The Importance Of Cleaning Staff

The role of custodians or cleaning staff in our healthcare facilities is largely underrated. Do you know that they play the biggest role in preventing and transmitting disease within the hospital setting?

How?

They clean, sanitize, and disinfect.

This may sound unexciting to the average reader but to those who are hospitalized and have a compromised immune system that is susceptible to further disease and infection from hospital-acquired infections, the housekeeping staff or environmental services of a healthcare facility may well save their lives.

The Enemies

Vancomycin-resistant enterococci. Methicillin-resistant Staphylococcus aureus. Gram-negative bacilli. Clostridium difficile. These are just some of the villains that live on or around the patient’s bedside and other hospital surfaces.

These pathogens are particularly dangerous because they can remain alive for extended periods of time (think days, weeks, or even months) on common dry environmental surfaces AND they easily contaminate areas regularly touched by patients and healthcare staff.

Where Does Contamination Happen?

Consider the unassuming tray table, bed rails, call bell, and bedside chair as potential sites of infection. Of course, the toilet, bedpan, and bathroom sink are also heavy on pathogen contamination and all are considered high-touch surfaces that carry an increased risk of transmission of disease.

This contamination can happen as easily as a nurse touching a contaminated surface and spreading it to another patient area. Or the patient coming into direct contact with deadly micro-organisms by touching the light switch in the common bathroom that is shared with three other patients.

The risk is real and these pathogens may be lethal in some patients with compromised conditions.

Housekeeping’s Role

The Housekeeping department of a hospital or health-care facility plays a critical role in preventing infection within the facility and are responsible for the regular cleaning and disinfection of all surfaces.

Alongside the Infection Control department, they directly contribute to the level of cleanliness within the area as well as keeping outbreaks under control.

They ensure that the appropriate cleaning techniques and procedures are implemented in the appropriate situation. For example, cleaning up a spilled drink in the lobby would be much different than disinfecting a room that has been contaminated by urine, blood, or feces.

The Tools

Now consider that different products offer different levels of cleaning appropriate for their specific application…
Cleaner – A cleaner’s main purpose is to physically remove soil and germs from surfaces and is the first and most important step in keeping a hospital clean.

Although a cleaner can remove pathogens from a surface, it does not kill them.

Sanitizer

The sanitizer has the ability to lower the number of bacteria on a surface to a safe level that is acceptable by health codes and regulations.

Although they work faster and are considered safer than disinfectants, they still do not have the broad reach and powerful germ-destroying abilities of disinfectants.

Disinfectant

This is the powerhouse of the infection-fighting toolkit. They destroy disease-causing bacteria, viruses, and fungi that are commonly found on hospital surfaces.

But keep in mind that although they kill micro-organisms, they do not eliminate their spores which are formed in response to adverse environmental conditions.

Sterilizer

This one is strictly used for instruments and objects used in patient procedures that come into contact with sterile body tissues. They kill all fungi, viruses, and bacteria, including their spores.

When and Where to Bring Out the Big Guns

It would make sense to think that disinfectants should be used throughout the entire healthcare facility. But, in reality, that is not necessary.

Taking into account that most healthcare facilities have their own set of protocols and procedures when it comes to effective and appropriate cleaning and disinfection, in general, disinfectants are used on all hard, inanimate, and nonporous surfaces and medical devices that may come into contact with a patient’s intact skin and mucous membranes.

Considering Most Touched Surfaces

Consider patient surfaces like bedside tables, phones, TV remotes, and IV stands.

These areas are frequently touched by patients, staff, and visitors. Because these disease-causing micro-organisms are not seen with the naked eye, it is difficult to detect which areas are contaminated and which ones are free from pathogens. This simple fact reinforces the importance of disinfecting all patient area surfaces.

However, disinfectants do not have to be used everywhere in the hospital. Non-critical surfaces like walls and floors in lobby areas and hallways generally do not require disinfection.

Preventing The Spread Of Infections

Studies have found that disinfecting these areas make no difference in lowering the rate of hospital-acquired infections. Cleaning walls and floors with a hospital-grade detergent should be sufficient to keep these areas clean and dirt-free which is what these cleaners were designed for.

Of course, if there is a bodily fluid spill, then the appropriate disinfection procedures should be followed.

Using Disinfectants Correctly

It is important to mention that if an area or object is to be disinfected, then the area should be thoroughly cleaned first to remove visible dirt and debris.

Dirty surfaces tend to impede the germ-destroying abilities of disinfectants and may not be as effective at killing the deadly micro-organisms that you think you are.

So consider the two-step process of disinfection…clean first. Then disinfect.

With these processes in place, you can be assured that your healthcare facility is clean, disinfected, and free of pathogens that can harm your patients.

References:
http://www.cleanlink.com/hs/article/Where-And-When-To-Use-Disinfectants-In-Healthcare-Facilities–16319

http://www.enviroxclean.com/Resources/Healthy-Cleaning-Guide/ArtMID/521/ArticleID/49/How-to-Clean-Sanitize-and-Disinfect-Your-Facility

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187643/

https://www.moh.gov.sg/content/dam/moh_web/Publications/Guidelines/Infection%20Control%20guidelines/Environmental%20Cleaning%20Guidelines-Jun%202013.pdf

https://www.nhmrc.gov.au/book/b5-1-recommended-routine-cleaning-frequencies-clinical-patient-and-resident-areas-acute

http://www.sahealth.sa.gov.au/wps/wcm/connect/18741180499970f0891e8faa8650257d/SA-Health-cleaning-standard-2014_%28V1%29-cdcb-ics-20150820.pdf?MOD=AJPERES&CACHEID=18741180499970f0891e8faa8650257d