There are many reasons why St. Luke’s Hospital, in Chesterfield, Mo., was recognized as one of America’s 50 Best Hospitals for a 7th year in a row. Certainly, outstanding patient care and clinical excellence takes top billing, but one cannot overlook the exemplary efforts made by the environmental services staff on infection prevention.

The reality is that many lives are lost every day because of the spread of infections in hospitals across the country, which is why infection prevention is an essential component to any environmental services program. In fact, J. Darrel Hicks, director of environmental services and patient transportation, has made it his goal to stay one step ahead of potential infection outbreaks.

This is not to say that St. Luke’s is immune to hospital-acquired infections (HAI). Certainly, a hospital licensed for 490 beds that spans 950,000 square feet, with an additional 300,000 square feet of medical office buildings on site will experience cases just like every other hospital. But, where St. Luke’s shines, is the infection is quickly controlled and eliminated before becoming a problem.

“We, fortunately, have never experienced an infection control outbreak at the hospital,” he says. “That success can be attributed to well-communicated processes; a strong and comprehensive hand hygiene program; mandatory education of infection prevention for all employees; well-trained, conscientious housekeepers; and good supervision in the environmental services (EVS) department.”

In The Event Of Infection

When a patient contracts a hospital acquired infection, members of Hicks’ 119 FTE (full-time equivalent) staff deviate from standard operating procedures and shift into “infection preventionists.” The staff incorporates additional cleaning processes into their routine in an effort to eliminate cross-contamination and further spread of the infection.

For example, in the event of an infection such as C. diff or MRSA, Hicks stresses the importance of patient isolation as the first step. Secluding the infection minimizes the likelihood of it spreading between patients and allows cleaners the opportunity to focus on its removal.

“The staff does a twice daily disinfection with bleach wipes in the affected area,” says Hicks. “We wipe all high-touch surfaces with the bleach wipes, and then at discharge, we clean the entire room and restroom with an all-purpose cleaner and microfiber cloth. Then we use the bleach wipes again to disinfect those same surfaces.”

Managers in similar facilities might find the infection prevention process time-consuming, but one cannot argue the successful results.

“It takes the staff about 10 minutes longer to clean the affected room,” says Hicks, “but we have six years of data to prove that the process works at controlling infections.”

Reducing Cross-Contamination

Reducing cross-contamination can make or break an infection prevention program. Skipping this step is an invitation to potential infection outbreaks.

“Germs aren’t contained in just the patient’s room,” says Hicks. “Which is why we need to broaden our scope of cleaning and disinfecting to include practically every area of the hospital.”

The only way to reduce cross-contamination and keep infections from spreading is to give the same amount of attention to the common areas, waiting rooms, nurses stations, and other spaces, that is given to the patient care room. This means strict cleaning protocols that target not just high touch points, but all surfaces throughout the facility.

Developing a thorough and comprehensive cleaning program of this scale — one that targets every surface of the hospital — will sometimes mean involving departments outside of EVS. Most often, this includes the nursing staff.

“Our EVS staff isn’t bashful about telling nurses and other staff what is being observed on the patient care floor,” says Hicks.

For example, if St. Luke’s EVS staff notices a slip in hand washing or sanitizing frequencies, they’ll speak up. Hicks has also trained his staff to monitor medical machines that move between patient rooms and proper disinfection techniques of those machines.

As an extra set of eyes on practices like these, Hicks and his staff are able to further minimize the threat of cross-contamination throughout the hospital.

“The EVS staff will also occasionally attend a nursing staff meeting on their assigned floor/area to talk about how we can work together to provide a safe, clean and disinfected environment for our patients and staff,” he says.

Keeping everyone focused on reducing cross-contamination through open communication goes a long way to promote proper infection prevention within the facility.

“I believe that all employees must know the basics of infection prevention,” says Hicks. “This includes an understanding of basic infections, multi-drug resistant organisms, how infections spread, identifying isolation signage, targeting high touch surfaces for disinfection and preventing cross-transmission through best practices.”

To guarantee effectiveness of his processes, Hicks will periodically test surfaces throughout the hospital using an ATP (adenosine triphosphate) meter, a device that measures the hygiene levels on a surface. Doing random tests guarantees that the employees are following proper protocol, the cleaning processes are effective and the chemicals are successful in removing the necessary soils that can spread infections.

In the event that Hicks is dissatisfied with the results from his random testing, processes will be reevaluated and staff training will be addressed.

Hicks has demonstrated that with a well-communicated program, comprehensive training and education on infection prevention, and attention to the details, his department will continue to excel at providing a safe and healthy environment — no doubt adding to the list of reasons why St. Luke’s Hospital continues to achieve top quality rankings/awards.