Infection
INFECTION CONNECTION
Control
Update Washing away the flu blues
Minimal time guidelines for
patient room cleaning and
by Susan Cantrell, ELS
disinfecting
The American Society for Healthcare Environmen-
tal Services (ASHES) of the American Hospital Asso-
ciation (AHA) at its annual meeting reaffirmed pre-
viously published practice guidance for the minimal
time for proper cleaning and surface disinfection of
P
icture this: you’re walking down workers resist the idea of clean hands; the
stairs, sliding your hand along the logic and the motivation certainly are there.
rail where a child had walked before It’s more that there isn’t enough time in the
patient rooms. The reaffirmation is due to wide varia-
you, who also slid his hand along the rail, day to clean their hands between every pa-
tions in cleaning practices. Over the last several years
just after wiping his hand across his runny tient contact or that it’s inconvenient to clean
the emergence of new microorganisms and the pro-
nose. You lift your hand from the rail and their hands at the time or perhaps that their
cess for removing them from surfaces has required
scratch your own nose. Someone sneezes, hands are already hurting from damage due
more time and attention, particularly to high touch
wipes their hands on their pants, then opens to repeated washing. Hand-hygiene compli-
surfaces. a door by the knob that you come along be- ance is a big deal, but it often gets short shrift,
The following statements are taken from the hind and open, too. Then you rub your eye. for a variety of reasons.
ASHES Practice Guidance for Healthcare Environmen- Driving through a fast-food restaurant you
tal Cleaning:
Cleaning an Occupied P
INFECTION CONNECTION
get handed your change from a cashier who The patient connection
atient Room-To ensure
just wiped thumb and forefinger down the
in compliance
consistent quality of cleaning and adequate staff-
corners of his mouth. Then, with the hand
Traditionally, the responsibility for compli-
ing resources for infection prevention, a total facil-
you accepted the change, you rub that bit
ance has been totally up to the healthcare
ity cleaning standard should be agreed upon in ad-
of lipstick off your front tooth.
worker. In the past few years, the onus of
vance by environmental services, infection control
The people who came before you may be
compliance has been expanded to include
and operations or administrative management. By
harboring the flu bug but not yet know it.
following all of the recommended practice steps,
patients. Patient-empowerment programs
When you touch your nose, eyes, or mouth
an occupied patient room clean will take approxi-
promote compliance because they educate
mately 25-30 minutes per room. Time is determined
after touching surfaces they contaminated,
patients as to how important hand hygiene
by the number of tasks and the time to perform
suddenly you may have it, too, and you’re
is to their health.
each task in an efficacious manner.
contaminating surfaces for the people who
The Centers for Disease Control and Pre-
Terminal Cleaning of the Patient Room (Dis-
come behind you.
vention offers a video, “Hand Hygiene Saves
charges or Transfers)-To ensure consistent quality
It is amazing how often we
Lives,” that, in many facilities, is played
of terminal cleaning and adequate staffing re-
touch our faces and are totally
for patients and their families upon
sources for infection prevention, a total facility
unaware of it. Start noticing,
admission. The video points out that
cleaning standard should be agreed upon in ad-
and you’ll be surprised. A re-
over 1 million infections per year
vance by environmental services, infection control
cent study by Nicas and Best,
are acquired by patients dur-
and operations or administrative management. By performed at the University of ing their hospital stay and that
following all of the recommended practice steps, California-Berkeley, found that
vigilant attention to hand hy-
a terminal clean will take approximately 40-45 min- students who were observed as
giene can make a difference in
utes per terminal clean. ASHES Practice Guidance
they read or worked on their
whether they’re one of the un-
may be found at www.ashes.org.
laptops touched their faces an
fortunate ones. It empowers
average of about 16 times an
Bathroom showers may deliver
Dial’s Complete Antimicrobial
patients to remind doctors,
hour, once every 4 minutes.
1
Foaming Hand Soap
nurses, family members, and
face full of pathogens Another study by Nicas and
other visitors to wash their
While daily bathroom showers provide a good cleans- Jones found that one-third of the risk for flu
hands with soap and water or use an alco-
ing for millions of Americans, they also can deliver a
infection was due to hand-to-face contact.
2
hol-based product before touching the pa-
face full of potentially pathogenic bacteria, accord-
What’s the single most important thing
tient. The video also addresses the problem
ing to a surprising new University of Colorado at
you can do to beat the flu bug? Listen to your
of being embarrassed to remind healthcare
Boulder study. The researchers used high-tech in-
mother: Wash your hands. Don’t touch your
givers. To view the video, go to http://
struments and lab methods to analyze roughly 50
face is good advice, too, but if your hands
www2a.cdc.gov/podcasts/player.asp?
showerheads from nine cities in seven states. They
are clean, chances of transferring bugs you
concluded about 30 percent of the devices harbored
f=9467#.
pick up from other people to your own mu-
significant levels of Mycobacterium avium, a patho-
Ecolab Healthcare (St. Paul, MN) is one
cous membranes are far less.
gen linked to pulmonary disease that most often
company that offers a patient-empowerment
infects people with compromised immune systems
program. Theirs is aptly named “It’s OK to
but which can occasionally infect healthy people.
Hand hygiene gets short shrift Ask,” because it’s designed to help patients
Researchers found that some M. avium and related
Wash your hands for good health. The mes- feel more comfortable in questioning
pathogens were clumped together in slimy “biofilms”
sage is everywhere we turn, particularly with caregivers entering their room about their
that clung to the inside of showerheads at more
flu season now here, but it’s important all of hand hygiene. Cheryl Littau, PhD, senior
than 100 times the “background” levels of munici-
the time. Nowhere are clean hands more program leader for skincare product devel-
pal water. The study appeared in the Sept. 14 online
important than in a healthcare setting; yet, opment, noted: “The World Health Organi-
edition of the Proceedings of the National Acad- it’s amazing how often caregivers don’t do zation (WHO)’s updated hand-hygiene
emy of Sciences. it when called for. It’s not that healthcare guidelines include patient empowerment as
See HAND HYGIENE on page 23
18 November 2009 • HEALTHCARE PURCHASING NEWS www.hpnonline.com
0911-IC-HH-short.pmd 18 10/13/2009, 9:36 AM
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