A Better Solution For Your Flooring!

Winter can be extremely rough on floors. Rain, snow, slush and ice melt are certainties in the winter months, especially in the Pacific NW. Not to mention countless staff, patients and visitors track these unwanted dangers onto finished floors every winter day. If a facility doesn’t have the proper floor care program in place, the floors are at a much higher risk for damages and loss of life span, causing more costly expenditures down the road.

The best preventative measures a facility can employ to keep its floors in good standing order throughout the winter months and all year round is a good floor finish, preferably an Ultra Durable Urethane Finish. This finish has a much longer life span then a standard acrylic floor finish. It is resistant to water, dirt and stains (such as oils and hospital chemicals) which reduces maintenance and simplifies cleaning. Ultra Durable Urethane Finish is 10 times the film thickness and much more abrasion resistance then acrylic finish, removing the need for burnishing, stripping or scrubbing. Most acrylic floor finishes need to be deep scrubbed or stripped and re-waxed about every 3-4 months depending on the traffic flow. An Ultra Durable Urethane floor finish can last up to 2-3 years before any reapplication is required. Saving a facility countless hours and money each year!

Proper application is crucial in assuring this floor finish will last its full potential. Like any construction or maintenance work, poor workmanship can make matters a hundred times worse. With the proper attention to detail and installation your facility floors can easily and effortlessly make it through the winter months and even years!

“…We have been using an Ultra Durable Urethane Finish since March of 2007 and it’s an incredible product…since then we have applied roughly 200,000 sqft of the product* and continuing with all hard surface flooring per request from the top administration. We have now made it a standard process with all construction, new floor installations and it is to be added to all previous waxed flooring…”

- Providence St Vincent’s Medical Center

Portland, OR

Positive Changes or Incompetence?

Infection Prevention has become a common term among healthcare these days. Due to the rise of Healthcare-associated Infections (HAIs), particularly antibiotic resistant pathogens; prevention has become the forefront in healthcare, causing increased regulation and economic changes. The big question is whether all the changes to help prevent further infections are really necessary or are they put in place to cover up incompetence?

In a recent article published in the American Journal of Infection Control, using direct covert observation or a fluorescent targeting method, only 40% of near patient surfaces are being properly cleaned in accordance with existing policies. Other studies have confirmed that patients admitted into rooms previously occupied by patients with an HAI have a significantly greater risk of acquiring the same pathogen than in a room where the previous patient did not have an HAI. (1)

Proper cleaning and disinfection are vitally important in killing antibiotic resistant pathogens, as well as hand hygiene and education. In the first attempt to achieve an HAI free environment (target zero) should be to look at the gaps in the current policies that are in place. If 40% of near patient surfaces are being cleaned what is going on with the 60% that aren’t and find out why. Could it be wrong chemicals, lack of knowledge or inadequate funding? Proper healthcare cleaning can’t be effectively done without the proper tools, training and budget. If one of these three key components are missing, your target zero environment cannot be achieved. It may seem like a no-brainer to clean a surface but to clean a surface properly and thoroughly in the effort to remove dangerous pathogens takes a lot more then common sense, a bottle of cleaning solution and a hand towel.

There are multiple steps to insure a surface is being cleaned and disinfected. It takes the proper cleaning equipment, such as microfiber vs. cotton and proper attire to prevent cross contamination. Not all cleaning solutions are made specifically for killing the correct pathogens or for application on certain surface. In order to properly kill pathogens with a disinfectant solution, the solution requires a correct kill time and a nonporous surface. If you are more aware of how an antibiotic resistant pathogen can survive, breed, and be killed, you are that much more aware of your surroundings and your involvement in cross contamination. Using the most effective solutions, training and educating a staff and allowing adequate time to properly and thoroughly disinfect an entire facility is going to take money. It cannot be done with a low end budget. Target zero results require full contribution to a proper budget.

People make mistakes; things get missed, overlooked or forgotten. The better we all are at being protective and taking initiative to be a target zero environments for healthcare the safer and healthier everyone in our communities will be.

Article written by: Chanel Schonert, MediClean

(1) Carling, P. C. & Bartley, J. B. (2010). Evaluating hygienic cleaning in healthcare settings: What you do not know can harm your patients. American Journal of Infection Control, 38 (5), s25-s33.

What's In Your Janitor Closet?

I was out on an estimate the other day and noticed a very scary sight…the janitor closet. However, this isn’t the first time I’ve come across an alarming janitor closet but, it did get me thinking I should write about it.

When you look in your janitor closet what do you see? The most common equipment is a mop, mop bucket, vacuum, and cleaning cloths. What does the equipment look like?

· Is the mop a conventional cotton loop mop?

· Is the mop bucket dirty and black on the inside?

· Is the vacuum a traditional upright that does not have a HEPA filtration system?

· Are the cleaning cloths cotton and look stained and dirty?

This type of equipment was the standard 10 years ago and for many commercial cleaning services it still is. For a healthcare environment it can be deadly. A conventional loop mop is made of cotton fibers; it is heavy and therefore can be very labor intensive. Conventional mopping techniques require janitors to change the mop solution after mopping every two or three rooms in order to help control cross contamination. That mop solution (including both chemicals and several gallons of water) is frequently being disposed of and replenished each cleaning day (a large waste). However, many janitors get lazy and tired of consistently changing the mop water and in turn don’t change out the water as frequently if at all. As a result this is the cause of the mop bucket being black on the inside. The cleanliness you were looking for from mopping is now being replaced with high levels of cross contamination and dirty mop water. The solution is microfiber.

Microfibers are made of polyester and polyamide (nylon) fibers that are approximately 1/16 the thickness of human hair. The density of the material enables it to hold six times its weight in water, making it more absorbent then a conventional loop mop. Microfibers are also positively charged and therefore attract more dust (which has a negative charge), and the fibers are able to penetrate a surfaces deeper than a conventional mop. In fact, a case study done by the University of California Davis Medical Center (UCDMC) found that after using a microfiber mop showed a 99% reduction in bacteria where only a 30% reduction was found with a conventional loop mop. Another benefit in using a microfiber mop is the savings you will see in both monetary and in labor. A microfiber mop holds more water therefore making its cleanable surface area larger. Microfiber is also guaranteed by the manufacture a minimum of 500 washings and they can be added to your laundry service. In an effort to eliminate cross contamination you can simply replace the “mop head” after cleaning each room (as long as you don’t put a dirty mop head back into the mop water) this will also eliminate the waste of gallons of water and floor disinfectant. This saves time, money! The same concept applies to using microfiber cloths for cleaning vs. cotton fiber cloths. All around microfiber is the best cleaning tool your facility should be utilizing.

A traditional vacuum for everyday cleaning is important. However, if it doesn’t have a true or absolute HEPA filtration system you are allowing cross contamination and poor indoor air quality. A true or absolute HEPA filtration system is effective enough to trap 99.97% of particles .3 micron or larger (such as bacteria, yeast, mold, dust, pollen, etc) and not allowing the particles to be re-circulated back in to the environment. True or absolute HEPA filters must pass a test to be considered HEPA worthy. True or absolute HEPA filters may be more expensive than other HEPA filters, but they must perform at a certain standard to receive the distinction of true or absolute. In a healthcare environment a vacuum with this high of filtration quality is extremely important.

Having the proper equipment for cleaning your facility is essential for our healthcare industry and in helping reduce the spread of HAIs. Check your janitor closet, if you notice any of the concerns I’ve mentioned talk with your cleaning service to see if they offer a higher standard in cleaning equipment. You will notice a difference in cleaning!

Written by: Chanel Schonert, MediClean

Common Culprits in Cross Contamination

Patient safety and reducing HAI's is the number one goal in healthcare for 2010.

One misconstrued problem in healthcare has been the use and protection of wearing gloves. Just as we're aware that hand-t0-surface transmission can account for a significant amount of cross contamination, so can gloves.

In a study by Boyce JM in 1997, found when healthcare works, doctors and nurses particularly, touched surfaces such as bed rails, blood pressure cuffs, computer keyboards, door knobs, bed tables, patient gowns and linens, their glove became contaminated 42 percent of the time.

In order to reduce HAI's (Healthcare Associated Infections) we need to stop the transmission of these bugs. Clostridium difficile (C. diff) is a known pathogen that has been implicated in the transmission when using gloves. According to Wave Truscott, PhD., the C. diff in our hospitals has two common hosts, an infected patient and contaminated surfaces, such as, bed rails, linen and patient gowns, computer keyboards, telephones, door knobs, and medical equipment. Cross contamination now has a passage way. If a healthcare worker, with gloves on, touches a patient who has C. diff and then proceeds to type on the keyboard to input notes, or the sink faucet, door knob, etc. before discarding his gloves, has now transferred the pathogen from host A to host B.

Host B now is a common surface where other hands with or without gloves continue to touch and transfer the pathogen throughout the facility. A facility where these pathogens can remain for weeks, months, even years depends on the host environment. The most effective way to stop the cross contamination of these bugs to is engage in thorough and proper surface cleaning constantly.

Healthcare facilities need to focus on the frequently touched ("high touched") surfaces in their practices. These areas should be cleaned daily and nightly, if they have a cleaning service. The CDC recommends a 5,000 ppm free chlorine solution for disinfecting, however, there are now EPA (Environmental Protection Agency) approved sporicidal disinfectants. These disinfectants should be handled with proper care regarding any dilution and dwelling times. If your facility has a cleaning service and you aren't sure whether a proper disinfecting solution is being used, here are some helpful questions you can ask.

1. Has it been tested against C. diff?

2. What are the kill claims?

3. Is it effective against blood borne pathogens?

4. Is pre-cleaning usually required or is it an all-in-one process?

5. Are there dilution controls?

6. Is it compatible with surfaces it must disinfect?

7. Is it a spray aerosols, which should not be used in surgery suites and can damage electronics.

8. How much wet contact time is required to kill spores?

9. Is it easy to use? Do they have handy wipes?

All these questions will help you identify the best disinfectant for your facility while continuing to help eliminate HAI's and cross contamination. However, consistent hand washing before and after using gloves as well as discarding gloves after each patient is a vital key.

Article written by: Chanel Schonert, MediClean

Reference:

Boyce JM Infect Control Hospital Epidemiol 1997; 18: 622-627

Virgo Publishing, Glove Hands, Surfaces are Common Culrits in Cross-Contamination, http://www.vpico.com/articlemnager/printerfriendly.aspx?article=289073

Are you Joint Commission Ready?

With less than a month left until 2010, MediClean wants to know if you are prepared for the New Year? With Health Care-Associated Infections (HAIs) being one of the leading causes of death and attributes to the financial burden of over $28 billion dollars a year in healthcare costs – safety protocols are undoubtedly on your mind.

Many of our healthcare organizations are highly regulated by OSHA, CDC, CMS, the State, and the Joint Commission. With this year’s recent H1N1 outbreak and the continued fight again HAIs and other Multi-drug resistant organisms (MDROs) it is only a matter of time before all healthcare organizations become just as regulated as our hospitals.

Depending on the organization, different interventions will be applied to fit their focus on reducing the spread of infections. However, there are a few guidelines and interventions that MediClean follows that are sure to help your organization be better prepared for the Joint Commission and insuring patient safety.

The first step is to set goals in your practice to minimize the possibility of transmission of infections. For example, one goal could be to limit unprotected exposure to pathogens throughout your practice and the transmission of infections associated with procedures and the use of equipment.

Once you have set these goals it is then time to implement them in your practice. A good intervention for limiting unprotected exposure to pathogens and the transmission of infections is to ensure that your laundry service and housekeeping are compliant with the same standards your organization is required to follow. Another intervention for this goal would be to improve your compliance in hand hygiene.

In order to stay in regulations with the Joint Commission you must comply with the current World Healthcare Organization (WHO) hand hygiene program or the CDC hand hygiene program. Many health care providers do not see the cause-and-effect relationship between properly washing your hands and preventing infection because of the delay between hand hygiene and emergence of an infection. According to the CDC the compliance rate in hand hygiene among staff in health care organizations ranges between 25%-50%. Therefore, another goal could be to improve compliance with your hand hygiene guidelines. Providing an intervention with your staff and patients that includes statistics, illustration connecting between hand hygiene and infection control may better your ratings.

The last step is to evaluate the effectiveness of your infection control processes. In order to see if the goals and implementations you set forth are really working you need to evaluate them. The Joint Commission will also want to see your results as will your administration. Evaluating your effectiveness can also help you in determining the best solutions for implementing your goals.

You should check the Joint Commissions web site (www.jointcommission.org) for further details regarding all regulations pertaining to your healthcare organization. 2010 is going to bring Infection Control to a much needed new light in healthcare. Insuring your patients and employee’s safety regardless of the cost should be on the forefront of all our minds. Regardless of the type of infection, all diseases highlight the importance of being prepared; it is just whether you would rather pay the price tag of reacting to the infections instead of preventing them all together.

Article written by: Chanel Schonert, MediClean