TRAINING & EDUCATION
The First Line Of Defence
imperative that they are trained properly.
Just a few years ago MRSA was the number one nasty bug, spreading fear into the hearts of hospital administrators and patients alike. Our chief strategy for fighting this bug was handwashing, mainly because MRSA clings to the skin. Now, however, the most dangerous germs are the ones that live on surfaces, such as door handles, bed rails, work surfaces, keyboards and phones. In recent studies it was shown that viruses such as Ebola can remain viable on surfaces for several days, while other germs such as the ones that cause colds, ear infections, and strep throat can linger for weeks or even months.
“Hand hygiene is very important,” said Michael Phillips, a hospital epidemiologist at New York University Langone Medical Center, who has been studying this problem. “But we are coming to understand that it is one of just several important interventions necessary to break the chain of infection that threatens our patients.”
The infectious organisms that require surfaces to be cleaned to break the chain of infection enter hospital rooms in a number of different ways. Although Acinetobacter and Pseudomonas prefer to live in the soil and water, people regularly carry these germs into hospitals from the outside world on their shoes and clothes.
The germs that live inside humans such as VRE, E. coli, Klebsiella and C. diff enter hospitals in patients' intestines and escape when patients
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suffer from diarrhea, contaminating the air and equipment around them. Many of these bugs can survive on surfaces such as glass, metal and plastic – the very materials used to make up the environment around us.
Consider VRE. One strain that caused an outbreak at the University Medical Center Utrecht in the Netherlands grew in a lab dish for 1,400 days after being dried in a test that mimicked what might happen in a patient’s room (MRSA also survives on surfaces, but for much shorter duration). “It forces us to raise the cleanliness of the hospital as a clinical issue, just as washing our hands is a clinical issue,” said Cliff McDonald, a medical epidemiologist at the U.S. Centres for Disease Control and Prevention. Because of such abilities, the latest bacterial threats create an infection risk at least as great as contaminated hands.
The responsibility of eliminating the germs on these surfaces falls to the cleaning team. Cleaners and janitors are regarded as disposable workers – hard to train because their first language may not be English and not worth training because they may not stay long in their jobs. “This is the level in the hospital hierarchy where you have the least investment, the least status and the least respect,” said Jan Patterson, President of the Society for Healthcare Epidemiology of America.
At N.Y.U. Langone in 2010, Phillips and his co-workers launched a
www.tomorrowscleaning.com
James Cleary, CEO of the ICT Institute and Link Learning, explains why cleaners are often the first line of defence when it comes to infection controls in hospitals, and why, because of this, it is
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