One of the more important lessons for me during the preparation of the guideline was the impact of an environmental services ( EVS ) program on the transmission of microorganisms .
In fact , Lynne made it a point to showcase the importance of EVS with a picture of an EVS staff member with a cleaning cart on the front page when the EIC guideline was initially published .” — Raymond
Chinn , MD , FISDA , FSHEA entire document . And then , when I got to the end , I went to a blank page and put the cursor at the top and hit the button for the generation of the index , and it worked , and I was so happy about that !”
Because the EIC guideline covered a wide breadth and depth of content , it was a lengthy document , Sehulster says , leading some at the CDC to want to abbreviate it lest end users find it too ponderous .
“ When you first see the printed full-text version of the guideline , you think , it ’ s a book !” she exclaims . “ How would people react to it , knowing it ’ s sort of like a book ? Interestingly , several of my colleagues within the division take one look at it and say , ‘ It ’ s too big , no one ’ s going to read it .’ I said , ‘ Well , let me ask you if you have a medical textbook ; do you take one look at that and say it ’ s too big , you can ’ t read it ?’ I said , ‘ That ’ s why the table of contents and the indexes are there , so you can go immediately to the location in the document and get your answer .’ I still hear today from people who tell me they carry the full-text document with them whenever they ’ re going on a consulting trip , because it ’ s their go-to document .”
Sehulster adds , “ The guideline is like my baby , so I feel like I ’ m its mother . It never ceases to amaze me how many people have come up to me at conferences , and so forth , and say how valuable the EIC guideline is to them , and the difference that it makes in their work . I hear this from people in medicine , hospital epidemiology , infection prevention , environmental services , the built-environment professionals , and that makes me feel good .”
Raymond Chinn , MD , FISDA , FSHEA
“ It is difficult to imagine that it ’ s been 20 years since the publication of the EIC Guideline ,” says Raymond Chinn , MD , FISDA , FSHEA , medical director of infection prevention for Sharp Metropolitan Medical Campus in San Diego . “ The recommendations set forth then continue to have applicability today and have also evolved as the science unfolds .”
Chinn is quick to credit his colleagues for their work on this seminal guidance document . “ For my participation in the preparation of the EIC Guideline , I am indebted to my co-author , Lynne Sehulster , Andrew Streifel , and the late Judene Bartley for their unwavering support of someone who was not from academia and who was new to guideline development .”
He recalls the intense commitment to the task that he and his colleagues shared .
“ I do remember those evenings when Lynne would wait for my call several times weekly in the late afternoon ( Lynne ’ s evening ) that were planned after completing my patient rounding , ending the call
day , and fulfilling my duties as chair of the infection prevention department and antimicrobial stewardship program . Being bi-costal was especially challenging , but Lynne ’ s wait for ‘ the call ’ was soothed by the music of Wagner that transported her to another sphere , as it were , until she had to return to reality . We would review the progress of the guideline , section by section , make recommendations to improve the text , and create a to-do list for our next meeting . One of the more difficult tasks was to write in ‘ one voice ,’ as there were many contributors to the guideline . Each comment -- and there were many -- from the expert reviewers required an assessment and a response . One of the more important lessons for me during the preparation of the guideline was the impact of an environmental services ( EVS ) program on the transmission of microorganisms . In fact , Lynne made it a point to showcase the importance of EVS with a picture of an EVS staff member with a cleaning cart on the front page when the EIC guideline was initially published .”
Chinn notes that during the preparation of the guideline , the lay press had highlighted numerous healthcare-associated aspergillosis outbreaks that resulted in significant morbidity and mortality in highly venerable populations . “ Andy and Judene , both prolific writers and national experts , were well-versed in strategies that were required to mitigate exposure to aspergillus during construction , demolition , and renovation activities . Judene promulgated the use of the infection control risk assessment ( ICRA ) that is now a standard in infection prevention . Andy was a great resource in my understanding of the intricacies of airflow , portable air cleaners , and air sampling . There was significant reliance on expert guidance from organization such as the American Institute of Architects and the American Society of Heating , Refrigerating and Air-Conditioning Engineers since randomized control trials were not available to support recommendations made for each of the components included in mitigation strategies , nor would it be ethical to study them .”
Chinn says participation in the guideline-creation process was a career highlight . “ The preparation of the EIC guideline has contributed significantly to my professional life and I am fortunate to have witnessed its impact on reducing the risk of healthcare-associated infections associated with the environment .”
Matt Arduino , PhD
As the CDC ’ s senior advisor for environmental hygiene and infection prevention , Matt Arduino ’ s training as a public health microbiologist also prepared him for the rigors of contributing to the EIC guideline ’ s sections on environmental services and on water in the healthcare
18 june 2023 • www . healthcarehygienemagazine . com