Welcome to the winter edition of The Lowdown. Infection prevention is a team sport, and everyone within a facility plays an important role. This edition focuses on support departments that are essential in breaking the chain of transmission to prevent the spread of infection. Happy reading!
The Importance of a Clean Environment
The environment can spread pathogens, like bacteria and viruses, which can survive on surfaces for days or months.1,2 This makes environmental services (EVS) a fundamental principle of infection prevention! Practicing good environmental hygiene will help make your facility safe for residents, healthcare workers, and families.
Incorporate cleaning and disinfection into the facility infection prevention plan, including properly training staff and emphasizing high-touch surfaces. High-touch surfaces increase the chance that microorganisms will spread. While surfaces may look clean, pathogens may be lurking. Use a checklist to document the completion of terminal and scheduled cleanings and monitor cleaning practices to ensure they are performed correctly and consistently. Always use an Environmental Protection Agency–registered disinfectant labeled for use in healthcare and follow the manufacturer’s instructions when using any cleaning or disinfecting product
If using disinfectant wipes, remember “keep it wet”! The area being disinfected needs to remain wet for the stated contact time. Keep the top of the dispenser closed to prevent the wipes from drying out. Use the right-size wipe for the size of the surface when cleaning. Small wipes are fine for bedside tables and use larger wipes for mattress covers. Proper use and storage of disinfectants is key!1,2
Environmental cleaning tools and resources are available from the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/hai/toolkits/appendices- evaluating-environ-cleaning.html.
Do You Know What a Fomite Is?
Are you unknowingly transmitting pathogens on equipment? Healthcare workers should be careful not to transmit pathogens on equipment. Studies have shown equipment to harbor serious pathogens, such as MRSA (methicillin-resistant Staphylococcusaureus),and Clostridioides difficile (C. diff.), making them a potential source for transmission. CDC guidelines state that reusable equipment, such as stethoscopes, must be disinfected between residents.2
It all starts with you! Make it a habit to disinfect equipment immediately after use and before storage. Follow the manufacturer’s instructions for use (IFU) to clean and disinfect equipment. Device manufacturers must provide written instructions to properly clean their products. Facility cleaning policies should follow the IFU.2,3
Laundry can also be a transmission source. Use Standard Precautions when handling contaminated linen and avoid shaking or agitating it. Bag or contain the contaminated linen where it is collected and hold it away from your clothing/ body during transport. Always transport and store clean linens safely to ensure cleanliness. Cover linen carts or store them in closed closets designated for clean linen only.2,4
Tools for the safe handling of linen are available from the Occupational Safety and Health Administration (OSHA) at www.osha.gov/etools/hospitals/laundry/ biological-hazards.
Pet Therapy and Infection Prevention
Animal-assisted intervention (AAI), or pet therapy, has been increasing in popularity. Pet therapy can improve the quality of life of residents of long-term care facilities. Studies have shown that pet therapy can reduce behavioral and psychological symptoms in people with dementia and be used as an alternative to medication.5
Even though Fido is cute and loveable, it’s important to remember that animals can serve as reservoirs for organisms, which can be introduced to the facility. They can also carry diseases and infections. These organisms can be transferred from pets to people or to the environment in the facility.
Resources
- Agency for Healthcare Research and Quality. Clean Equipment and Environment Promotes Safe Pa- tient Care. AHRQ. https://www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/educa- tion-bundles/infection-prevention/environment-and-equipment/environ-equip-slides.html. Published March 2017. Accessed November 8, 2023.
Centers for Disease Control and Prevention. Healthcare-Associated Infections: Prevention Toolkits Options for Evaluating Environmental Cleaning. CDC. https://www.cdc.gov/hai/toolkits/appendi- ces-evaluating-environ-cleaning.html. Updated May 2019. Accessed November 8, 2023.
- Greene-Golden S. The Importance of Following Manufacturers’ IFUs. Infection Control Today. https:// www.infectioncontroltoday.com/view/importance-following-manufacturers-ifus. Published August 1, 2019. Accessed November 8, 2023.
- Occupational Safety and Health Administration. Hospital eTools: Laundry – Biological Hazards. OSHA. https://www.osha.gov/etools/hospitals/laundry/biological-hazards. Accessed November 8, 2023.
- Karefjard A, Nordgren L. Effects of Dog-Assisted Intervention on Quality of Life in Nursing Home Residents With Dementia. Scand J Occup Ther. 2019;26(6):433-440. Epub April 25, 2018. doi: 10.1080/11038128.2018.1467486.
- Linder D, Siebens H, Mueller M, Gibbs D, Freeman L. Animal-Assisted Interventions: A National Survey of Health and Safety Policies in Hospitals, Eldercare Facilities, and Therapy Animal Organizations. Am J Infect Control. 2017;45(8):883-887. Epub June 30, 2017. doi: 10.1016/j.ajic.2017.04.287
- Centers for Disease Control and Prevention. (2003) Guidelines for Environmental Infection Control in Health-Care Facilities. Recommendations of CDC and the Healthcare Infection Control Practices Ad- visory Committee (HICPAC). CDC. https://www.cdc.gov/infectioncontrol/guidelines/environmental/ index.html#h. Updated July 2019. Accessed November 8, 2023.
