or following a “ looks clean , I know clean when I see it ” is the prevailing attitude . It is that attitude that needs replacing with science and value-based decisions . EVS personnel save lives , and they must be empowered and required to incorporate value and science-backed purchasing decisions .
Now , more than ever before , in the business of healthcare environmental services , science-based resources are available for EVS departments to be a professional , life-saving , critical and science-based collaborative department . Recognized authorities such as EvSOP ©, CDC , the Healthcare Infection Control Practices Advisory Committee ( HICPAC ), the Association for the Healthcare Environment ( AHE ), the Association for Professionals in Infection Control and Epidemiology ( APIC ), Infection Prevention and Control Canada ( ipac ), Public Health Ontario , the Provincial Infectious Diseases Advisory Committee ( PIDAC ), the Centers for Medicare and Medicaid Services ( CMS ), the Association for periOperative Registered Nurses ( AORN ), the Joint Commission ( TJC ) and numerous other deeming authorities are all calling for a science-based approach in EVS departments .
For decades , if not longer , too many facility power brokers held on to the antiquated “ It looks clean , I know clean when I see it ” position . Thank science that this retrograde philosophy is no longer the predominant driving force behind infection prevention and environmental services . All of the aforementioned authorities are recommending the American National Standards Institute ( ANSI ) and Association for the Advancement of Medical Instrumentation ( AAMI ) definition of hygienically clean : “ Free of pathogens in sufficient numbers to cause human illness ( 20 colony-forming units per 10 cm2 = 20 CFU / dm2 ).” Note : a dm is a decimeter . The decimeter is a unit of length in the metric system , equal to one-tenth of a meter , ten centimeters or 3.937 inches .
As there is an accepted definition for hygienically clean , how is it achieved through testing ? That depends upon the surface tested . If a soft surface such as EVS healthcare-grade ultra-microfiber ( HGUM ©) infection prevention textile products , healthcare textiles used by patients , or uniforms , scrubs , or lab coats , destructive testing occurs on a textile sample . When testing a solid surface , the most common method is laboratory sterile swabs and agar / RODAC plates .
Before hygienically clean can be achieved and tested for , there must be a science and value-based process in place to select appropriate infection prevention tools . How is that accomplished ? One way is through the use of the CDC / HICPAC Infection Prevention Product Review Worksheet . A worksheet is a tool
Emmert Wolf , apparently famous only for one long-lasting and actual quote , said , “ A man is only as good as his tools .” In today ’ s vernacular , an acceptable version of that quote might be , “ A person / worker / technician / human is only as good as the tools they use .” Regardless of the common noun used , the emphasis is on “ tool .” There is not one particular tool that is most important for EVS technicians . Just as cleaning and disinfecting chemical decisions are science and value-based , associations and authorities having jurisdiction base their recommendations on science and recommend microfiber , particularly ultra-microfiber infection prevention textiles .
In their Practice Guidance for Healthcare Environmental Services , the AHE states , “ Microfiber cleaning materials should be used ,” and “ Using the proper tools or equipment with the proper chemical products in the most effective and productive method of cleaning . The tools should always include microfiber .”
In a May 2016 webinar titled : Evidence for Easily Improving OR Environmental Hygiene , Linda Homan , RN , BSC , CIC , and Dawn Hughes , RN , MSN , MBA , CNOR , RNFA , said , “ Half the environmental hygiene battle
OR Environmental boasts superior chemistry absorption and
Hygiene ability to release chemistry to the surface when compared to traditional cotton cleaning cloths . It is also lint-free , which is important in the OR .”
Another very informative and authoritative guide , Ontario Agency for Health Protection and Promotion ( Public Health Ontario ), Provincial Infectious Diseases Advisory Committee . Best practices for environmental cleaning for prevention and control of infections in all health care settings . 3rd ed . Toronto , ON : Queen ’ s Printer for Ontario ; 2018 , has a detailed and accurate description of microfiber and ultra-microfiber cleaning products and infection prevention ultra-microfiber tools in section 1.3.3 Microfiber and Ultramicrofiber Cleaning Products .
Unlike the agencies having jurisdiction and associations previously listed that came together to agree on an accepted definition of hygienically clean , the microfiber and ultra-microfiber manufacturers appear to have resisted a mutual definition to differentiate between various microfiber textiles . Due to the vast differences in manufacturer product construction , design , material selection , instructions for care and maintenance , EvSOP © decided to put itself out there to improve the provide an infection prevention textile definition . EvSOP © recognized the necessity of assisting EVS and IPs in choosing infection prevention healthcare textiles . Healthcare needed specific microfiber textile characteristics to define an HGUM ©, which is not manufacturer- or brand-specific . Here are the factors that set HGUM © apart from other ultra-microfiber products :
● The individual fiber size ( in denier ) of less than . 03 , a required bicomponent composition of polyester ( 80 percent to 85 percent ) and polyamide ( 15 percent to 20 percent )
● A minimum number of bicomponent splits
● A split percentage of the bicomponent of more than 90 percent
● High grams per square meter for the face fiber on flat mops
● Non-cellulosic composition of the mop interior ( what makes up the “ mop sandwich ”)
● Compatible with all EPA-registered hospital-grade disinfectants
● Withstands CDC / CMS laundering guidelines through more than 120 reprocessing cycles