John Weir – Healthcare Cleaning Professional

The major difference between cleaning a medical facility and any other building is the focus on the un-seen enemy, bacteria. Environmental Service’s job is to not only provide good visible results, but to reduce the number of surface bacteria to a safe level in order to control cross infection. This is an extremely important responsibility because it keeps harmful bacteria from infecting the person next door or across the hall. Persons whose bodies are recuperating from surgery, injury or a primary infection are in a weakened condition and therefore, cannot put p their normal fight against harmful bacteria. A secondary infection in these cases can cause very serious illness.

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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.

There has been a lot of media attention about the Institute of Medicine’s (IOM) report “To Err is Human,” especially over outbreaks of community-based Methicillin-resistant Staphylococcus aureus (MRSA). However, we should concentrate on the second report from the IOM, “Crossing the Quality Chasm,” which provides a road map for quality.

In this report, the IOM describes “Six Aims” to ensure health care quality. The Six Aims are identified as: safe, timely, effective, efficient, equitable and patient-centered health care. So what does this mean for ASHES members?

There is no other service in the health care environment that more intimately and consistently touches patients than environmental services. The patient comes in constant contact with our products, from the textiles that they wear and sleep on to the furniture, fixtures and various pieces of equipment they touch on a daily basis.

Taking this into consideration, our base of operations must be in complete balance with the Six Aims. A health care institution may employ the best in clinical care and purchase the finest technology available, yet little of it will matter if the institution is not properly cleaned and disinfected where appropriate. At its very core, environmental services’ reason for being is patient-centered. If we do not perform our roles in a safe, effective, efficient, equitable and timely manner we compromise the quality and health of our patients.

Environmental services staff and the roles they play are often the forgotten heroes in the quest for quality. As the rest of the institution works to achieve and improve upon the Six Aims, our services are often viewed as a way to improve timeliness and the core purpose is defeated. It is our job and obligation to make sure that everyone in the institution and within the industry is aware of how vital our services are to the safety and the healing environment of the patient.

There is no substitute for a clean environment that is free from potentially harmful organisms. The quality initiatives of environmental, waste, linen and transport services cannot be minimized or overlooked as insignificant in the quest for quality improvement.

What can you do? Get involved! In the IOM report, quality is defined as, “The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Professional knowledge is not limited to our profession. Be knowledgeable about other professions and their roles in quality as well. Be knowledgeable about what is going on in your institution. Make sure when the rest of your institution is working on the Six Aims, that you and your staff are involved and that you have allies in the infection control, safety and quality departments so you are included in the discussions and decisions when initiatives are being developed.

It is common for improvement initiatives that seem simple in the planning phase to turn into a problem for another department further down the continuum of care. This is not done intentionally; it usually occurs from lack of awareness about the rest of the cycle. Do not let this happen to you. Keep your eyes and ears open to what improvements are being discussed in your institution and play an active role.

Quality should be a topic when you meet with your boss, your peers across the institution and your staff. They tend to know more than we do at times, because they are on the units every day.

What steps have you taken in order to be consistent with professional knowledge? Let’s talk about it.

On the road to excellence!

Tina L. Cermignano, CHESP
Operations Manager
Children’s Hospital of Philadelphia
Philadelphia

We know that our primary purpose is cleaning. We train our staff to recognize dirt and soil in so many forms and to remove it. We educate, coach and celebrate our successes. We also know that good strategies for combating infection and cross contamination include things such as hand washing and personal protective equipment. In fact recent studies point more often to poor hand washing practices then the environment as the primary cause of hospital acquired infections.

We in Environmental Services understand the importance of hand washing as well as the importance of a clean environment. No matter how well hospital employees adhere to hand washing policies we simply cannot keep pathogens out. Without a top quality training program focused on cleaning and disinfecting the environment, infections will continue to be a problem; germs must be killed wherever they exist within the hospital environment.

I teach my staff to focus on cleaning. Our primary purpose is cleaning, and we never stop and say good enough. We clean and disinfect so that our surfaces not only look clean, they are free of contamination also. I work closely with our infection control department to track results and the partnership has helped to develop best practices that have proven very successful.

When you think about your role in healthcare, remember that without a healthy environment, patients will get sicker, and ultimately, go somewhere else for their healthcare. Support you facility with excellent cleaning, a team relationship with your infection control department as well as your staff. And don’t ever lose focus on cleaning for success.