John Weir – Healthcare Cleaning Professional

Cleaning and maintaining the built environment of a healthcare facility, or a building where healthcare services are delivered is driven largely by regulations and guidelines. These include regulations set forth by the Occupational Health and Safety Administration (OSHA), The Joint Commission (TJC), the Centers for Medicare and Medicaid Services (CMS), state and local agencies such as state health departments, and guidelines established by the Centers for Disease Control and Prevention (CDC). Other organizations providing guidelines include the Association for periOperative Nursing (AORN) for the operating room setting, the Association for Professionals in Infection Control (APIC) and the American Society for Healthcare Environmental Services (ASHES).

A standard of cleanliness must be created and taught.  You will find, as long as you remain in environmental services, that you will constantly learn new methods, procedures and requirements as this is dynamic and evolving occupation.

The standards of cleanliness must include protocols for consistent cleaning and disinfecting of all high touch areas and surfaces. Areas in need of less frequent cleaning because they are not a likely source of contamination should be identified and steps needed for cleaning various rooms must be identified and explained.

In Environmental Services, we are aware that first impression of our facility is very important to our clients and other staff, so we strive daily to provide a clean, safe and attractive environment. We also ensure that patient rooms are cleaned to the highest level to prevent cross contamination. The hospital, staff and patient depend on us to do our job with excellence.

Cleanliness is a prime concern to every member of our team because a clean environment successfully keeps bacteria and other germs from multiplying on facility surfaces, and this helps prevent a sick person from being at a greater risk from other diseases and conditions.

Yet as important as it is to remove soil and germs from the physical environment, it is also important to keep all areas neat and organized and in good repair. After all, surroundings with a pleasant appearance help to cheer up patients and send the message that their caregivers are concerned about every detail of service. A clean and attractive facility can actually enhance a patient’s ability to receive care and get well again.

I had a request for basic cleaning principles for a doctor’s office. Here is a list for any healthcare facility, and for your home as well.

• Scrubbing is the best way to physically remove dirt, debris and microorganisms.
• Cleaning is required prior to any disinfection process because dirt and debris will decrease the effectiveness of 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 the the dirtiest areas and debris that falls will be cleaned up last.
• Dry sweeping, mopping and dusting should be avoided to prevent dust and microorganisms from getting into the air and landing on clean surfaces.
• Mixing and dilution instructions must be followed. Too much or too little will reduce the effectiveness of cleaners and disinfectants.
• Cleaning methods and written cleaning schedules (work routines) 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. Work schedules and procedures should be consistent and posted.

There you go, general principles for cleaning hospitals, clinics and other healthcare facilities summarized.

March 21, 2010 — The great healthcare reform battle of 2009 and 2010, for the most part, is over.

Congressional Democrats today finally passed their bill.

The only thing it needs now is the signature of President Barack Obama to become the law of the land.

In a 219 to 212 vote, the House  approved a bill enacted by the Senate last December that represents the most sweeping government initiative in healthcare since the creation of Medicare and Medicaid in 1965.

Most notably, the legislation will require most Americans to acquire health insurance, help cash-strapped individuals and families purchase it through government-operated insurance marketplaces called exchanges, increase Medicaid enrollment by almost 50%, and impose regulations on private insurers that would prevent them from denying someone coverage based on preexisting conditions.

After the historic vote, the House is expected to turn  to a budget reconciliation bill that would amend the now-approved Senate bill more to the House’s and the president’s liking. Taken together with this reconciliation bill, the Senate reform package would extend insurance coverage to 32 million more Americans over 10 years at a cost of $938 billion, although it would reduce the federal deficit during that period by $143 billion, according to the latest estimates of the Congressional Budget Office (a few days ago, the CBO had released slightly different dollar amounts).

If approved by the House, the budget reconciliation bill will go before the Senate, where Senate Majority Leader Harry Reid (D-NV) says he has the minimum 51 votes required to pass it. Reconciliation bills — which adjust revenue and spending lines in the federal budget — cannot be filibustered in the Senate. It takes 60 votes in the Senate to override the endless speeches and procedural motions that characterize a filibuster and force a vote on legislation. Republican Senators, who unanimously opposed the reform bill approved by their chamber last year, command 41 votes.

Today’s House Vote Makes History in More Ways Than One

In addition to dramatically reshaping the American healthcare system — which accounts for one sixth of the nation’s economy — the legislation passed by the House today was historic for other reasons. For the first time, the American Medical Association supported a plan for government-orchestrated healthcare reform after having denounced earlier proposals, including legislation creating Medicare and Medicaid, as dangerous experiments in "socialized medicine." Other major medical societies that backed today’s bill were the American College of Physicians and the American Academy of Pediatrics.

The fear of federalization still resonated, though, among Republican politicians who formed a thick stone wall against the legislation. Their arguments against what they called a government takeover of medicine at times reached rhetorical fever pitches that will be remembered for years.

Sarah Palin, the former governor of Alaska and the Republican vice presidential candidate last year, warned that under the Democrats’ reform plan, bureaucratic "death panels" would deny care to the disabled and elderly in the name of cost-saving. Even though the likes of the AARP called these claims unfounded, the debate about complex healthcare policy soon featured the catch-phrase "pulling the plug on granny."

At the same time, the new Tea Party movement entered the fray, holding rallies, flooding congressional town hall meetings, and waving’s signs with messages such as "Save Granny. Defeat Obamacare" and "Get Government Out of Our Lives." Such protesters showed up today in force in Washington, DC, as the House casts its vote.

Fiery denunciations of reform legislation also resounded inside the Capitol building up until the time of the vote.

"My colleagues are celebrating the birth of a great new entitlement program," said Rep. Marsha Blackburn (R-TN). "Only they see dependency on the federal government and the death of freedom as a cause for celebration. Freedom dies a little bit today."

Last-Minute Promise of Executive Order Against Abortion Funding Secured Key Votes

One obstacle to House Democrats rounding up enough votes for victory was the issue of federal funding of abortions in an overhauled healthcare system.

When House Democrats crafted and passed their own reform bill last year, they included language that would prohibit any woman receiving an insurance premium subsidy from purchasing a health plan that covered an abortion other than a federally sanctioned one to save the life of the woman or in cases of rape and incest. The Senate bill contains a complicated anti-abortion restriction that resembles the House version in intent, but Democratic reform advocates in the House like Rep. Bart Stupak (D-MI) who are also abortion opponents said the Senate language was not strong enough for them to support the bill in good conscience.

Earlier today, President Obama convinced Rep. Stupak and his coalition of like-minded Democrats to change their votes to "Yea" by promising to issue an executive order that would ensure no abortions would be federally funded under the reform bill before the House on Sunday. President Obama released the text of the order and said he would sign it as soon as the House passed the bill.

It was good enough for Rep. Stupak.

"We’ve been able to come to an agreement to protect the sanctity of life in healthcare reform," Rep. Stupak said Sunday.

Two Medical Societies Applaud Reform Bill, But Say More Legislative Work Remains

In a press release issued tonight, American Medical Association President J. James Rohack, MD, said that by extending health insurance to millions more Americans, the bill passed by the House "will help patients and the physicians who care for them."

"Every day physicians see the devastating effect being uninsured has on the health of our patients," Dr. Rohack said. "Physicians dedicate their lives to helping patients, and we have an historic opportunity now to do just that."

Similarly, Lori Heim, MD, the president of the American Academy of Family Physicians, hailed the bill’s passage in a written statement. "As a result of today’s vote, Americans can look forward to health security because they soon will have the chance to buy health insurance that meets their needs without emptying their bank accounts," Dr. Heim stated.

Both Dr. Heim and Dr. Rohack said that their societies will continue to work with Congress on what they see as the unfinished business of healthcare reform, particularly medical liability reform and a permanent solution to the problematic formula for setting Medicare reimbursement for physicians, which calls for a 21.2% pay cut this year.

One of the organizations I am a member of, and actually the first that I joined, is the International Executive Housekeeping Association or IEHA.

Since 1930, the International Executive Housekeepers Association (IEHA) has been a non-profit organization committed to raising professionalism in the cleaning industry and providing a cleaner, safer, healthier environment.

IEHA members are Executive Housekeepers—managers who direct housekeeping programs in commercial, industrial or institutional facilities. IEHA provides members with an array of channels through which they can achieve personal and professional growth. Some are: leadership opportunities; resource materials; education program designation; employment referral service; a Technical Question Hotline (1-800-200-6342); networking; an annual convention and trade show, including several educational sessions; and a monthly trade publication, Executive Housekeeping Today.

Take a moment and learn more about our professional organization:

Time sure goes by fast. Sorry to have been away so long. I’ve been staying very busy, writing 83 performance evaluations, finishing my totally updated training manual, and learning as much as I can to be a great hospital safety officer.

I’m going to be posting some questions I’ve been asked recently, and give you my answers. I’ll be posting these at least a couple times each week. Hopefully some of the housekeeping questions will be helpful to you.

Storage on the floor must be neat and orderly.

No storage within 18 inches of the ceiling, except on shelves against the wall as long as sprinklers are not obstructed.

No evidence of smoking.

All exit signs are illuminated.

No storage of flammables or anything except cleaning items under sinks.

No door stops are allowed.

All equipment must be placed on one side of the hallway. Preferably nothing is in the hallway except crash carts and isolation supply tables.

Abate all trip hazards (secure cords).

Ensure stairwells are clean and no equipment is stored there.

All chemicals are labeled and your chemical list is available.

Do not block fire pull boxes, fire extinguishers or medical gas shut offs.

No evidence of smoking, no butts within 25′ of an entrance.

All gas cylinders in racks.

No visible dust or dirt on surfaces, floors or equipment.

No linen on floor, furniture or window sills; soiled linen in closed bag or covered hamper. All clean linen is covered.

No employee food/drink in patient refrigerators or at nurses stations. No food or drink on or in housekeeping cart or closet.

Check stairwells for trash and storage.

If I asked how many of you have seen a killer phrases poster … or even have one hanging in your office … I’m sure I’d see hands going up all over the world. What I seldom see are the replacements for the killer phrases … the things we can say instead of those old negative chestnuts. The one most of us already know is to replace “Yes, but …” with “Yes, and …” in order to build on ideas. But there are a lot more killer phrases that need replacing. I’ve listed a few and would like to invite you to send us your killer phrase with an appropriate Leap Stimulator.

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How to get rid of backlogs
There are basically two types of task which we are faced with during a typical day. First there is the type of task which either gets done or doesn’t get done. You either renew the car insurance or you don’t. You either paint the bedroom or you don’t. You either buy a new dress or you don’t. You either send your great aunt a birthday card or you don’t. The consequences of doing or not doing this type of task may range from the trivial to the momentous, but essentially they are one-offs.

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Change Begins With Choice

by Jim Rohn

Any day we wish; we can discipline ourselves to change it all. Any day we wish; we can open the book that will open our mind to new knowledge. Any day we wish; we can start a new activity. Any day we wish; we can start the process of life change. We can do it immediately, or next week, or next month, or next year.

We can also do nothing. We can pretend rather than perform. And if the idea of having to change ourselves makes us uncomfortable, we can remain as we are. We can choose rest over labor, entertainment over education, delusion over truth, and doubt over confidence. The choices are ours to make. But while we curse the effect, we continue to nourish the cause. As Shakespeare uniquely observed, "The fault is not in the stars, but in ourselves." We created our circumstances by our past choices. We have both the ability and the responsibility to make better choices beginning today. Those who are in search of the good life do not need more answers or more time to think things over to reach better conclusions. They need the truth. They need the whole truth. And they need nothing but the truth.

We cannot allow our errors in judgment, repeated every day, to lead us down the wrong path. We must keep coming back to those basics that make the biggest difference in how our life works out. And then we must make the very choices that will bring life, happiness and joy into our daily lives.

And if I may be so bold to offer my last piece of advice for someone seeking and needing to make changes in their life – If you don’t like how things are, change it! You’re not a tree. You have the ability to totally transform every area in your life – and it all begins with your very own power of choice.

To Your Success,