Cleanliness in healthcare facilities (long term care, clinics, medical offices, and laboratories) has never been under more scrutiny, with facility managers facing a unique set of challenges, from many different directions. Surface contamination found on high-touch surfaces can be easily spread from person to person. Generally, management and cleaning staff are unsure how to best assess physical spaces to identify areas that could harbor pathogens. This goes without mentioning the inability to assess which cleaning protocols and products perform best.
In a healthcare facility, the first priority is to mitigate risks to patients and staff, while ensuring that complex code requirements are met. However, facility managers are continually pressured internally. Facility managers have to coordinate with a multitude of departments and personnel to determine that standards are met, additionally having to maintain those requirements. High turnover staff rates and diverse cleaning staff makeup requires training programs to be easy to implement, simple to follow, yet highly effective. Currently, managers cannot ensure that increasing cleaning frequency and applying more human resources to cleaning is financially sustainable. To top it off, there is often little to no data that would justify increased budgets and resources would improve efficiency.
What does “clean” mean?
Traditionally, judging cleanliness relies on the human senses, particularly what you can see and smell. A lingering lemon or lavender scent in a public restroom, and streak-and-dirt-free floor, could signal that a facility prioritizes cleanliness. Though we know pleasant fragrance does not necessarily mean something is clean, this is typically where any doubts of cleanliness ends. As humans, a foul smell to us is an identifier that something is unclean. Although microorganisms and germs have always been a concern, cleaning took on an entirely new meaning with SARS-CoV-2, a virus with no sensory cue of its presence.1
The emergence of SARS-CoV-2, a highly infectious virus, has redefined what is clean. It is not enough that surfaces and spaces only look clean, they must be clean beyond what the naked eye can see.
Organizations that demonstrated their dedication to preventative measures during the pandemic and beyond, set themselves up for success. According to the International Council of Shopping Centers, studies found that 66% of consumers want to see more frequent cleaning when they return to stores. Therefore, not only is visual and regular cleaning a must, facilities must use effective products and technologies to improve cleaning performance and showcase they are prioritizing cleaning.1
The dirty story behind healthcare-associated infections.
About 50 years ago, contaminated surfaces were thought to play a negligible role in the transmission of healthcare-associated infections. However, more recent scientific evidence proves that microorganisms can persist for long periods on surfaces, and spread to patients through contact with either surfaces or indirectly, via the hands of healthcare workers. Studies have shown that subsequent patients are at risk of acquiring the same pathogen as the previous patient, if residual surface contamination is not removed by disinfection.
Healthcare-associated infections (HAIs) are a significant burden globally, with millions of patients affected each year. These infections affect both high and limited-resource healthcare settings, but in limited-resource settings, infection rates are approximately twice as high (15 out of every 100 patients versus 7 out of every 100 patients). It has also been documented that some healthcare-associated pathogens can survive on environmental surfaces for months. It is dangerous to ignore the threat posed by disease agents, primarily viral, carried by individuals who have active disease, are recovering from disease, or have recovered from illness, yet continue to shed viruses and contaminate common touch points.
How can surface contamination in healthcare environments be detected, and prevented?
One study, the Researching Effective Approaches to Cleaning in Hospitals (REACH) trial, clearly showed the important role of thorough environmental cleaning in the prevention of HAIs. The study demonstrated that the implementation of a multi-modal cleaning protocol, consisting of component training, technique, product, audit, and communication, not only improves the performance, knowledge, and attitude of the environmental services staff, but may also reduce the occurrence of clinically important pathogens.
Why is it important to detect and prevent contamination?
- Increased absenteeism of staff in healthcare facilities due to illnesses and HAIs place far greater burdens on already-overworked staff, and tax already overstretched resources.
- One attempt to measure HAI costs from a societal perspective was carried out by Marchetti and Rossiter. They found that the annual direct medical costs of hospital HAIs ranged from $34 billion to $74 billion (in the U.S.A.), while the additional social costs of HAIs, which included lost wages for incapacitation and premature death, ranged from $62 billion to $73 billion.3
- Germs can enter our bodies through the mouth, nose, eyes and breaks in the skin, without us even knowing we’ve been infected.
- Americans spend about $5 billion each year on their colds – about $3 billion on doctors’ visits and $2 billion on treatments.4
- An estimated 60 million days of school and 50 million days of work are lost annually because of the common cold.4
- Germs can be transferred from inanimate surfaces to hands and vice-versa.
- Salmonella can survive freezing and can survive on dry surfaces for at least 24 hours.4
How to clean for health.
Clean high-touch areas more often.
A cleaning professional is likely to enter a patient room two to three times each day to clean the bathroom, empty trash and pick up soiled linens. Cleaning around a patient is not easy, but it is important to disinfect high-touch spots like handrails, phones, call buttons, and mattresses.
Likewise, any workplace has spots that people use and touch more than others; focus the energy of cleaning staff on these areas, as they are especially prone to carrying infections. Research shows that germs tend to congregate on door handles, kitchen sinks, elevator buttons and keyboards. You’ll also want to hit the high-touch surfaces of areas such as the breakroom and conference rooms: sink handles, microwave doors, phones and chair armrests.2
Clean according to needs and risk.
It is helpful to “triage” the places that must be cleaned by the risks they pose. In a hospital, operating rooms must be disinfected the most aggressively, followed by patient rooms, then common areas and finally staff offices. Floors should be swept, mopped or auto-scrubbed daily, but disinfecting floors is a waste of time; one can disinfect the floor, but shortly after it will become contaminated again. Testing shows it’s not an area of the room that shows potential for cross-contamination.
In industries other than healthcare, you can also triage according to use and risk. Bathrooms and break rooms, for example, need constant attention, while less-used conference rooms might not need as much upkeep.2
Dedicate the resources.
It is critical that the people cleaning and disinfecting a healthcare facility are properly educated in processes and given enough time and resources to do the job thoroughly. This is also key to maintaining employees’ health. For example, staff need to know to wear personal protective equipment. And of course, any employee with a contagious illness should be encouraged to stay home. People who clean non-healthcare workplaces don’t face the same threats as their counterparts in a hospital, but they are still responsible for fighting pathogens that could make people sick. By adapting the tools of their colleagues in healthcare, they can help ensure that people and businesses stay well.2
What to look for in a comprehensive, precision cleaning solution.
- Processes and programs designed to inspire confidence among staff, clients, families, and stakeholders.
- New evidence-based technologies that accurately reveal hidden contamination on hard surfaces, allowing a precision cleaning approach, i.e. a way to identify and target contamination-prone areas, monitor and measure performance and improve cleaning processes for better health, safety and hygiene outcomes.
- A system that provides you with the data and trend analysis you need to make better informed decisions about resources, investments and performance outcomes.
- Technology that allows cleaning teams to create assessments that provide fast, accurate and actionable feedback.
Technology is transforming how we clean, and how we define “clean”.
The coronavirus pandemic has shifted the public’s perception of the critical importance of the cleaning process and its role in protecting health and safety. People are more aware than ever about the importance of disinfection, hand hygiene in public settings, and the efforts that facilities are taking to reduce the spread of illness. Meanwhile, forward-thinking organizations are looking for ways to effectively implement new cleaning products and technologies, train, certify, and safeguard their cleaning staff, and improve their overall approach to cleaning.
By focusing on cleaning for health, facilities such as schools, commercial offices, retail stores, airports, convention centers and more can reduce pathogen loads, uphold the wellbeing of employees, and protect building occupants and visitors.
Cleaning for health should not only be practiced in hospitals, long term care, clinics, medical offices, and laboratories. In reality, it should be practiced and perfected in any number of other sectors including institutions, education, food safety and building services contracting. Using an evidence-based cleaning process guided by the latest in detection technology, with the objective of ensuring healthy outcomes for employees, customers and visitors, must be the number one priority in any facility.
For more information on how Optisolve technologies can help your organization use precision cleaning for health visit: www.optisolve.net
1 Three Best Practices for ‘Cleaning for Health’ – How to clean beyond appearance and show your facility’s commitment to health post pandemic
2 Borrow Cleaning Practices From the Healthcare Industry
3 Understanding the Economic Impact of Health Care-Associated Infections: A Cost Perspective Analysis
4 American Cleaning Institute: Cleaning for Health
Best Practices for Environmental Cleaning in Healthcare Facilities: Resource-Limited Settings
Contact Transmission of Infectious Disease Agents: The Science and Implications for Cleaning and Disinfection of Surfaces
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