Do you ever feel like you’re bashing your head against a wall or like a salmon swimming upstream? Having been in the infection control arena, focusing on cleaning and disinfection, I often wonder why we have to repeat the same things over and over. Why do we keep having to prove the things we know to be true and know that work over and over and over again?
A recent article published in ICHE titled “ I don’t mean to sound callous or disrespectful of the researchers, but this is not rocket science.” concluded that the program the researchers introduced was able to address environmental service worker’s knowledge gaps, challenges and barriers resulting in behaviour change and sustained improvements in cleaning.
In June 2011, in my “ Looking back through history, 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. ”, I referenced a collection of articles published by APIC, where the take home message was cleaning is important. Cleaning needs to be done right the first time, and that cleaning saves lives.
In June 2012, a guest blogger, Rick Wray’s blog “ He further discussed a program they had at their facility where assorted hospital staff were partnered with a member of our cleaning staff to learn from and to work with them to clean patient rooms. One senior leader became aware of the pride and diligence of the staff member with whom he was partnered. She was reluctant to let him do the cleaning; not because it was a job beneath his usual position but because he wouldn't do it well enough and she would have to clean up behind him.” talked to the fact that achieving optimal cleaning requires an understanding of the complex interplay of chemistry, human factors and behavioural science involved in cleaning processes.
In December 2014, in my blog “” when it comes to cleaning and disinfection there are just as many people who believe they cannot affect change so they do nothing, and just as many people again that plainly think cleaning and disinfection is someone else's responsibility. However, based on another by Donskey to determine if we had sufficient evidence to prove that improved cleaning and disinfection could reduce HAIs, the conclusion was that, "Although the quality of much of the evidence remains suboptimal, a number of high-quality investigations now support environmental disinfection as a control strategy. Based on these data, current guidelines for pathogens such as C. difficile, MRSA, VRE, and norovirus emphasize the importance of environmental disinfection as a control measure."
These are but a few examples of the work the infection prevention community has completed to link the importance of cleaning and disinfection to the reduction in HAIs. The work has investigated best practices to ensure the cleaning processes used will meet the needs of our healthcare facilities and there are several studies that highlight the importance of providing training to our EVS staff and elevate them to a higher level to support the fact that they are a crucial part of our infection prevention program.
In reviewing this study, we have proven yet again that cleaning when completed effectively by skilled and trained staff, can directly impact the lives of patients. If we know it, and if we have proven it time and time again, why can’t we get the C-suite or the wallet holders to understand the importance of cleaning and disinfection and the importance of having a skilled environmental services team? How do we get them to understand that this investment will save money and more importantly save lives?