Healthcare Hygiene magazine January 2020 | Page 39

environmental hygiene
By J. Darrel Hicks, MREH, CHESP
Moving Out of the Cul-de-sac
F
or more than 50 years, I’ve lived in suburbs where
cul-de-sacs abound. City designers abandoned dense
urban grids for garden communities with meandering
streets and cul-de-sacs in the 1930s. These new cul-de-sac
neighborhoods were thought to be safer and more private
alternatives to the pollution, poverty and overcrowding of
traditional cities.
For the past four months I’ve been working as the interim
environmental services director in a hospital in California. One
of my frustrations has been in getting the infection control
committee’s approval of a new EPA-registered disinfectant.
In tandem with the new disinfectant, I was seeking approval
of a total room disinfection technology.
In the past two years before my arrival, the infection
control committee approved a hospital-wide disinfectant
with a tuberculocidal claim that meets OSHA’s bloodborne
pathogen standard for disinfecting surfaces contaminated by
blood or other potentially infectious materials. The product
must remain wet for 5 minutes. But, for all contact-isolation
rooms, a product that requires 3 minutes of contact on
pre-cleaned surfaces is used.
Currently, the infection control committee is living happily
on the cul-de-sac where it is safe to the through traffic. The
cul-de-sac is where the kids can safely play in the circle and
neighbors get to have the occasional “block party.” But
the cul-de-sac is not where new and better solutions to the
problems the hospital faces lives.
The “cul-de-sac” mentality is not isolated to a hospital
in California. This mentality thwarts new and innovative
products and processes from improving environmental
hygiene. Decision-makers and stakeholders too often
hide behind questions such as “Who else is using it?”
and “What does it kill?” or make statements such as “We
don’t switch disinfectants unless there’s a problem that isn’t
being addressed.”
It’s at this juncture that feels like quitting this pursuit for a
“better, more efficacious” way of room disinfection. Instead
of quitting, entrepreneur Seth Godin says, “One should
rededicate or try ‘an invigorated new strategy designed to
break the problem apart.’”
Godin goes on to say, “I like to call this the pivot. It’s
an adjustment, a strategic relocation, a change in direction
that you make while keeping your eye on your goal. You’re
like an airplane making constant course corrections until it
reaches its final destination.”
I will continue building a relationship with the infection
control nurse and infectious diseases physician to identify
areas of common agreement. I will implement new and
better cleaning and disinfection tools for the EVS staff to
more thoroughly clean the patient rooms. Education and
retraining will get done in short order. And, I’ll work with
the infection control nurse on doing fluorescent marking
www.healthcarehygienemagazine.com • january 2020
of rooms before daily or terminal cleaning. This will allow
us to begin building data and confidence in the program
that will ultimately take us off the cul-de-sac and onto the
interstate of better outcomes.
Check your calendar. It’s not only a new year, but it’s a
new decade, too.
If you find yourself or your organization comfortably
living on the cul-de-sac while infection rates remain stagnant
and patient satisfaction scores are slightly above the 50th
percentile, perhaps it’s time to move out of the cul-de-sac
and onto the interstate.
J. Darrel Hicks, BA, MREH, CHESP, is the owner/principal
of Darrel Hicks, LLC and the author of the book Infection
Prevention for Dummies. He is also a board member of the
Healthcare Surfaces Institute.
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