It was no surprise that low-resource settings had a problem with resources , but what was surprising was that high-resource settings struggled with resources , even more than 70 percent of respondents said that they thought that their budgets for environmental hygiene were pretty good , and their overall attitude was that their programs were adequately effective .”
Notably , respondents didn ’ t agree with the assessment that improvement is indicated ; overall , 71 percent of respondents felt that their healthcare facility gave enough importance to HEH , and 47 percent felt that the budget allocated for cleaning and disinfection was adequate .
“ It was no surprise that low-resource settings had a problem with resources , but what was surprising was that high-resource settings struggled with resources , even more than 70 percent of respondents said that they thought that their budgets for environmental hygiene were pretty good , and their overall attitude was that their programs were adequately effective ,” Peters says . “ Then when we see the responses to the survey questions , we realize that there ’ s a significant issue . Unless you know you have a problem , you can ’ t fix it because you won ’ t know to address it , of course . I think there ’ s a gap between the perceptions of EVS managers and personnel who are responsible for the environmental hygiene program .”
Peters continues , “ Part of that is probably due to the fact that there ’ s very little international exchange on best practices in environmental hygiene , so people tend to work in silos in their institutions , with little awareness of recommendations or best practices in other countries that could or should be applicable . I think there ’ s a gap in people working together from different institutions and from different settings so that they can see there are other , potentially better ways to perform their jobs – maybe there ’ s not one right way but there are a number of ways that a task could be approached .”
Proper HEH comprises the cleaning of all surfaces in hospital rooms . It is reliant on multiple factors , including adequate cleaning products and supplies ; best practices-based protocols ; training , education and quality control ; and the institutional safety climate . EVS departments responsible for HEH face numerous challenges ; as Peters , et al . ( 2022 ) acknowledge , “ Many healthcare institutions do not focus adequately on the environment ; it is common knowledge that departments responsible for HEH face numerous challenges including limited budgets , an unstable and often uneducated workforce , a lack of evidence-based practices , and a lack of access to safe and effective products .”
Under the direction of professor Didier Pittet , Peters and several colleagues designed a pilot study to evaluate the strengths and challenges in EVS 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 their improvement over time . Researchers sent the preliminary HEHSAF to 743 healthcare facilities between April and June 2021 ; 51 healthcare facilities from 35 countries ultimately participated in the study .
Overall , 98 percent of participating healthcare facilities lacked in some or all the five components of the multimodal IP & C improvement strategy , independent of income level . The survey found that overall , products and supplies were always available in 67 percent of healthcare facilities , and rarely or not available in 6 percent .
Fifty-two percent of healthcare facilities responded that all HEH protocols were based on best practices and updated regularly , while 14 percent reported that available protocols were not based on current best practices or were not available at all . Seventy percent of healthcare facilities adapted all their HEH protocols to different risk zones , while 6 percent did not . Respondents reported using a number of products and supplies for surfaces . Only one healthcare facility did not report using any type of disinfectant . Ninety-four percent used detergent , either alone or in a product combined with a disinfectant . For manual cleaning , 84 percent of healthcare facilities reported using wipes , cloths or sponges . Traditional mop and buckets were still used in most healthcare facilities , and only 4 percent reported using bucketless mopping systems exclusively . Fifty-four percent of healthcare facilities used larger mechanical cleaning machines for cleaning floors or large surfaces . Half of healthcare facilities performed automated disinfection , either with UV or gaseous hydrogen peroxide .
The survey also revealed suboptimal education and training of EVS personnel . Eighty-four percent of healthcare facilities employed EVS staff directly , while others outsourced their EVS staff . Eighty-six percent of healthcare facilities provided on-the-job training ; other methods were used less frequently . Six percent of healthcare facilities did not know what type of training their EVS staff received or did not provide any training at all . Only 22 percent of healthcare facilities provided or required ( if staff was outsourced ) comprehensive formal training upon hiring ; 28 percent did not provide or require any formal training at all . Forty-six percent of healthcare facilities provided regular additional training at least once per year , while 10 percent did not propose any additional training . Seventy-five percent of healthcare facilities did not provide their EVS staff access to any certification programs . Unsurprisingly , the same proportion of institutions did not make it possible for EVS staff to advance into management roles .
Regarding monitoring and feedback , which evidence shows plays a significant role in the improvement of EVS programs as well as ensure effectiveness of cleaning practices , 87 percent of healthcare facilities monitored staff performance . Sixty percent of healthcare facilities gave immediate feedback at the individual level and 27 percent gave systematic feedback at the team level . Seventy-seven percent of healthcare facilities reported usually giving