You must have a champion of environmental hygiene , you must have the infection preventionist , the hospital epidemiologist , even the quality assurance manager , serving as leaders along with environmental services directors , managers and personnel making cleaning and disinfection a priority .”

As Carling and colleagues summarize , “ Given the fact that HO-CDI is the most frequent HAI today , representing 56 percent of NHSN-reported HAIs in U . S . hospitals and likely so globally , its mitigation is clearly critical . In light of our recent greatly clarified understanding of the healthcare epidemiology of HO-CDI ; implementation of new antibiotic and testing stewardship programs ; the development of new potent sporicides which can be used on a daily basis for patient-zone disinfection cleaning ; and the extensive documentation that such cleaning can be sustainably optimized with ongoing education and objective , quantitative performance monitoring and feed-back , there is reason to believe that great reductions in HO-CDI are feasible , particularly when hand hygiene is also optimized .” But there is a caveat , according to Carling . “ The biggest problem I see is it takes dedication of purpose . You must have a champion of environmental hygiene , you must have the infection preventionist , the hospital epidemiologist , even the quality assurance manager , serving as leaders along with environmental services directors , managers and personnel making cleaning and disinfection a priority .

That Stanford study with Mike Parry studying all those years of such excellent cleaning in that hospital was because the nurses took that programmatic approach , took on the task of fluorescent marking themselves on their own units . So , they owned the cleaning in their hospital ; when you have that kind of ownership of practice , that ’ s how you can drive real results . The challenge is getting people motivated to do better , saving money and lives at the same time .”

References and recommended reading :

Carling PC , Parry MF and Olmstead R . Environmental approaches to controlling Clostridioides difficile infection in healthcare settings . Antimicrobial Resistance & Infection Control . Vol . 12 , article number 94 ( 2023 ).

Carling PC , O ’ Hara LM , Harris AD and Olmsted R . Mitigating hospital-onset Clostridioides difficile : The impact of an optimized environmental hygiene program in eight hospitals . Infect Control Hosp Epidemiol . 2023 Mar ; 44 ( 3 ): 440-446 . doi : 10.1017 / ice . 2022.84 . Epub 2022 Jun 20 .

Parry MF , Sestovic M , et al . Environmental cleaning and disinfection : Sustaining changed practice and improving quality in the community hospital . Antimicrob Steward Healthc Epidemiol . 2022 Jul 12 ; 2 ( 1 ): e113 . doi : 10.1017 / ash . 2022.257 . eCollection 2022 .

Wenzel RP and Edmond MB . Infection control : the case for horizontal rather than vertical interventional programs . Int J Inf Dis . 2010 ; 14 : S3-5 .

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