In the past, we have often lauded the advantage of microfiber for cleaning. This is repeated today, but with the use of a disposable microfiber as the first step in the disinfection process. Of course, we are talking about cleaning first, then disinfecting. However, the products highlighted in this article are compatible with common disinfectants. These products are Rubbermaid‘s Hygen single-use microfiber swabs and wipes.
WHAT IS A MICROFIBER AGAIN?
Microfiber is a synthetic textile fiber (polyester, polyamide or a mixture) that is very fine and light with a denomination which is less than one decitex. A microfiber (filament) is characterised by its small diameter, the nature of its fiber and its structure. Therefore, not all microfibers are the same or of the same quality. This revolutionary material has quickly become a must in the hygiene, health and automotive sectors. To know more about it, read this article, Spotlight on microfiber!
THE HYGEN LINE FROM RUBBERMAID
The Hygen line was designed specifically for the healthcare industry. It is an excellent option for any facility looking to improve its cleaning efficiency, especially during the COVID-19 period. The HYGEN disposable microfiber pad and wipe contribute to the area cleaning as the first step in the disinfection process.
Microfiber pads and wipes
They eliminate 99.7% or more of the viruses and bacteria tested to help improve cleaning efficiency. And this was tested with water only
Help reduce cross-contamination with disposable pads/wipes that encourage cleaning with new pads/wipes for each area or task
Built-in scrub strips are made of polyester to help effectively remove dirt
DEMONSTRATION OF THE DISPOSABLE MICROFIBER
Here’s a video from Rubbermaid Commercial Products. They demonstrated the benefit of their Hygen disposable microfiber wipe compared to a paper towel and a disinfectant wipe. They use a fluorescent marker to demonstrate and verify cleaning practices.
Thus, using this disposable microfiber with a disinfectant provides an added layer of assurance. They will clean and disinfect well your floors and surfaces by combining the microbe removal power of the microfiber with the disinfectant’s killing power.
How can proper work organization contribute to the cleanliness of a hospital? How to be in the right place with the right equipment? Here are the questions we are going to answer in this post of the Cleaning in Hospitals series.
Evaluation of production needs
First, we need to assess the needs in hygiene and cleanliness. In order to do this, a standard evaluation is preferable but it needs to be adjusted based on the type of place, units, and traffic.
It is during the evaluation of needs that the hygiene and cleanliness estimate (see Cleaning in Hospitals part 2) is going to be determined. All daily, weekly, monthly, and annual tasks have to be considered.
Usually, the results are presented by production yields (square meters/hour) or FTE (Full Time Equivalent).
How to reduce time waste
How to measure productivity in a context where an important aspect of the task is moving? Actually, hygiene and cleanliness departments are almost always in the basement, whereas most of their work happens on the floors!
We increase productivity by reducing traveling.
It is for this reason that the cleaning cart needs to be as complete as possible and the water sources or janitor’s closets well stocked with supplies (i.e.: paper products or waste bags), equipment, and sanitary products. Moreover, it is important to remember that a good entrance carpet can greatly reduce dirt.
Have a successful day!
Here are a few hints on how to have a successful day:
Establish a sequence of actions to perform in a day/week/month
Define a sequential order of rooms
Integrate linked and periodical tasks (monthly)
Make sure to have time gaps to focus on periodical tasks (dusting of high surfaces, polishing, etc.)
Minimize traveling
Work by space and not by task
Distribute tasks equitably
One look is worth a thousand words: choose a colorful plan together with some graphics instead of a list of tasks on a word file!
This is all for this series of posts on Cleaning in Hospitals! Don’t forget that we’re always here to help, don’t hesitate to book an appointment by calling 514.645.2753 or subscribe to one of our training seminars. I really hope that you liked this serie of posts!
References: Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
The hygiene and cleanliness staff represents a key element in the fight against infections in hospital environments. Often little valued, their role in the global strategy of surface cleaning is extremely important.
The hygiene that comes from the work of the cleaning staff requires a high performance level. In order to reach that, the executing staff and the managers need to master all the different elements representing this profession.
Cleaning products and equipment are undeniably crucial in order to ensure performance during the environment asepsis of any establishment. Therefore, it is important to associate the day-to-day actions of the cleaning staff with a range of products and equipment that favor the quality of their performance.
Since several years, partly due to the devotion and the involvement of many members in the healthcare system, we take into consideration new factors:
Provincial training
Establishment of an AEP hygiene and cleanliness in healthcare environments of 630 hours now offered by many school boards
Provincial day of hygiene and cleanliness
Etc.
Having said this, the hygiene and cleanliness staff deserves our deepest gratitude. Thank you so much!
The next post is going to talk more in detail about one aspect of their profession: work organization.
Don’t miss any posts about this series, subscribe to this blog!
References:
Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
Cleaning in hospitals allows reducing risks of infection among patients. This is not the only factor, of course: good personal hygiene habits such as washing hands and the use of protective equipment such as overalls, gloves, masks, or protective glasses are also important elements.
For this reason, interventions must be well coordinated in order to have a good surface maintenance plan. The manager of hygiene and cleanliness should therefore take into account:
The type of place associated to the level of risk
The tasks to perform
The required cleaning frequency
If well applied, a detailed estimate allows validating the cleaning performance.
The global approach is going to be determined by type of place:
Regular eradication (e.g.: operating rooms)
Keeping environmental effects as light as possible (e.g.: low infection risk such as individual office spaces)
Balance of microorganisms. This approach is based on the competition between good and bad microbes. The presence of good microbes guarantees less space for bad microbes to grow (e.g.: living environments)
Green cleaning. Approach that uses less toxic products
Review and improve arrangements and/or surfaces (during conception or renovation)
The next post of this series is going to talk about another key factor: the hygiene and cleanliness staff.
References:
Le nettoyage dans les hôpitaux du 21e siècle by Dr. Stephanie J. Dancer, Medical, Microbiology, Hairmyres Hospital, UK appeared on the magazine Le Nettoyage professionnel, July/August 2012.
Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
For a long time, cleaning has been all about the look; fresh smell and the absence of stains or dirt were the criteria to determine that a place is clean. Today, these criteria are still generally accepted in environments such as offices and classrooms.
It’s common knowledge, however, that microbes (bacteria or viruses) invisible to the human eye represent a risk for spreading infections. Take the example of the influenza virus: it can survive for up to 48 hours on a hard surface!
Without cleaning and disinfection procedures or a quality check procedure, microbes can survive in hospital environments.
Three key elements have to be considered in order to perform an infective risk analysis:
Is the patient carrying a disease agent? Disease agents are classified based on their spreading capacity and their virulence. The choice of a disinfectant will be based on this.
Do the functional activities of a sector represent a risk of spreading infections from the environment? E.g.: food service, offices, Intensive Care, etc.
The intensity of contact is related to the traffic and the surfaces that are more likely to be touched. E.g.: bathroom fittings.
Have you already performed an infective risk analysis? The next post is going to explain how cleaning allows reducing risks of infection among patients.
Don’t miss any posts about this series, subscribe to this blog! You just need to write your e-mail address, it’s that easy!
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References:
Le nettoyage dans les hôpitaux du 21e siècle by Dr. Stephanie J. Dancer, Medical, Microbiology, Hairmyres Hospital, UK appeared on the magazine Le Nettoyage professionnel, July/August 2012.
Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
Hygen microfiber from Rubbermaid Commercial Products
The COVID-19 has led us to adopt new protocols to ensure patient and staff safety in healthcare facilities. Having said that, it is crucial to equip yourself with the right surface cleaning and disinfection products in healthcare facilities! What are the right products? How should you clean? Let’s explore them with the help from Rubbermaid Commercial Products, a world leader in the commercial cleaning industry! Of course, in these strange days, depending on the availability of some products, Lalema has suggestions as well ;)!
SURFACE CLEANING PRODUCTS
First of all, here are some products suggested by RCP for surface cleaning. Overall, most of them are available. Otherwise, we have replacements.
Recommended surface cleaning products
Hygen microfiber cloths – Rubbermaid Commercial Products’ all-purpose 16″ x 16″ HYGEN microfiber cloths remove 99.9% of the viruses and bacteria tested on surfaces.
Bowl Brush – This bowl brush has a plastic handle. The brush is made of polypropylene bristles. It is odor and stain resistant.
Toilet brush holder – This toilet brush holder is made of polypropylene. It is stain and odor resistant.
Bottle and Sprayer: Graduated bottle for inserting and spraying cleaning solutions.
Dry Wipes and MYOSAN TB Kit – Kit of dry wipes and MYOSAN TB designed to disinfect and eliminate microorganisms on hard surfaces. It should inactivate the new coronavirus SARS-CoV-2, the virus that causes COVID-19.
Dry Wipes and MYOSAN TB Kit
BEST PRACTICES
Second, as expectations for cleanliness and hygiene rise, facilities must ensure that they have an established surface cleaning and disinfection process. This includes regular cleaning of high-traffic areas. Below are the best surface cleaning practices used in hospitals around the world today.
CLEANING TIPS
Clean systematically, clockwise or counterclockwise – No surface is forgotten, this process saves time and is more ergonomic
Go from clean to dirty – This reduces the likelihood of the spread of infections and contaminants
Clean from the top to the bottom – Any dust or debris dislodged from the upper surface will naturally fall to the lower surfaces
Wipe in one direction (unidirectional wiping) – Unidirectional wiping ensures that the solution is applied over the entire surface, while circular wiping re-contaminates areas
Color Coding – Use single color wiping cloth for each zone. For example:
Red for high risk areas
Blue for mirrors
Yellow for baths and showers
8-SURFACE FOLDING METHODOLOGY
Finally, the 8-surface folding methodology! This is the 8-sided folding for microfiber cloths. It optimizes the use of the cloth while reducing the risk of cross-contamination during the cleaning process. Here are the steps:
8-SURFACE FOLDING METHODOLOGY
8-surface folding methodology by Rubbermaid Commercial Products
Start by opening a clean microfiber cloth
Fold the microfiber cloth in half
Fold the microfiber cloth into four pieces
Clean surfaces with both sides of the cloth exposed
Open the microfiber cloth once to change the sides
Fold over to expose both clean cleaning surfaces
Fully open the microfiber cloth when all four sides have been used
Repeat steps 2 to 7 to use all eight sides
In short, these tips are only general since we could have gone deeper into the details or in further checklists. However, the importance is to set up a methodology for surface cleaning and disinfection and to be equipped with the right products. Don’t forget to wear personal safety equipment! Let’s save the subject of floor cleaning for another day!
Lalema would like to thank and salute all the staff in the healthcare facilities for their services!
You’ve already seen on this blog just how dirty cellphones can get, but did you know that cellphones and other electronics such as tablets and laptops can also cause contamination in a healthcare setting, potentially making them a source of HAIs? Hospital staff use technology throughout their workday, whether it be to enter patient information in a computer or for personal use on their breaks. If they don’t wash their hands before and after using the device, it can become contaminated causing those workers to spread the bacteria all throughout the hospital.
According to Kelly M. Pyrek (2019),
“A casual online poll of ICT readers shows that 83 percent of survey respondents use their personal mobile technology devices within the hospital, and just 68 percent said they clean/decontaminate these devices regularly. Fifty-seven percent of respondents indicated they use a hospital-issued mobile technology device in the course of their workday; 56 percent report cleaning the device themselves, while 7 percent let someone else clean the device.”
Kelly M. Pyrek, Infection Control Today, 2019
Many hospitals are now realizing that technological devices are a potential source of the spread of infection within a healthcare setting and some of them are beginning to implement protocols regarding the use and disinfection of electronics.
That being said, the cleaning and monitoring of technological devices can be complicated. As James Davis, MSN, RN, explains to Infection Control Today (2019), tech companies such as Apple only tell people to wipe down their devices with a damp cloth. However, that recommendation does not take into consideration the use of devices in a healthcare setting, where bacteria and infection are everywhere.
Some recommendations that Davis and Shivek, Phd, senior product engineer, give include:
Always washing your hands before and after using your device
Placing a layer between the device and the environment is key
Phone covers are becoming increasingly popular, however must be replaced frequently
Placing the mobile device in a ziploc bag is another option, especially if it’s being brought into an isolation room
No matter what, always wipe down the device before and after using it. Even if it was in ziploc bag or had a cover over it, wiping your device is key to ensuring that harmful bacteria are eliminated.
The cleaning and monitoring of technological devices is a daunting task for healthcare facilities, especially if it is an employee’s personal device. Davis (2019) stresses that because of this, employees should be personally responsible for the cleaning and disinfecting of their mobile devices. Although a complicated task, the recommendations provided by Infection Control Today allow us to understand how to better prevent the contamination of our mobile technology, which may in turn help prevent the spread of infection.
Healthcare-associated infections (HAIs) are one of the biggest risks in healthcare today and Canada is no exception to this. In fact, Canada has one of the highest occurrences of HAIs out of all developed nations, with 200,000 cases per year and consequently, 8000 deaths (Statistics Canada, 2016). The spread of HAIs can be prevented, as we have seen on this blog, with proper handwashing techniques as well as proper disinfection protocols for equipment and patient rooms. The problem is that hospitals need A LOT of staff in order to properly disinfect, and control and prevent infection. And yet, Canada, as well as other countries, are seeing cuts in hospital staff.
According to a report prepared by Venrock (2018), one of the predictions for trends in healthcare for 2018 was the continuation of cutting and hiring less hospital staff. This is mostly due to hospitals working to balance their budgets. But at what costs does this balancing of budgets come at?
Although not a recent report, CBC’s Marketplace investigation of hospital cleanliness from 2012 does a good job at showing the consequences of hospital staff cuts (see video below). They interviewed nurses, doctors and hospital cleaners to find out more about staff cuts and its relation to infection control.
One hospital cleaner described the following:
“They’ve really cut staff, and we don’t have a lot of time to actually get done what we’re supposed to get done in a day. We used to have one person to one wing of the hospital to clean, but now we have three floors to clean.”
Anonymous, Hospital Cleaner (2012)
According to the report, in order to sufficiently clean a hospital room, it would take just over an hour. However, with the staff cuts being made, hospital cleaners are only getting on average 15 minutes for each room. This leads to a lot of uncleaned surfaces, leaving harmful pathogens in patient rooms. Furthermore, sometimes the harmful bacteria will even be spread from one room to another, since cleaners either don’t have the time to change cleaning materials or there aren’t enough cleaning materials. One example given in the report is that a cleaner will mop a patient’s room and then continue mopping into another room with the same water, simply because they don’t have the time to change the water.
Hospital staff cuts may save hospitals money, however, the potential risks that result from staff cuts are very significant and should not be overlooked. Leaving surfaces infected by pathogens can be detrimental to both patients and staff, and that is why it is essential to have an adequate number of educated staff to control the spread of infection.
To learn more about the consequences of hospital staff cuts, refer to this CBC Marketplace video:
According to Infection Control Today (2018), a recent study carried out in a hospital in the UK has determined that a “one wipe” cleaning system was proven to be more effective than the traditional “two wipes” system in reducing the risk of MRSA in hospitals. Between 2013-2016, the hospital had been using a “two wipe” system, which consisted of first using a detergent wipe and then using an alcohol wipe as a disinfectant. In May 2016, a universal cleaning and disinfection wipe was introduced to the healthcare facility, and it made a significant difference.
According to Infection Control Today (2018),
“Using a Poisson model the researchers demonstrated that the average hospital acquisition rate of MRSA/100,000 patient bed days reduced by 6.3 percent per month after the introduction of the new universal wipe.”
Infection Control Today (2018)
These results were significant, and led to a big change in how this UK healthcare facility cleans its equipment. Not only did the universal disinfectant wipes lead to higher efficacy, but they also led to higher efficiency, since healthcare workers now only have to go over the equipment once and are assured that it will be clean.
Keeping this in mind, there are many different types of disinfectant wipes to choose from. If you would like to learn more about different types of disinfectant wipes, and how each of them work, feel free to visit our official website, and view our product offerings, or contact us directly by phone or email.
Click on the link below to view our product offerings for disinfectant wipes.
On this blog, we have already reviewed many of the sources of a major health problem: hospital-acquired infections (HAIs). And yet, every day, researchers seem to discover new sources of HAIs. One of the latest discoveries is that hospital privacy curtains in hospital rooms are extremely contaminated with pathogens. A study conducted in Winnipeg, Canada, revealed that freshly hung hospital curtains with minimal contamination became more contaminated each day that they hung in the hospital rooms. Furthermore, after 14 days of being in the room, 87.5% of the curtains were tested positive for methicillin-resistant Staphylococcus aureus (MRSA).
Kevin Shek (Bsc), the leader of the study on hospital privacy curtains carrying pathogens, writes,
“We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed.”
Kevin Shek (2018)
Healthcare facilities have been placing a great amount of effort in reducing the risk of HAIs in terms of hand-washing and the cleaning of equipment and high-touch surfaces, however, other things such as curtains, mattresses, and bedsheets have often been overlooked. A survey that was conducted to determine how hospital privacy curtains are cleaned/changed revealed frightening results. Only about half of the hospitals had a written policy which specified how often the curtains needed to be changed. 37% of respondents answered that hospital curtains were changed only when visibly soiled. 13% of respondents answered that the curtains were changed only once per year. Considering the results obtained from the Winnipeg hospital study, where curtains became increasingly more contaminated with each day that they remain in a patient’s room, the responses from the survey are alarming.
In terms of controlling the spread of infection, hospitals really need to consider that almost anything in the facility could be contaminated. Hospital cleaning is becoming increasingly complicated, as there are so many places where harmful pathogens can be found. It will be increasingly important that healthcare facilities develop new protocols and policies to prevent HAIs.
The list of potential areas of contamination in hospitals seems to keep growing, leading us to identify more sources of hospital-acquired infections (HAIs) and making hospital cleaning continuously more complicated. To add to this, researchers are now finding that hospital floors are a significant source of hospital-acquired infections. Every day, hospital and clinic floors are flooded by thousands of people. Shoes soles, wheels from equipment, such as monitors or stretchers and bodily fluids all contribute to the contamination of hospital floors.
It seems so obvious; floors are dirty in general. Hospital floors must be even dirtier. However, as Koganti, et. al. (2016) describes,
“… hospital floors are often heavily contaminated but are not considered an important source for pathogen dissemination because they are rarely touched. However, floors are frequently contacted by objects that are subsequently touched by hands (e.g., shoes, socks, slippers). In addition, it is not uncommon for high-touch objects such as call buttons and blood pressure cuffs to be in contact with the floor.”
(Koganti, et. al. (2016).
In addition to this, shoe soles and wheels on equipment also frequently touch hospital floors. Shoes of healthcare professionals can lead to the spread of infection since these workers are visiting many different patient rooms. Similarly, equipment such as monitors, stretchers or infusion pumps all have wheels which touch the floors of multiple hospital rooms.
Now you might be thinking, ‘but surely hospital floors are routinely cleaned?’ While that is true, researchers are now finding that much of the floor cleaning that is done is relatively ineffective since the bacteria is able to reproduce so quickly. So, what can be done to help reduce the risk of hospital floor contamination?
A good hygiene program for hospital floors, to reduce the risk of contamination
The cleaning and the disinfection of floors are essential elements of an effective hygiene program for hospitals. Regular floor maintenance implies the systematic elimination of hidden bacterias, which can be achieved by using vacuums, mopping and other elimination processes.
A good floor disinfection program consists of using effective disinfectants/detergents and procedures that are notable for reducing the risk of contamination. It is also important that cleaning equipment be properly cleaned and maintained, so that bacteria doesn’t spread when cleaning.
Cleaning hospital floors seems like a daunting task, especially since bacteria has been able to reproduce and spread itself so quickly. Healthcare facilities will need to become more exigent with their floor cleaning programs, if they are going to seriously tackle the threat of hospital-acquired infections.
Hospital-acquired infections are a serious threat in healthcare facilities today and researchers keep finding new sources of these infections. We know that sources of HAIs include surfaces, high-touch objects, hands and medical devices, but did you know that these infections can also occur due to the water and plumbing systems in healthcare facilities?
Source: Public Domain Pictures
According to Infection Control Today (2018), “Potable and utility water systems in healthcare settings are reservoirs and vectors of Hospital-acquired infections, resulting in pneumonias, bacteremias, skin infections, surgical site infections, eye infections and others.”
Hospitals are major users of potable water, whether it be for drinking, bathing, hand-washing or rinsing medical devices. It is therefore important that healthcare facilities realize that the water entering their facilities is not considered sterile.
Why is the water in plumbing systems infected? The design of and water use patterns in premise plumbing creates biofilms, which provide shelter and food for harmful bacterias. According to Infection Control Today (2018), “Biofilms in premise plumbing systems are complex ecosystems, and it is within these biofilms that bacteria, fungi and amoeba find the food, water and shelter they need.” Many bacteria develop in the biofilms, such as Legionella, Ancinetobacter aumanniii, Aspergillus flavus, etc.
Legionella – what is it and how does it affect patients in a healthcare setting?
Legionella colonies
Source: Wikimedia Commons
Legionella is one example of a bacteria that is found naturally in water. This bacteria is known for causing Legionnaires’ disease: a severe form of pneumonia. This disease is one of the most significant waterborne infections. Legionnaires normally has a mortality rate of only 10%, however, if acquired in a hospital, this rate goes up to anywhere between 25-50% (Infection Control Today, 2018)! Hospitals experience the highest number of outbreaks of Legionnaires disease (compared to other types of buildings) due to having a large number of patients with weakened immune systems or that have chronic diseases. It is important to note that the majority of Legionnaires cases in hospitals are due to the drinking water system.
How to reduce the risk of wHAIs: education and water management programs
So now that we are aware of waterborne hospital acquired infections (wHAIs), is there a way to reduce the risk that potable water poses to healthcare facilities? Infection Control Today (2018) suggests both education and water management programs as possible solutions to reducing the wHAI risk. Firstly, through education, it is important that healthcare workers know that potable water does carry bacteria and does cause an increase in HAIs. Second, once this idea of water carrying bacteria is understood, it will be important to implement water management programs. There can be no standardized water management programs, as all facilities differ in factors such as age of establishment and system, overall design of plumbing system, populations served, etc. Some hospitals have already tried different methods of water disinfection. Examples of these methods used to reduce risk include the use of sterile water in high-risk patient areas, engineering controls and point-of-use water filters.
To summarize, healthcare facilities must realize the risk that water and plumbing systems pose to their patients and employees. Hospital-acquired infections are one of the leading causes of death in North America and it is therefore crucial that hospitals take action against any source that could spread these infections. Education and water management programs are the best ways to help reduce the risk of wHAIs, according to Infection Control Today (2018).
In order to make it easier to identify a medical instrument, many doctors use different marking systems.The methods in which medical instruments can be marked are quite strict, in order to prevent the spread of bacteria. For example, instruments cannot be engraved because bacteria can get stuck in the small holes and grow. The article “Instrument Marking Methods Must be Maintained Properly”, by Nancy Chobin, describes three different methods of marking medical instruments and how these methods still have disadvantages and need to be maintained.
Source: Wikimedia Commons
First method for marking a medical instrument
Firstly, instruments are often marked by different colored tapes, however, many healthcare professionals fail to realize that the tape on the instruments can harbour bacteria and must be very carefully maintained. The tape should be replaced as soon as it begins to chip, as those small tears in the tape could allow for microorganisms to grow. According to Chobin “All tape and adhesive residues should be completely removed and the instrument washed before it is re-taped.” It is also stressed that a sharp object should not be used to remove tape, as this could simply create small fissures on the instrument where bacteria could grow.
Two other methods for marking a medical instrument
There are two other methods for marking instruments that are considered “acceptable”; chemical etching and color-bonding. These methods also come with some disadvantages, such as color-bonded instruments also chipping sometimes, however, seem to be more “sanitary” than using tape.
Why is this important? The general goal of healthcare facilities is to improve the health of its patients, while at the same time controlling and preventing the spread of infections and contamination. This means that healthcare facilities should aim to prevent, at all costs, the growth of bacteria. In order to be able to do so effectively, healthcare workers must know where all sources of bacteria may come from.
Source: Infection Control Today. Vol. 21. No. 12. December 2017.
Preventing and controlling the spread of contamination and infection is of very high importance for healthcare facilities, and it is safe to say that many measures have already been taken in order to reach these goals. However, like many things, there is still much room for improvement moreover when it is about surface damage.
Source: Shaw Air Force Base
Evidently healthcare facilities use a wide variety of equipment, from monitors to surgical instruments to cleaning tools, and over time, this equipment wears down. Sometimes, equipment will break completely and be unusable, however sometimes there will only be a few scratches or other small damage. But what happens when these scratches or other forms of damage become shelters and areas of growth for microorganisms? This is an example of how surface damage may not only impede the prevention of bacteria growth, but also provide the microorganisms with a place to grow.
What is surface damage?
According to Infection Control Today, surface damage is defined as:
a quantifiable physical or chemical change from the original manufactured state of an object (surface or device).
While it is recognized that surface damage of medical equipment poses a potential threat in the spread of bacteria in healthcare facilities, there is no standardized method for healthcare workers to determine what is considered surface damage, and at what point the damage is likely to cause the spread of bacteria. In a later blog post, I will discuss the ideal surface damage testing protocol, proposed by Peter Teska et al. in “Infection Control Today.” In this article, the authors discuss ideal methods of avoiding the problems that surface damage presents.
Are your surfaces damaged?
At Lalema, when we talk about hygiene and cleanliness, we offer a wide range of technical and consulting services. Find out more.
As a follow-up to my previous blog post about the problem of hospital bed mattresses being contaminated, I would like to go into further detail the recommendations provided by the Food and Drug Administration (FDA). As previously mentioned, the FDA recommends that healthcare facilities take preventative measures against contamination of hospital bed mattresses in four simple steps: inspection, removal and replacement, maintenance and the development of an inspection plan.
Source: Flickr
Inspection involves routinely checking the bed mattress cover for any signs of damage, stains or tears, as well as checking if the bed mattress cover is past its expiry date (Yes – bed covers do have a limited lifespan). It is also important to frequently remove the cover and check the inside surface, as well the mattress itself for these same conditions.
Next, it is important to replace any mattress covers with visible signs of damage or stains. Also, mattresses with damage or visible stains should be removed immediately.
For maintenance, it is important to clean and disinfect undamaged bed mattress covers. This can be done according to the bed cover cleaning guidelines given by the manufacturer.
Finally, FDA suggests that healthcare facilities develop an inspection plan that can be applied for all medical bed mattresses and covers. It is important to check the expected life of the bed mattress, as well as the cover.
Source: Infection Control Today. Vol. 22. No. 1. January 2018.
For a long time, cleaning has been all about the look; fresh smell and the absence of stains or dirt were the criteria to determine that a place is clean. Today, these criteria are still generally accepted in environments such as offices and classrooms.
It’s common knowledge, however, that microbes (bacteria or viruses) invisible to the human eye represent a risk for spreading infections. Take the example of the influenza virus: it can survive for up to 48 hours on a hard surface!
Without cleaning and disinfection procedures or a quality check procedure, microbes can survive in hospital environments.
Three key elements have to be considered in order to perform an infective risk analysis:
Is the patient carrying a disease agent? Disease agents are classified based on their spreading capacity and their virulence. The choice of a disinfectant will be based on this.
Do the functional activities of a sector represent a risk of spreading infections from the environment? E.g.: food service, offices, Intensive Care, etc.
The intensity of contact is related to the traffic and the surfaces that are more likely to be touched. E.g.: bathroom fittings.
Infective Risk Analysis
Cleaning in hospitals allows reducing risks of infection among patients. This is not the only factor, of course: good personal hygiene habits such as washing hands and the use of protective equipment such as overalls, gloves, masks, or protective glasses are also important elements.
For this reason, interventions must be well coordinated in order to have a good surface maintenance plan. The manager of hygiene and cleanliness should therefore take into account:
The type of place associated to the level of risk
The tasks to perform
The required cleaning frequency
If well applied, a detailed estimate allows validating the cleaning performance.
The global approach is going to be determined by type of place:
Regular eradication (e.g.: operating rooms)
Keeping environmental effects as light as possible (e.g.: low infection risk such as individual office spaces)
Balance of microorganisms. This approach is based on the competition between good and bad microbes. The presence of good microbes guarantees less space for bad microbes to grow (e.g.: living environments)
Green cleaning. Approach that uses less toxic products
Review and improve arrangements and/or surfaces (during conception or renovation)
The Cleaning Staff: key to success
The hygiene and cleanliness staff represents a key element in the fight against infections in hospital environments. Often little valued, their role in the global strategy of surface cleaning is extremely important.
The hygiene that comes from the work of the cleaning staff requires a high performance level. In order to reach that, the executing staff and the managers need to master all the different elements representing this profession.
Cleaning products and equipment are undeniably crucial in order to ensure performance during the environment asepsis of any establishment. Therefore, it is important to associate the day-to-day actions of the cleaning staff with a range of products and equipment that favor the quality of their performance.
Since several years, partly due to the devotion and the involvement of many members in the healthcare system, we take into consideration new factors:
Provincial training
Establishment of an AEP hygiene and cleanliness in healthcare environments of 630 hours now offered by many school boards
Provincial day of hygiene and cleanliness
Etc.
Having said this, the hygiene and cleanliness staff deserves our deepest gratitude. Thank you so much!
Work Organization
How can proper work organization contribute to the cleanliness of a hospital? How to be in the right place with the right equipment? Here are the questions we are going to answer in this post of the Cleaning in Hospitals series.
Evaluation of production needs
First, we need to assess the needs in hygiene and cleanliness. In order to do this, a standard evaluation is preferable but it needs to be adjusted based on the type of place, units, and traffic.
It is during the evaluation of needs that the hygiene and cleanliness estimate (see Cleaning in Hospitals part 2) is going to be determined. All daily, weekly, monthly, and annual tasks have to be considered.
Usually, the results are presented by production yields (square meters/hour) or FTE (Full Time Equivalent).
How to reduce time waste
How to measure productivity in a context where an important aspect of the task is moving? Actually, hygiene and cleanliness departments are almost always in the basement, whereas most of their work happens on the floors!
We increase productivity by reducing traveling.
It is for this reason that the cleaning cart needs to be as complete as possible and the water sources or janitor’s closets well stocked with supplies (i.e.: paper products or waste bags), equipment, and sanitary products.
Moreover, it is important to remember that a good entrance carpet can greatly reduce dirt.
Have a successful day!
Here are a few hints on how to have a successful day:
Establish a sequence of actions to perform in a day/week/month
Define a sequential order of rooms
Integrate linked and periodical tasks (monthly)
Make sure to have time gaps to focus on periodical tasks (dusting of high surfaces, polishing, etc.)
Minimize traveling
Work by space and not by task
Distribute tasks equitably
One look is worth a thousand words: choose a colorful plan together with some graphics instead of a list of tasks on a word file!
Want to know more?
Look this free webinar from my collegue Remi:
Need help?
Don’t hesitate to call 514.645.2753 or subscribe to one of our training seminars. I really hope that you liked this post!
Ebola is a virus. There is currently no vaccine or treatment. It causes severe disease, causing serious symptoms including vomiting and bleeding. The mortality rate can reach 90%. Primary infection comes from a contact with an infected animal and it can spread quickly.
How can you get infected by Ebola?
By coming into contact with following bodily fluids such as blood, urine, feces and vomit. Of by one of the following means: by contact with a dead victim, by ingestion of infected animal meat or by having sexual intercourse with an infected person.
What are the symptoms of Ebola?
The symptoms of Ebola are fever, headache, nausea and fatigue. It may also include bleeding from nose, mouth or eyes, coughing, diarrhea or vomiting with the possible presence of blood.
How to prevent ebola transmission
The risk of transmission of the Ebola virus in Canada is very low. However, certain precautions must be taken. The Public Health Agency of Canada also recommends that travelers avoid all nonessential travel to Guinea, Liberia and Sierra Leone.
There is a risk only if you have been in contact with sick people. In such case, if you experience symptoms, call 8-1-1 (Quebec) and inform them of your discomfort. You will be directed to the healthcare center care that can help you.
What to do to prevent the spread of Ebola virus
The Ministère de la Santé et des Services sociaux in collaboration with the Institut nationale de santé publique du Québec has issued recommendations in case of an outbreak. It is important that each healthcare center that can receive a potentially infectious patient put in place appropriate precautionary measures. Thus, it is important to have the required equipment for this type of care.
The Ebola outbreak in West Africa is slowly becoming an epidemic that is spreading beyond Africa. Although the risk of transmission is relatively low, it is the largest ever recorded outbreak of Ebola. WHO, CDC and other NGOs have declared a state of emergency and fight tirelessly to limit the outbreak.
Importance of hygiene when it comes to Ebola
The debate today is polarized on the ethical use of experimental drugs. However, few media state of the propagation modes and the importance of hygiene against this virus. Although transmission is being achieved mainly by direct contact between two people, contaminated objects and surfaces can present a risk that is hard to assessed. Thus, the CDC and WHO suggest that objects in direct contact with the patient must be decontaminated properly and that medical or objects contaminated with body fluids must be incinerated.
Stabilized Sodium Hypochlorite
All well and good, but what product can be used to disinfect appropriately? Ebola Virus Outbreak Guidelines written by members of the Ministry of Public Health of Gabon suggest the use of sodium hypochlorite.
We do not always know the microbial threats we face, but if in doubt use a disinfectant caliber is required.
How can proper work organization contribute to the cleanliness of a hospital? How to be in the right place with the right equipment? Here are the questions we are going to answer in this post of the Cleaning in Hospitals series.
Evaluation of production needs
First, we need to assess the needs in hygiene and cleanliness. In order to do this, a standard evaluation is preferable but it needs to be adjusted based on the type of place, units, and traffic.
It is during the evaluation of needs that the hygiene and cleanliness estimate (see Cleaning in Hospitals part 2) is going to be determined. All daily, weekly, monthly, and annual tasks have to be considered.
Usually, the results are presented by production yields (square meters/hour) or FTE (Full Time Equivalent).
How to reduce time waste
How to measure productivity in a context where an important aspect of the task is moving? Actually, hygiene and cleanliness departments are almost always in the basement, whereas most of their work happens on the floors!
We increase productivity by reducing traveling.
It is for this reason that the cleaning cart needs to be as complete as possible and the water sources or janitor’s closets well stocked with supplies (i.e.: paper products or waste bags), equipment, and sanitary products.
Moreover, it is important to remember that a good entrance carpet can greatly reduce dirt.
Have a successful day!
Here are a few hints on how to have a successful day:
Establish a sequence of actions to perform in a day/week/month
Define a sequential order of rooms
Integrate linked and periodical tasks (monthly)
Make sure to have time gaps to focus on periodical tasks (dusting of high surfaces, polishing, etc.)
Minimize traveling
Work by space and not by task
Distribute tasks equitably
One look is worth a thousand words: choose a colorful plan together with some graphics instead of a list of tasks on a word file!
This is all for this series of posts on Cleaning in Hospitals! Don’t forget that we’re always here to help, don’t hesitate to book an appointment by calling 514.645.2753 or subscribe to one of our training seminars. I really hope that you liked this serie of posts!
References:
Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
The hygiene and cleanliness staff represents a key element in the fight against infections in hospital environments. Often little valued, their role in the global strategy of surface cleaning is extremely important.
The hygiene that comes from the work of the cleaning staff requires a high performance level. In order to reach that, the executing staff and the managers need to master all the different elements representing this profession.
Cleaning products and equipment are undeniably crucial in order to ensure performance during the environment asepsis of any establishment. Therefore, it is important to associate the day-to-day actions of the cleaning staff with a range of products and equipment that favor the quality of their performance.
Since several years, partly due to the devotion and the involvement of many members in the healthcare system, we take into consideration new factors:
Provincial training
Establishment of an AEP hygiene and cleanliness in healthcare environments of 630 hours now offered by many school boards
Provincial day of hygiene and cleanliness
Etc.
Having said this, the hygiene and cleanliness staff deserves our deepest gratitude. Thank you so much!
The next post is going to talk more in detail about one aspect of their profession: work organization.
Don’t miss any posts about this series, subscribe to this blog!
References:
Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
Cleaning in hospitals allows reducing risks of infection among patients. This is not the only factor, of course: good personal hygiene habits such as washing hands and the use of protective equipment such as overalls, gloves, masks, or protective glasses are also important elements.
For this reason, interventions must be well coordinated in order to have a good surface maintenance plan. The manager of hygiene and cleanliness should therefore take into account:
The type of place associated to the level of risk
The tasks to perform
The required cleaning frequency
If well applied, a detailed estimate allows validating the cleaning performance.
The global approach is going to be determined by type of place:
Regular eradication (e.g.: operating rooms)
Keeping environmental effects as light as possible (e.g.: low infection risk such as individual office spaces)
Balance of microorganisms. This approach is based on the competition between good and bad microbes. The presence of good microbes guarantees less space for bad microbes to grow (e.g.: living environments)
Green cleaning. Approach that uses less toxic products
Review and improve arrangements and/or surfaces (during conception or renovation)
The next post of this series is going to talk about another key factor: the hygiene and cleanliness staff.
References:
Le nettoyage dans les hôpitaux du 21e siècle by Dr. Stephanie J. Dancer, Medical, Microbiology, Hairmyres Hospital, UK appeared on the magazine Le Nettoyage professionnel, July/August 2012.
Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
For a long time, cleaning has been all about the look; fresh smell and the absence of stains or dirt were the criteria to determine that a place is clean. Today, these criteria are still generally accepted in environments such as offices and classrooms.
It’s common knowledge, however, that microbes (bacteria or viruses) invisible to the human eye represent a risk for spreading infections. Take the example of the influenza virus: it can survive for up to 48 hours on a hard surface!
Without cleaning and disinfection procedures or a quality check procedure, microbes can survive in hospital environments.
Three key elements have to be considered in order to perform an infective risk analysis:
Is the patient carrying a disease agent? Disease agents are classified based on their spreading capacity and their virulence. The choice of a disinfectant will be based on this.
Do the functional activities of a sector represent a risk of spreading infections from the environment? E.g.: food service, offices, Intensive Care, etc.
The intensity of contact is related to the traffic and the surfaces that are more likely to be touched. E.g.: bathroom fittings.
Have you already performed an infective risk analysis? The next post is going to explain how cleaning allows reducing risks of infection among patients.
Don’t miss any posts about this series, subscribe to this blog! You just need to write your e-mail address, it’s that easy!
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References:
Le nettoyage dans les hôpitaux du 21e siècle by Dr. Stephanie J. Dancer, Medical, Microbiology, Hairmyres Hospital, UK appeared on the magazine Le Nettoyage professionnel, July/August 2012.
Hygiène et salubrité en milieux de soins – Démarche pour le développement de stratégies d’entretien des surfaces, MSSS, 2010, 52 pages.
