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Thursday, June 9, 2011

To Clean or Not To Clean...

What do ovens, fish tanks, toilets, litter boxes and even glass have in common? I’d like to say nothing, but truthfully they are just a few among the self-cleaning products that cater to our laziness and dirt aversions. I’ll even wager a bet that some of you have an automated pool vacuum – I do to, his name is James.

Why do we have this aversion to cleaning? Is it laziness? Is it because most families are now dual income with a couple of kids and are too busy running from work to hockey games, practices or tournaments? Is it because in this day and age we have access to self-cleaning products and can afford to hire a housekeeper we simply choose to have the attitude that “it’s someone else’s problem”? We are certainly quick to point out stores, restaurants and even hospitals that we think are dirty so are we really too busy to give it any thought?

While I can hazard a guess, I certainly do not have the answer. I do know that the commercial and residential cleaning services industry in North America generates over $53.6 BILLION US dollars annually and that in 2008 over $700 MILLION in the US alone was spent on cleaning chemicals for the healthcare market. As an Infection Control history buff, I know that Florence Nightingale during the Crimean War (1853 – 1856) identified the link between overcrowding, hygiene and poor patient outcome and by instituting a cleaning program and increasing the space between patients, saw a marked decrease in infection transmission. Health Canada and the CDC clearly expound the importance of environmental cleaning programs within the various Infection Prevention and Control Guidelines that have been published. Not to mention the numerous publications in scientific journals worldwide investigating the link between the environment and infection transmission – in fact just last week, APIC (Association for Professionals in Infection Control and Epidemiology) published a collection of Environmental Cleaning articles. The key take home message is that cleaning is important. Cleaning needs to be done right – the first time. Cleaning can save lives.

Clean means free of dirt and organic matter. The physical action of cleaning removes dirt that can be used by some pathogens for food, it removes dirt that can harbor pathogens and lead to transmission and if measuring the log reduction of pathogens from a surface after cleaning, cleaning can almost achieve disinfection – at the very least, cleaning renders the surfaces safe. We have to remember; cleaning does not mean spray and walk away. We continue to look for that illusive silver bullet, but to my knowledge there are no self-cleaning hospitals and I’m pretty certain Cinderella and her merry band of mice and birds is a fairytale. Cleaning takes time and it takes manpower. Cutting corners by cutting down on the amount of time our cleaning staff have to clean a room or cutting back on the number of cleaning staff we have to clean our facilities is setting people up to fail. We are setting ourselves up for hospital acquired infections (HAIs). The importance of cleaning staff and their direct impact on infection prevention and patient safety needs to be elevated. I realize that the environmental services department is a cost centre, but perhaps rather than looking at silos, we need to look at the hospital at the holistic level. What is the cost of a HAI? Could twenty more minutes or one more person help stop HAIs and save facilities money? I think the answer is yes.

Is there any question about the importance of cleaning and the association that cleaning staff have on patient safety and stopping hospital acquired infections? I don’t think so. Perhaps we need to take the concept of Earth Day where people think nothing of cleaning up litter from road sides to healthcare. Wouldn’t you love to see a day where everyone from the CEO down rolled up their sleeves and helped keep your hospital clean? I know I would!

Bugging Off!Nicole

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