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Environmental services ( EVS ) staff are key players in keeping the healthcare environment safe for patients .
Part of that environment of care includes reducing the exposure to waterassociated pathogens .” — Christine Yount , MPH ,
REHS
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HHM Are you seeing the
perennial issues that face EVS or are you also observing unusual environment-related issues and breaches that need to be addressed ?
K-WC : Contact time , contamination , and who cleans what are still frequent infection prevention and control ( IP & C ) challenges but newer technologies being introduced into hospitals such as robots , present additional challenges . I think any time a new technology , disinfectant product , or tool is incorporated into a facility ’ s standard operating procedures ( SOPs ), it ’ s important to ensure that corresponding training , education , and procedures are put in place for all staff .
CY : Ice machines are not considered medical devices but ice from ice machines is frequently used on vulnerable patients . If not properly maintained , ice machines can grow biofilm which presents a potential risk to these vulnerable patients . Facilities are often the ones cleaning and sanitizing ice machines based off the instructions for use . However , a healthcare facility may have to do this more frequently based off the facility ’ s water management program . It ’ s not always a “ one-size-fits all ” and ice is often overlooked as a risk to HAIs .
HHM How important are risk
assessments and risk mitigation in environmental hygiene-related scenarios and why ?
K-WC : Risk assessments help identify potential hazards to vulnerable patients and help healthcare facilities implement mitigation strategies to minimize or eliminate risks . It ’ s key to protecting patient safety . Cleaning and disinfection in a healthcare setting is about mitigating risk of infection from the environment to the patient . Therefore , EVS technicians , managers , and supervisors play a crucial role in risk mitigation and should be incorporated into the facility ’ s risk assessments .
CY : For water-associated risks , CDC has the Water Infection Control
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Risk Assessment ( WICRA ) tool to help healthcare water management program team evaluate water sources , modes of transmission , patient susceptibility , patient exposure , and program preparedness . The risk scores help the healthcare facility prioritize mitigation actions .
HHM Are these breaches
related to knowledge gaps , practice gaps , or both , and why ?
K-WC : It ’ s a combination of knowledge and practice gaps that likely contribute to IP & C breaches . For EVS technicians , formal classroom-based training may occur during onboarding , but much of the actual training is likely to be on the job , under the guidance and supervision of experienced techs . Therefore , it ’ s important to focus on continuing education of not only new techs , but experienced ones as well .
CY : EVS staff may be aware of some of the risks water and plumbing components can pose to patients , but knowledge gaps do exist . Therefore , it ’ s essential to educate EVS staff on how their actions and practices around water and plumbing components can impact patient safety . Providing this knowledge will help them understand the importance of their role in mitigating water-associated risks .
HHM What are some ways
that environmental hygiene practice can be elevated despite ongoing resourcing , staffing and budgeting challenges at so many healthcare facilities ?
CY : Integrating environmental services into the hospital ’ s safety culture is a core component of environmental cleaning and disinfection in healthcare facilities . 1 The facility ’ s multidisciplinary team , which includes EVS personnel , should meet regularly to review practices , operations , and quality measures with the goal of patient safety . Cleaning and disinfection is also a component of standard precautions , which should be applied in all healthcare settings .
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HHM How do you think IP & C and EVS can better communicate and collaborate for success ?
K-WC : I believe the relationship between infection preventionist and EVS staff is generally well established . When we get a chance to speak with these groups , they always speak highly of each other and share anecdotes on how they ’ ve been allies for each other . Continuing to highlight this relationship is important , but incorporating EVS staff into other aspects of the healthcare management team is also crucial to build relationships and increase understanding so EVS can feel better supported . We need to continue to push the message that EVS technicians are more than just “ housekeeping ” and are vital members of the care team .
HHM What other imperatives would you like to address ?
K-WC : There are many facilities that have employed emerging technologies such as UV-C robots , electrostatic sprayers , and others into their work streams . These can be important tools in the fight against HAIs , but it ’ s important to remember that these are adjunct technologies and should not take the place of cleaning and disinfecting with an Environmental Protection Agency ( EPA ) -registered disinfectant . Facilities should fully understand the manufacturer ’ s instructions for use ( IFU ) and the decision to use these technologies should include a multidisciplinary team , including EVS staff .
Reference :
1 . Considerations for Reducing Risk :
Surfaces in Healthcare Facilities . Available
at : https :// www . cdc . gov / healthcare-associated-infections
/ hcp / infection-control /? C-
DC _ AAref _ Val = https :// www . cdc . gov / hai /
prevent / environment / surfaces . html
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