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.