HOW CAN WE PREVENT INFECTIONS? The Clean Environment

HOW CAN WE PREVENT INFECTIONS?The Clean Environment

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Hospitals in the Past

Hospitals were dirty, smelly, over-crowded places, full of disease

Hospitals were places where poor people went to die.

Hospitals in the Past

Women and children died from infection because doctors went straight from doing autopsies to delivering their babies without washing their hands.

Things started to Change

Florence Nightingale devoted her life to improve health by improving the environment.Proved that clean environment, warmth, air quality, sunlight and quiet led to good health.

Others Followed

Doctors began to learn about how germs are spread.

Doctors like Holmes and Pasteur realized that the simple thing like a doctor washing his hands led to less people getting sick and dying.

Hospitals Today

Today we expect hospitals to be very clean places of healing.

Specialized Team

Today we have created a specialized team devoted to making sure the environment is clean enough.

To promote healingTo prevent the spread of disease

YOUare the

SpecializedTeam

Tell us what you know…

Handout copy for everyone

We will walk through questions together but please answer on your own

Hand in your copy of your answers when you finish

Tell us what you know…Question 1

People who live in a long term care setting are not at a greater risk for infections.

TRUE FALSE


MRSA bacteria can live on surfaces in a patient’s room or a resident’s room.

TRUE FALSE


Cleaning a surface removes germs and kills them.

TRUE FALSE


When cleaning a patient’s room or a resident’s room you must clean from the dirtiest area to the cleanest area in the room.

TRUE FALSE


Environmental staff play as important a part in preventing the spread of infection as nurses and doctors do.

TRUE FALSE


Disinfection on its own will prevent the spread of infection.

TRUE FALSE


When cleaning a patient’s room or a resident’s room you must clean from the lowest area to the highest area.

TRUE FALSE


Environmental cleaning is an important part of infection control in SCHR.

TRUE FALSE

ALL DONEPLEASE HAND IN YOUR ANSWERS

The Clean Environment

GERMSFound in places that look dirty and found in places that look clean

Can cause illness, especially in those who are already sick or weak (newborns, elderly, dialysis and cancer patients)

Cleaner than Your Own Home

The hospital and nursing home must be cleaner than your home.

Our patients and residents are vulnerable and need to be protected from MRSA and other germs that may come into the hospital or long term care facility.

Cleaner than Your Own Home

Remember germs are there even though we cannot see them

Host, Agent, Environment

HOST

(Residents & Patients)

ENVIRONMENT

AGENT

(Bug/Germ,

MRSA)

Chain of Infection

Portal of

Exit

Portal

of Entry

Transmission

Reservoir(HCW, Environment,

Patient) Infectious

Agent(MRSA)

Host

Susceptibility(older,

immunocompromized)

Outbreak Graph

0

2

4

6

8

10

12

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b

8-Fe

b

10-F

eb

12-F

eb

14-F

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eb

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Mar

3-M

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Date of Onset

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ick

Peo

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Staff with Illness Residents with Illness

Infection Control Notified

Facility Closed

Outbreak Declared

Over 20 Days Later

Seven Deaths during outbreak

Team Work

There are many different tools required to provide the best protection for our residents/patients and employees

Preventing infections:Takes team work Is like putting together the pieces of a

puzzle

Preventing Infections

Name some important things you do to prevent infections like MRSA….

Infection Control Puzzle

MasksHandwashing

ENVIRONMENTAL CLEANING

VaccinationGowns

Gloves De-cluttering

Cleaning EquipmentEducation & Training

High Touched Spots (HTS)

Can you name some high touch spots in the patient or

resident’s room?


Bed: Footboard

Window Sill

Bed Rails

Bedside Tables

Bed: Adjustment

Clothing Storage Handle


Sink Tap

Toilet Seat

Towel Dispenser Light Switch

Cleaning HTS

How do we know we have done a good job?

Let’s try it out…..

Environmental Services are One of Our Most Important lines of Defense in Infection Control

Lines of Defense

Vaccines

Hand Hygiene

Environmental Cleaning Treatment

Personal Protective Equipment

How Do We Prevent Infections?

Educate about infection prevention and control

Update cleaning procedures

Focus on High Touched Spots

How Do We Prevent Infections

Standard Precautions are used with every patient or resident.

-Hand washing/Hand antiseptics-Gloves-Gowns-Masks/Eye protection-Care of equipment

Tell Me About MRSA

Staphylococcus aureus is a bacteria/germ Up to 30% of us carry it on our body Can cause infections such as boils, impetigo and

blood infections

Methicillin Resistant Staphylococcus aureus (MRSA) is same Staph. aureus bacteria/germ that has become resistant to some of the most common antibiotics we use to treat Staph infections.

Tell Me About MRSA

MRSA can survive in the environment (door knobs, bed rails, bathroom faucets, etc… high touch).

There is evidence MRSA could survive more than 38 weeks on sterile goods.

(Infection Control and Hospital Epidemiology May 2003 SHEA Guideline for Preventing Nosocomial Transmission of Multidrug-Resistant Strains of Staphylococcus aureus

and Enterococcus – see page 368)

Definition of CleaningCleaning is defined as the physical removal of foreign material For example - dust, soil such as blood, secretions,

excretions and microorganisms

Cleaning physically removes microorganisms/germs. It does not kill germs. Cleaning is accomplished with water, detergents

and mechanical action.

Definition of Disinfection

Disinfection is stopping/killing germs that cause disease.

We use special products for disinfection.

Clean and Disinfect

We must clean first and then disinfect to prevent the spread of infection and stop germs in their tracks.

Disinfectants are not effective when used on items or areas that are soiled with organic material including microorganisms.

Operation Clean Sweep

Where do you start??

Director and Chief ofOperation Clean Sweep

Cleaning Principles

Cleaning goes from clean

to dirty

Cleaning Principles

Clean from top

to bottom

De-Cluttering

Assess your environment

Minimize supplies in room

Reduce clutter and remove unnecessary equipment in the room

How to Measure Cleanliness

Past practice has been to measure cleanliness by what we can see (e.g. dust, litter, dirt)….

…but it is important that the measurement of cleanliness be extended to what we can not see with the naked eye.

Approaches that Have Proven Successful

How do we know we have done a good job? By assessing the effectiveness of cleaning with an

environmental tracer (e.g. Glitterbug Lotion) that can highlight surfaces that were skipped or not completely done during the cleaning process.

Approaches that Have Proven Successful

Use improved cleaning protocols.Use checklists to document that all areas were cleaned as per schedule, especially high touch areas.Educate about cleaning High Touched Spots (HTS)Develop tools to measure if policies/procedures are being followed

Hand Hygiene Activity

Cleaning Protocols

Let’s Try Them Out

Let’s go back up to the patient/resident’s room….

Outbreak Graph

0

2

4

6

8

10

12

6-Fe

b

8-Fe

b

10-F

eb

12-F

eb

14-F

eb

16-F

eb

18-F

eb

20-F

eb

22-F

eb

24-F

eb

26-F

eb

28-F

eb1-

Mar

3-M

ar

Date of Onset

Nu

mb

er o

f S

ick

Peo

ple

Staff with Illness Residents with Illness

Infection Control Notified

Facility Closed

Outbreak Declared

Over 20 Days Later

Seven Deaths during outbreak

How Are We Doing Now

Baseline Environmental Cleaning at the 4 SCHR Facilities

0%

14%

5%

15%

25%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Facility 1 Facility 2 Facility 3 Facility 4 Average

Per

cen

t o

f H

TS

Cle

aned

21% = Goal for April 1, 2009 (Improve by 50%)

Nov/Dec 2008

Goal for July 2, 2009 (Improve to 95%)

How Are We Doing Now

Baseline Cleaning of High Touch Spots

40%

10%

20%

0%

10%

30%

10%

0%

20%

0%

14%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Bed R

ails

Bedsi

de Tab

les

Was

hroom

: Sin

k Tap

Was

hroom

: Towel

Dis

pense

r

Was

hroom

: Toile

t Sea

t

Light S

witches

Bed: F

ootboar

d

Bed: A

djust

men

t

Cloth

ing S

tora

ge Han

dle

Win

dow Sill

Overa

ll

Pe

rce

nt

Cle

an

ed

Goal for July 2, 2009 (Improve to 95%)

Nov/Dec 2008

Wrap Up

Tell us what you learned …

Please answer questions on your own and hand in your answers when you are finished

You can make a difference

Handwashing

Follow protocols

Right cleaning product

Gloves

Elbow grease

Team Work

As a health care team we must work together to make our health care facilities a safe place to stay.

It is everyone’s responsibility to learn the best way to prevent the spread of germs and follow those procedures.

Handwashing

Team Work Prevents Infections

Hand Hygiene

Effective RoutineCleaning

=

Daily Cleaning of

High Touch Areas

You are important.......

Each one of you is very important in preventing the spread of germs that may make someone very sick.

You must each do your very best to prevent the spread of germs.

Tell us what we can do to improve …

Please complete the evaluation form and hand it in before you leave.

Thanks for your feedback today.

HOW CAN WE PREVENT INFECTIONS? The Clean Environment

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