When it comes to tackling HAIs, consultants emphasize the need for detailed, methodical cleaning procedures.

"I've done a lot of audits and there is inconsistency regarding what surfaces are missed," says Solomon. "Sometimes it's the door handles, other times it's the light switch or the headboard. So ensure that you have a consistent room-cleaning path: Are you going clockwise, or cleaning from the back to the front of the room?"

At Divine Savior Healthcare, housekeepers move in a clockwise direction around the patient room and end up at the patient bed. Bristol uses fluorescent marking gel to validate the cleanliness of high-touch surfaces.

"It's a good training tool, because I can show them what they're missing," she says.

Typically, lack of time and improper cleaning procedures are to blame — which is why EVS directors need to allot staff enough time to disinfect and stress the importance of a two-part cleaning and disinfection process.

"Before you can disinfect a surface, it has to be clean," says Fellows. "Then, the disinfectant has to be allowed to stay on the surface for the required dwell time. People try to use disinfectant to clean when they're short on time, but the power of the disinfectant is used up on whatever dirt is on the surface."

Fellows urges housekeeping departments to throw out trigger sprayers.

"I watch people spritz disinfectant on and then wipe it off," he says. "It has to be applied in a way that allows the surface to remain wet long enough for the disinfectant to do its job. Instead use a flip-top on a quart bottle and apply enough disinfectant to saturate the cloth properly."

No doubt, the hot zone is a hotbed for HAIs — but the threat of cross-contamination extends well beyond the patient room. High-touch surfaces hospital-wide can play a role in the spread of infectious diseases. Management can support housekeeping's efforts by providing them with comprehensive policies, ongoing training and sufficient time to get the job done.

Kassandra Kania is a freelancer based in Charlotte, North Carolina. She is a frequent contributor to Facility Cleaning Decisions.

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