If you had to choose ONLY ONE super-strategy to help cut HAIs in your facility , would it be hand hygiene or environmental hygiene ?
Introducing IP & C Conundrums , the forum where tough questions related to infection prevention and control are discussed and debated to identify solutions . Each month , we ’ ll pose a question for members of the IP & C community to consider , and we ’ ll share the dialogue in every issue of Healthcare Hygiene magazine .
We posed our first question to readers : If you had to choose ONLY ONE super-strategy to help cut HAIs in your facility , would it be hand hygiene or environmental hygiene ? And then we asked them to explain why they believe their strategy works better to address pathogen transmission .
• HAND HYGIENE Hand hygiene before , during , and after the performance of environmental cleaning .
Crystal Heishman MBA , MSN , RN , ONC , CIC , CRNI , FAPIC ; UofL Health
• ENVIRONMENTAL HYGIENE If the environment is not clean , pathogens remain on surfaces , shared equipment and in bathrooms . It is an area that can be more controlled and monitored . Hand hygiene alone will not stop the spread , as we know from experience it is not always done and often not correctly done .
Jenny Breen , Peninsular Health
• HAND HYGIENE
Studies show where multi-modal and sustained hand hygiene practice is used as a main intervention , not only has a significant improvement in hand hygiene compliance been achieved but it demonstrates a substantial decrease of multidrug-resistant organisms ( MDROs ) and colonization rates .
Anita Enane , independent consultant
• ENVIRONMENTAL HYGIENE
Because many organisms that cause healthcare-acquired infections ( HAIs ) are becoming resistant to chemicals used in environmental cleaning , new strategies are needed .
Andy Davies , Mackwell Health
• ENVIRONMENTAL HYGIENE
Everyone will say hand hygiene , which breaks the chain of infection effectively at almost each link , however , the challenges of compliance continue at 46 percent among clinicians and sad to say will always be a challenge as providers struggle to maintain skin moisture and barrier , access to sinks for soap and water or ABHR dispensers . Environmental cleaning will target both the reservoir and mode of transmission . This will effectively break down the biofilm and bioburden which allows quorum sensing and transformation of pathogens into multidrug-resistant organisms ( MDROs ). Again , the challenge is adequately cleaning all hard and soft surfaces , fixed or mobile , and ensuring safe , non-toxic disinfectants yet still making sure they are EPA- or Health Canada-registered to kill target pathogen and have necessary dwell or contact time and surface compatibility . Additionally , human factors engineering and consistency of environmental processing ( cleaning , disinfection , and monitoring for cleanliness ), the tools used , and the training of environmental services ( EVS ) staff are also other variables , and having enough staff members who are adequately trained continue to pose challenges . Honestly , you need both ; however , each comes with its own benefits and burdens and proper application . Reminds me of the sitcom song , “ Love and marriage go together like a horse and carriage … you can ’ t have one without the other .” See : https :// www . cdc . gov / hai / prevent / environment / surfaces . html and https :// www . cdc . gov / handwashing / why-handwashing . html
Aaron Jett , Healthcare Risk Mitigation
• ENVIRONMENTAL HYGIENE
Microorganisms are present in the environment and on our body . Most times , they are able to establish pathology when they get in contact with the body . They do this partly by overwhelming the immune system . [ Microbes ] must overcome the normal flora on the body . Hand hygiene , as good as it is , in a way helps the environmental organisms because the competition is already removed . Thus , environmental cleaning is better .
Adeyemi Olanrewaju , Texas State University
• HAND HYGIENE The hands are the most heavily contaminated because they are used [ the most ].
Kelvin Aizebhughele , Al Anamel Medical Centre
THE QUESTION FOR FEBRUARY ’ S
COLUMN IS :
Who is responsible for cleaning electronic patientcare equipment at the bedside , nursing personnel or environmental services personnel ?
To Join the conversation click here
january 2024 • www . healthcarehygienemagazine . com •
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