As we think ahead now to a post- COVID-19 world , it is imperative that healthcare leaders and decisionmakers shift their focus to the critical area of infection prevention and to providing a safe environment of care .” and diarrhea splatter . Finally , I acquiesced to my discomfort and spoke up . I asked the nurse manager to turn the commode over . Her embarrassment was immediate . The tremble in her voice as she apologized profusely let me know she was sincerely mortified , and I felt horrible .
This is just one of the experiences that showed me everyone responsible for the patient , whether direct or indirect , should have their training be under the umbrella of “ patient-centered ” care . We need to shift the paradigm from just cleaning the room , to cleaning and disinfecting the room starting from the patient nucleus and expanding outward .
This incident highlights one of the other issues I have witness regarding EVS and housekeeping - the clear delineation of who is responsible for what . Was it the job of housekeeping to clean and disinfect the commode or is it the domain of a CNA ? There needs to be better communication between clinical staff and environmental staff . That will be easier to achieve when members of the environmental team are viewed as “ coworkers ” rather than support , which allows for reciprocal respect . The EvSOP playbook is a step in this direction through the promotion of a higher level of training , and certification to elevate the profession , backed by evidence based processes that create clarity to who cleans what , how , and when .
Many times , infection control issues are encountered and remain unresolved . Following my surgeries , when I had to ambulate the floor for exercise , I moved very slowly . Each of my parents had an arm and an IV pole . The more I walked the more it caused my wound bed to drain and sometimes , the seal around the plastic covering on my wound sprung a leak before I could make it back to my room . Whenever it happened , a trail of reddish-pink serosanguinous to sometimes creamy pink purulent drainage followed behind me . Not once was a call made to come clean and sanitize the floor , leaving other patients at risk who might unknowingly step in that trail . At best , someone would throw a white towel or sheet onto the floor and slide it back and forth with their foot , smearing the drainage across the floor until it dried .
Although I was only a doctor or nurse on TV , I knew that this and many of the other things I was observing were not appropriate . I made a vow that if I made it out of the hospital alive , I would do everything I could to bring awareness to these unnecessary hazards and help change the system .
While bedridden , I bought a ‘ talk-to- type ’ program and began using social media to share my experience with others . I researched and learned that over 100,000 patients like me did not survive their hospital-acquired infections . Personally , I witnessed that less than half of my caregivers washed their hands without any provocation from me . The more I learned , the angrier I felt , along with feelings of disappointment , and betrayal . I channeled my anger into videos and blogs documenting the struggles of harmed patients and in just a few months , the social media group I created for Survivors and families grew to more than 2,500 people .
My parents and I founded the Alliance for Safety Awareness for Patients ( ASAP - http :// patientsafetyasap . org ) to educate , protect and empower patients through knowledge and awareness of HAIs . As soon as I was well enough , I also began visiting medical schools and nursing programs and speaking on issues like patient safety and infection prevention .
In 2009 , I was proud to co-sponsor two laws for public reporting of hospital infection rates and mandatory infection prevention education for all California healthcare workers with patient contact . SB158 and SB1058 are known collectively as “ Nile ’ s Law ” after Nile Calvin Moss , the son of fellow advocates Carole and Ty Moss . They had joined the networking group following the death of their 15-year-old at a children ’ s hospital in the middle of a MRSA outbreak .
In a somewhat “ full-circle moment ” I was appointed and served for nine years on the California Department of Public Health ’ s HAI Prevention Advisory Committee .
Ultimately in 2015 , I was appointed by President Barack Obama as a voting member of the Presidential Advisory Council for Combating Antibiotic Resistant Bacteria ( PACCARB ), a position I continued to serve under the Trump administration until the end of my term in February 2020 . The same day the Coronavirus Task Force was first announced .
As we think ahead now to a post-COVID-19 world , it is imperative that healthcare leaders and decision-makers shift their focus to the critical area of infection prevention and to providing a safe environment of care .
There are already many evidence-based interventions that can be implemented to prevent infections and save lives . A true desire and will to do it are required , along with the commitment to allocate the right resources where the entire ROI is measured in lives saved , not just in the profit margins on a balance sheet , but weighing everything through the lens of Cost , Quality , and Outcome ( CQO ). It necessitates bold infection prevention champions taking the lead in their facilities and then replicating their passion and commitment to the patient across all departments – e . g . transport , EVS , nursing , and surgery .
None of it will be easy , but neither is surviving , recovering from , and rebuilding a life after the devastation of an HAI . So , while it is a daunting task , we owe it to our patients to at least try .
Alicia Cole currently serves on the Patient & Family Executive Council for the Centers for Medicare & Medicaid Services Partnership for Patients 2.0 . She also sits on the Environmental Services and the Education & Awareness Sub-committees of the California Department of Public Health ’ s HAI Advisory Committee . She also serves on the EvSOP © Advisory Council advocating for EVS and infection prevention professionals .
www . healthcarehygienemagazine . com • october 2020
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