Healthcare Hygiene magazine September 2020 September 2020 | Page 28

Time for
Quality Outcomes
By Aaron Jett
Editor’s note
This article is
the eighth in a
year-long series
describing
an industry
journey led by
environmental
services and
infection
prevention
toward
better patient
outcomes,
quality and cost
savings.
sticky floor, dirty bathroom, unemptied
A trashcan, dusty ledge, or missed surface
getting wiped — when you hear about these
things, what goes through your thoughts?
As your mind races to explain the “why,”
could one of those reasons perhaps be that
the person responsible for cleaning didn’t
have enough time?
In last month’s article in this series, “A
Better Way to Understand Your Microbial
Jungle: What’s in There and How to Know
When It’s Gone,” authors Paul Pearce
and John Scherberger made an insightful
comment that goes to the very heart of
this article: “EVS teams must have with the
knowledge, proper cleaning tools ... and
sufficient time to incorporate them. All of
these essential factors must be in place.”
William Rutala has also consistently said, “Good Products
+ Good Processes (Training) + Good Processing = Good
Patient Outcomes.”
This fundamental truth that sufficient time is needed to clean
and disinfect properly exists in all areas of our lives, especially
in healthcare, and now with the COVID-19 pandemic, we have
increased awareness as to the essential need for proper cleaning
and disinfection.
If soil, dust, dirt and debris are visible, one can count on what
can’t be seen there, too — the pathogens that can make us sick
within that microbial jungle.
So why devote an entire article to sufficient time to incorporate
best practices, tools and training?
There are many reasons why sufficient time to incorporate
best practices for cleaning and disinfecting are negatively
affected. These may include unexpected increase in census
levels, negatively affected staffing levels, call-offs, inaccurate
estimation on needed resources, and scope creep as other
tasks and areas added without increased headcount.
More massive-soil areas such as the operating rrom (OR),
the emergency department (ED), and labor and delivery (L&D),
plus inferior-quality tools — such as non-healthcare grade
ultrafine microfiber — are also contributors. Too often, tasking
environmental services (EVS) personnel to use disposable
wipes designed for clinical staff to address small-area spot
cleaning impedes their productivity and raises their frustration
level due to time constraints. EVS faces complications of processing
(cleaning and disinfecting) various pieces of medical
equipment, having to choose which two-step disinfectant to
use, and knowing which leaves residue and haze is a common
impediment for them. When people with the best intentions
choose which chemicals EVS is to use, they will often require
EVS to double their best efforts to return to polish or clean,
so as not to give the appearance of a soiled surface. EVS is
the one department that tends to encounter too many EVS
supervisors providing “direction.” The question of “who
cleans what, when, and how” is a great time waster and
results in less than optimal results. Perhaps a more excellent
way of saying that is “too many cooks spoil the broth.”
A good friend of mine likes to use an analogy about a football
field. If tasked to vacuum an empty football field (yes, crazy, and
Astroturf, of course), it will take a pre-determined amount of time
using specialized equipment. Now, if that same football field had
furniture, waste cans and people occupying each cubicle, would
one expect it would take the same amount of time? Now, let’s
add an office party, and the occupants of these cubicles decided
to have cake and punch. And, oh yes, the special occasion
included streamers, decorations, and poppers that sent confetti
everywhere. Let’s not forget glitter that sticks to everything! With
each change in circumstance or added equipment, assets and
people — not to mention their behavior in what they do in that
space — cleaning time is significantly affected. Combining all of
the above (to be sure, a party is not an everyday event) with an
understaffed EVS department that does not have sufficient time,
training, proper tools, and processes, the result is a minimally
effective department.
When an EVS department does not have
appropriate tools, equipment, EPA registered
hospital-grade disinfectant, healthcare grade ultramicrofiber
infection prevention textiles, the training
to utilize that equipment, or unclear service level
agreements, disappointment on all levels result.”
28 september 2020 • www.healthcarehygienemagazine.com