Best Practices for High Touch Surface Cleaning in Healthcare
In lieu of recent changes in guidelines from the Centers for Disease Control (CDC) calling for increased cleaning performance and integration of new auditing controls to regulate cleaning efficacy, the International Executive Housekeepers Association (IEHA) and Cintas Corporation released a list of best practices for reducing healthcare acquired infections (HAIs) and enhancing levels of cleanliness within a healthcare facility.
“The days of infection prevention and environmental service departments working autonomously are over,” said J. Darrel Hicks, REH, author of Infection Prevention for Dummies. “These new guidelines clearly demonstrate the increased need for cooperation between the two departments and the need for a reevaluation of current cleaning programs in place.”
Recent hospital studies found that only 25 to 45 percent of touch points nearest the patient met the definition of “clean” according to research criteria. Interventions raised the rate of clean to 75 percent. To improve cleaning performance and help reduce opportunities for HAIs, the following are recommended:
1. Cultivate an environment of partnership. Infection prevention should work together with environmental service departments to ensure the facility is being cleaned at optimal levels with the resources available. Schedule ongoing meetings with the other department so there is open communication between the two groups.
2. Benchmark cleaning products and processes. Work with manufacturers to identify product needs and have them assist in audits to ensure the proper processes are in place and that the products are used effectively. Infection prevention can also be a valuable resource throughout the product evaluation process.
3. Conduct time audits. For comprehensive surface cleaning, environmental service workers need enough time to thoroughly address all surfaces throughout a patient room. By working with infection prevention to conduct time studies, environmental service managers can determine exactly how much time is needed to thoroughly clean and disinfect all appropriate surface areas.
4. Provide thorough employee training. Education is the key to a quality infection prevention program, so cleaning personnel should be trained on not only how to effectively clean and disinfect surfaces, but why it is important. Training should include courses on microbiology so workers can understand some of the chemistry behind the disinfection process. With this knowledge, workers will possess the tools necessary to identify high touch surface cleaning targets.
5. Recognize and empower cleaning personnel. As acknowledged by the updated CDC guidelines, cleaning personnel are an integral part of any infection prevention program, so they should be recognized as such. Ongoing recognition will empower workers and encourage them to focus on job performance. Monthly award programs or yearly company-wide events such as International Housekeepers Week provide opportunities for much deserved recognition.
6. Measure cleaning performance on an ongoing basis. The CDC offers a checklist of areas to be routinely checked and monitored. These include bed rails, tray tables, light switches and other high-touch areas throughout the patient room. To ensure these areas are cleaned effectively, handheld devices such as adenosine triphosphate (ATP) meters can measure soil levels. Black light markers and UV lights can also measure cleaning performance.
“Environmental service departments play an integral role in infection prevention efforts,” added Brent Schafer, Vice President of Healthcare, Cintas. “By following these best practices, healthcare organizations can coordinate efforts and keep high touch surfaces free of infection.”