In talking with Gordon Buntrock, Director of Environmental Services Operations Support for ARAMARK Healthcare, he noted that he is working with hospitals to implement processes such as “foam in-foam out” hand sanitizing and new technologies, like ultraviolet light, vaporized hydrogen peroxide disinfection and the use of silver and copper materials that prevent bacteria from reproducing, to make strides in reducing HAI.

New and better cleaning materials are also improving outcomes, such as switching from cleaning multiple patient rooms with mops and buckets to microfiber mops that remove 95 percent of bacteria and are replaced after each room.

“Today’s technological advances and more effective processes enable Environmental Service teams to better support hospital infection control goals,” said Buntrock. “No one technology will solve this problem from an Environmental Services perspective.  The trick is to deploy the correct technology with proven processes to meet a specific hospital’s needs.”

A unique hand-washing basin is located in the reception area of the children’s hospital.

Using a waterfall design, children are encouraged to wash their hands along with “grown-ups”.  A raised adult sink with faucet allows for a gradual flow of water as it slowly but pointedly cascades to a drain in the lower sink.  Using art, and a “cool” factor, children learn the importance from staff of washing their hands.  By watching what adults are doing, the child mimics adult behavior.

Is there a connection between education of children and a low infection rate? Well, I say that if an organization puts its mind to it, and is clever enough to develop a way to engage its youngest patients to be part of the “care team”…then it is no accident that it a leader is decreasing infection rates.  Patient education is certainly a part of the approach!

Hospitals will need to improve quality measures up to avoid penalties.  Being one of the bottom 25^th percentile of all US Hospitals will lead to negative financial impact.  My feeling is that hospitals that are attuned to this are going to be pulling away from the pack.

Said Carling: “When it comes to combating hospital infections and transmissions, three intervention points are particularly practical. You enhance patient isolation, you enhance hand hygiene, or you enhance environmental hygiene. Isolation is hard to do and hard to comply with. For the last 12 years, the whole hand-hygiene juggernaut has rolled along and a lot of work is being done to improve compliance. But it still is a problem area. Compliance isn’t what we want in most hospitals. There’s also the whole problem that with hand hygiene, you can’t do it at the most critical times. When you move between a patient and  machinery then back to the patient, then back to the machinery, you can’t perform hand hygiene between every patient contact even if you were really conscientious .”

Carling positions Environmental Services (ES) line staff as  “part of infection control and what they do is important.”   Traditional negative reinforcement for ES staff (e.g., “the floor is dirty in the corner,”  “the floor isn’t shiny”) needs to be repositioned to allow for opportunities for positive feedback from infectious disease professionals.  This  includes not just training and raising awareness for ES staff members, but also for getting them to feel involved with the infectious control process.

Carling stated, “There is good evidence with C. diff, VRE and MRSA that using a structured program can certainly decrease environmental contamination. There’s little doubt, as you might expect, that improved environmental hygiene and disinfectant cleaning decreases environmental contamination.”  Carling feels there is more work to be done with epidemiological studies that examine the potential impact that a structured training program focusing on ES staffs’ role in the HAI process has on decreasing hospital infections.

I’m interested in any examples you may have for how hospital infectious diseases departments involve ES staff in meeting their goals.