INFECTION PREVENTION meet and interact, where they are dealing
with people who are sick, where they’re dealing with coworkers who may come to work with a cold, so asking those questions about ‘what is the facility doing to maintain accountability associated with the air?’” She continued, “We’re constantly look- ing at new ways of cleaning surfaces or new ways to do hand hygiene or being sure that we have enough of these prod- ucts to provide a safe environment. But if I ask most people in the hospital what they do for air quality they couldn’t tell me. They might say ‘we’re compliant with the regulation’ or ‘we provide good air because the facility said so,’ but do they really know what is going on with the
Monitoring Contamination as Best Hygiene Practice According to Douglas Mackay, VP of Sales and Marketing at Ruhof, one of the best hygiene practices is monitoring contam- ination in targeted areas of a hospital or healthcare facility in order to prevent hospital-acquired infections (HAIs). “The utilization of an ATP Contam-
ination Monitoring System is a highly effective method for continuously mon- itoring and improving hygiene practices in a healthcare setting, thus aiding in the prevention of hospital-acquired infections. With the use of a ATP handheld and a ATP test swab, a healthcare worker can use the system in any area of a healthcare facility to quickly verify the cleanliness of surgical instruments, endoscopes or any non-critical surfaces such as counters, operating room tables, bedrails, comput- ers, etc.—anywhere contamination can grow, affecting patient and staff health.” Mackay continued, “An ATP Contam-
ination Monitoring System works via innovative bioluminescence technology to verify surface cleanliness, providing rapid and actionable data to Sterile Pro- cessing, Endoscopy, Operating Room, and Environmental Services departments. The ATP cloud-based application coupled with the ‘Smart’ handheld provide users with a visual presentation of the testing environments—along with a predictive scheduling of testing based on prior test results—while other features include RFID/ barcode scanners for the quick and easy identification of test points.” He summed up, “With regular testing,
tracking, and reporting, an ATP Monitor- ing System is truly an excellent tool that can efficiently identify problem areas, as well as make workplace cleanliness cost-effective while also providing evi- dence of due diligence to satisfy regulatory requirements.”
air? How the air interacts with these other modalities of protecting patients and pro- tecting coworkers within the patient care environment and, quite frankly, holding everyone accountable for the safest pos- sible environment.”
Awareness and accountability As with many factors that contribute to infection prevention, there is no one easy answer to the question of the best way to maintain hygiene accountability. Among the most noted and quoted replies from industry professionals are not only the awareness and education of hygiene prac- tices, but also the verification by managers that any required compliance has been met. Nancy Moureau, PhD, RN, CRNI, CPUI, VA-BC, is CEO at PICC Excellence, Inc., and also a research and educational consultant for Parker Laboratories. She said, “Accountability for hygiene and safety for patients and healthcare workers revolves around educators and managers monitoring activities for
Nancy Moureau
compliance with policies. With the high volume of patients and procedures, the number of tasks can be overwhelming and lead to shortcuts, use of whatever supplies are within reach, and clinical judgment fatigue. Constant reminders through mul- timodal education are necessary to main- tain high-level accountability and awareness of safety practices.” She continued, “But more than just edu- cation, someone needs to be watching. Just like with homework completed in grade school, if the teacher does not look at the work or grade the material, the student becomes less and less interested in per- forming at a high-level. While that is a simplified example, clinicians often need to be motivated by who is looking at their performance. Management performing walking-rounds of work areas provide that level of accountability needed to maintain good performance and accountability for the best practices.”
Addressing best practices of accountabil- ity, GOJO’s DiGiorgio added, “The ideal would be to have an open, transparent, non-punitive environment where staff feel comfortable speaking up to one another if hand hygiene is not performed. When you’ve progressed to the point with your efforts where a nurse can stop a surgeon and remind him or her that they need to perform hand hygiene, it is truly a testa- ment to what you’ve built with your pro- gram. It just takes a lot of work and is part of the ongoing multimodal strategy for improving compliance.”
24 October 2023 • HEALTHCARE PURCHASING NEWS •
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MD-Medical Data’s Lee, pointed out, “Infection prevention is not just about the patient. It is about staff safety, too. Creating accountability through compliance audits has been done typically through the ‘secret shopper’ methodology. Unfortunately, this method is very limited in scope, accuracy, subjectivity, and is relatively ineffective. The current evidence-based methodology is the use of technology that allows for 24/7 data collection.”
He advised, “Be careful here, for there are a number of technologies on the market that advertise hygiene compliance. You need to understand what you want to measure. Some technologies only measure entry/ exit at the doorway of the patient’s room. Some will measure patient contact. Some will measure various contact with patient environment, like workstations, keyboards, bathrooms, etc. The CDC says, ‘If you are measuring entry/exit methodology, you are measuring the wrong thing.’ So, it is import- ant to select a technology that matches your safety protocols and workflow.”
More education, less HAIs As hospitals and healthcare facilities look to meet established protocols for best hygiene practices, infection preventionists often look beyond the minimum require- ments to ensure a higher level of hygiene is achieved whenever possible in order to prevent additional HAIs. PICC Excellence’s Moureau asserted, “Peripheral and central venous access devices are one of the biggest contrib- utors to bloodstream infections. Many clinicians feel it is necessary to use more application of sterile insertion procedures. Unfortunately, observation shows us that even the most basic procedures have fre- quent contamination, that hand-hygiene practices are inconsistent, and that there is a need to emphasize basic aseptic non-touch technique practices for all procedures.” She continued, “One novel idea is using a sterile barrier between the skin and the gel and transducer, which reduces both infection risk and the level of disinfection needed for the ultrasound transducer. Another is having a standardized and complete IV start kit or central line inser- tion kit that clinicians can grab and use at a moment’s notice.”
Reiterating the importance of education, she added, “Again, we are back to educa- tion as a key element to reducing infections and providing the necessary information to help clinicians function with safe practices for patients. More time should be spent teaching at the bedside, reinforcing the basic skills of asepsis, cleaning tabletop surfaces, preparing supplies, and disin- fecting intravenous access ports prior to
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