from the editor
It Took 20 Years , But Healthcare Environmental Hygiene is Finally Getting Its Due
Next year marks the 20 th anniversary of the CDC ’ s environmental hygiene guidelines , and just now we are seeing the results of the first quantified overview of the strengths and challenges associated with healthcare environmental hygiene ( HEH ) practices in healthcare institutions globally . The study ’ s authors say they will use the findings to further enhance an in-development self-assessment tool that will help facilities benchmark and improve HEH .
“ We were surprised to find that 98 percent of the facilities participating in our survey were majorly lacking in one or more of the World Health Organization ’ s multi-modal improvement strategies for infection prevention and control practices ,” says Alexandra Peters , PhD , of the University of Geneva , first author of study . “ This survey suggests that challenges with key components of HEH , including staff education and training , workplace culture , and access to adequate products and equipment , remain ubiquitous regardless of geography or income level . These results reinforce the need for a self-assessment tool to help HCFs worldwide identify HEH challenges and necessary resources .”
As we have known for decades , proper , robust cleaning and disinfection of the healthcare environment is a pillar of infection prevention and control , and it ’ s dismaying to see how long it has taken for this intervention to receive the recognition of its importance on the level of criticality we have ascribed to hand hygiene , for example . HEH relies on adequate cleaning products and supplies ; best practices-based protocols ; training , education and quality control ; and the institutional safety climate . As we know too well , healthcare environmental services ( EVS ) departments lack adequate budgets , proper staffing and resourcing , and access to safe and effective products .
Under the direction of Didier Pittet of the University of Geneva Hospitals and Faculty of Medicine , Peters and several colleagues designed a pilot study to evaluate the strengths and challenges in HEH programs around the world and across resource levels . The study also evaluated a preliminary version of the Healthcare Environmental Hygiene Self-Assessment Framework ( HEHSAF ), a 39-question tool designed by global experts to help facilities ’ HEH programs evaluate their current strengths and challenges and
healthcarehygienemagazine their improvement over time . Researchers sent the preliminary HEHSAF to 743 HCFs between April and June 2021 ; 51 HCFs from 35 countries ultimately participated in the study .
Overall , 98 percent ( 50 out of 51 ) of participating HCFs lacked in some or all of the five components of the multi-modal IP & C improvement strategy , independent of income level . Other key findings include :
• 71 percent of respondents felt that their facility gave enough importance to HEH and 47 percent felt that the budget allocated for cleaning and disinfection was adequate .
• 67 percent of healthcare facilities reported that necessary products and supplies were always available , 27 percent said they were sometimes available and 6 percent said they were never or rarely available . Among the 90 percent of HCFs that reported HEH equipment and supplies were available , 16 percent could still not perform adequate sterilization because equipment was not in good working condition .
• Just over half of facilities reported that their protocols were based on best practices and updated regularly .
• Only 22 percent of HCFs provided or required ( if staff was outsourced ) comprehensive formal HEH training upon hiring ; 28 percent did not provide or require any formal training at all .
“ This study highlights environmental hygiene needs that are similar to those we identified more than 25 years ago for hand hygiene promotion at the time we introduced alcohol-based hand gels in hospitals ,” says Pittet , who is also chair of the Clean Hospitals Initiative , leading the WHO Hand Hygiene promotion initiative “ Save Lives : Clean Your Hands ” and lead senior author of the study .
Until next month , bust those bugs ! Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
Reference : Peters A , et al . Results of an international pilot survey on healthcare environmental hygiene at the facility level . Am J Infect Control . May 26 , 2022 . https :// doi . org / 10.1016 / j . ajic . 2022.02.029
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