Check on the employee frequently until they are thoroughly comfortable in the performance of their duties.  Always encourage the employee to ask questions.

6. Evaluation Employee Performance

a. What are the areas of poor performance?
b. Should they be retrained?
c. If retraining is required, when should it be started, and how long should it last?
d. Is the schedule being met?  If not, why?

Any Questions?