As we concluded in the “Top 10” blog, the number one abuse or misuse of disinfectants in 2011was lack of training. We CANNOT expect our staff to know how to correctly use the products and tools to do their jobs unless we TEACH them how to use them. Certainly in some aspects of our life, such as learning to walk or talk or in my case learning to swim (my mother quite literally “threw” me in the pool as was the rage for teaching babies when I was 4 months old), the concept of THE SINK OR SWIM SQUAD can be an effective learning process. For driving, practicing medicine, ensuring public safety through public health and I dare say for using cleaning and disinfecting chemicals a formal, comprehensive and reproducible education system needs to be in place. Isn’t that the concept behind Young Drivers of Canada or the myriad of Medical or Public Health Schools around the world? Why then is there not a Healthcare Environmental Services School?
If we teach everyone the where’s, what’s, why’s and how’s to using disinfectants and cleaning chemicals we won’t have any stories of how we have seen them used and abused. The goal of any Environmental Services Department within a healthcare facility should be to prevent the spread of infectious agents among patients and healthcare workers by meticulous cleaning and disinfection of environmental surfaces and patient care equipment. To reach this goal the EVS department will need to have a comprehensive training program, the objective of which should be to provide EVS staff with the information they need to do their jobs safely. The training program should be a part of the big picture - “how to protect yourself”. At a minimum the training program should include a formal written plan for each of the following topics:
1. Identification of Occupational Risks and Hazards associated with handling infectious waste
2. Sharps Safety
3. Blood Borne Pathogens
4. Infection Control Training (Microbiology and Transmission)
5. Hand Hygiene
6. Personal Protective Equipment (PPE) including donning & doffing
7. MSDS and Hazards associated with using chemicals (cleaning agents, disinfectants etc)
8. Product Usage Training including proper cleaning and disinfection techniques
It’s likely that now you, the person responsible for developing the program, is overwhelmed at the thought of the amount of work that needs to be done! Don’t panic. A quick Google search of “Sharps Safety Training for North America” found 76,600,000 hits. Rest assured there is a plethora of information out there so you do not need to reinvent the wheel. Remember to delegate! Talk to your Infection Preventionist and ask for their help in writing the Infection Control and Hand Hygiene segments (there’s section 4 & 5 completed). Talk to Purchasing to find out what company you are purchasing needles or other sharps from and find out who the sales rep is. I can guarantee that a company who sells sharps will have a training program developed (that’s section 2 out of the way). Now call up your chemical sales rep, any reputable company who sells product for cleaning and disinfection should have training material for handling, cleaning and disinfection of blood borne pathogens and who better than to come in and do the product usage training (section 3 and 8 are now complete!). Use your Occupational Health and Safety rep to help create the Occupational Risks and Hazards, MSDS and Personal Protective Equipment training (that takes care of section 1, 6, and 7). With a few telephone calls and a little collaboration the program is done.
My ultimate dream would be to see the development of an Environmental Services Certification Course that becomes the industry standard and prerequisite for anyone who is hired to clean in healthcare facilities. While I do not expect this to happen this year, I certainly hope your top priority for 2012 is to educate your staff on how to correctly use cleaning and disinfectant products.