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Maintenance of Environmental Services Cleaning and Disinfection in the ICU After a Performance Improvement Project
Poster Abstracts / American Journal of Infection Control 40 (2012) e31-e176
e159
Type of Hand Hygiene Professional category
Soap and water N
Nurse Medical Doctor Visitors Others Total
1.391 345 17 271 2.024
Alcohol
% 55,6 62,5 19,3 50,8 55,8
N 654 61 44 90 849
% 26,1 11,1 50,0 16,9 23,1
Soap and water + Alcohol N 459 146 27 172 804
% 18,3 26,4 30,7 32,3 21,9
Total N 2.504 552 88 533 3.677
% 100,0 100,0 100,0 100,0 100,0
50,2%. 1) Compliance according to the type of opportunity and professional category - *Others mean other Professional Category that non nurses and medical doctors, like physiotherapist, laboratory technician, speech therapist, etc. 2) Type of product used (if alcohol based hand rub product or soap and water or both) for HH in each type of opportunity 3) Professional category x product used. Conclusions: Results evaluation helped the infection control team to focus on training according to the needs related to the type of opportunity and professional category. Results also indicated that healthcare workers use to use soap and water followed by Alcohol Based Hand Rub (ABHR) product and so team should improve compliance to ABHR products as recommended by CDC (since 2002) and by WHO (2006 and 2009).
Presentation Number 15-216 Maintenance of Environmental Services Cleaning and Disinfection in the ICU After a Performance Improvement Project Teresa Fitzgerald BSN, RN, CIC, Infection Preventionist, The Nebraska Medical Center; Ms. Lee A. Sholtz MSN, RN, CIC, Infection Preventionist, The Nebraska Medical Center; Ms. Nedra Marion MPA, RN, CIC, Manager, Infection Control and Epidemilogy, The Nebraska Medical Center; Mr. Paul Turner CHESP, Director, Environmental Services, Sodexo and The Nebraska Medical Center; Dr. Philip C. Carling MD, Director of Hospital Epidemiology, Caritas Carney Hospital; Dr. Mark E. Rupp MD, Medical Director of Infection Control and Epidemiology, The Nebraska Medical Center Issue: Performance Improvement projects (PIP) directed toward improving the performance of Environmental Service (EVS) Staff can be successful. Sustainability of performance improvement is best ensured with permanent systematic changes and ongoing monitoring and feedback. If performance levels decrease, actions should be taken to assess the cause of the decline and to redirect efforts to restore performance levels. Project: In a collaborative effort, Infection Control and Epidemiology (ICE) worked with EVS staff on a PIP to achieve optimal cleaning and disinfection of ICU rooms. EVS staff were provided with instruction on cleaning high-touch surfaces using a training video and cleaning checklist. ICE staff marked 15 high-touch items in approximately 45 ICU rooms each month with an ultraviolet-
tagged marking solution (DAZOÒ, Ecolab, St. Paul, MN), and evaluated results (using ultra violet light) after terminal room cleaning. Results were shared with EVS staff in face-to-face meetings on a monthly basis for 6 months. Cleaning performance increased from baseline of 52% to a sustained level of 80-85%. A maintenance program was then instituted which included surveillance of 30 ICU rooms/quarter and feedback on a quarterly basis to EVS administration. Results: After three quarterly maintenance reports to EVS administration, cleaning performance had declined to 57-66%. In an effort to restore cleaning performance, ICE began reporting data including the room number, the date the room was marked, the date the room was read, and the cleaning results for the 15 marked items to EVS supervisors on a monthly basis. This allowed follow up with individual EVS staff on their cleaning performance. Also, the number of rooms marked and read per quarter was increased to 45. The next two quarters showed an increase in performance to 74% and 71% respectively. With results being less than anticipated, and below optimum, a return to face-to-face reporting was instituted. Lesson Learned: PIP can be effective in achieving desired results, but maintenance requires ongoing vigilance. Although quarterly feedback to EVS administration was initially thought to be adequate maintenance, we found this method to be inadequate in maintaining cleaning performance. With the reporting of data to staff supervisors, cleaning performance was not restored to previously observed levels. Face-to-face monthly reporting with EVS front-line employees has been reinstituted with hopes this collaborative approach will increase cleaning performance to optimum levels.
Presentation Number 15-217 State Public Health Department Performs External Observations of Hand Hygiene Compliance in All Maine Acute Care Hospitals, 2011 Donna Dunton RN, BSN, CIC, Director of Infection Prevention and Control, Eastern Maine Medical Center; Ms. Stefanie DeVita BSN, RN, MPH, CDC/CSTE Applied Epidemiology Fellow, Maine Center for Disease Control and Prevention
APIC 39th Annual Educational Conference & International Meeting j San Antonio, TX j June 4-6, 2012
e159
Type of Hand Hygiene Professional category
Soap and water N
Nurse Medical Doctor Visitors Others Total
1.391 345 17 271 2.024
Alcohol
% 55,6 62,5 19,3 50,8 55,8
N 654 61 44 90 849
% 26,1 11,1 50,0 16,9 23,1
Soap and water + Alcohol N 459 146 27 172 804
% 18,3 26,4 30,7 32,3 21,9
Total N 2.504 552 88 533 3.677
% 100,0 100,0 100,0 100,0 100,0
50,2%. 1) Compliance according to the type of opportunity and professional category - *Others mean other Professional Category that non nurses and medical doctors, like physiotherapist, laboratory technician, speech therapist, etc. 2) Type of product used (if alcohol based hand rub product or soap and water or both) for HH in each type of opportunity 3) Professional category x product used. Conclusions: Results evaluation helped the infection control team to focus on training according to the needs related to the type of opportunity and professional category. Results also indicated that healthcare workers use to use soap and water followed by Alcohol Based Hand Rub (ABHR) product and so team should improve compliance to ABHR products as recommended by CDC (since 2002) and by WHO (2006 and 2009).
Presentation Number 15-216 Maintenance of Environmental Services Cleaning and Disinfection in the ICU After a Performance Improvement Project Teresa Fitzgerald BSN, RN, CIC, Infection Preventionist, The Nebraska Medical Center; Ms. Lee A. Sholtz MSN, RN, CIC, Infection Preventionist, The Nebraska Medical Center; Ms. Nedra Marion MPA, RN, CIC, Manager, Infection Control and Epidemilogy, The Nebraska Medical Center; Mr. Paul Turner CHESP, Director, Environmental Services, Sodexo and The Nebraska Medical Center; Dr. Philip C. Carling MD, Director of Hospital Epidemiology, Caritas Carney Hospital; Dr. Mark E. Rupp MD, Medical Director of Infection Control and Epidemiology, The Nebraska Medical Center Issue: Performance Improvement projects (PIP) directed toward improving the performance of Environmental Service (EVS) Staff can be successful. Sustainability of performance improvement is best ensured with permanent systematic changes and ongoing monitoring and feedback. If performance levels decrease, actions should be taken to assess the cause of the decline and to redirect efforts to restore performance levels. Project: In a collaborative effort, Infection Control and Epidemiology (ICE) worked with EVS staff on a PIP to achieve optimal cleaning and disinfection of ICU rooms. EVS staff were provided with instruction on cleaning high-touch surfaces using a training video and cleaning checklist. ICE staff marked 15 high-touch items in approximately 45 ICU rooms each month with an ultraviolet-
tagged marking solution (DAZOÒ, Ecolab, St. Paul, MN), and evaluated results (using ultra violet light) after terminal room cleaning. Results were shared with EVS staff in face-to-face meetings on a monthly basis for 6 months. Cleaning performance increased from baseline of 52% to a sustained level of 80-85%. A maintenance program was then instituted which included surveillance of 30 ICU rooms/quarter and feedback on a quarterly basis to EVS administration. Results: After three quarterly maintenance reports to EVS administration, cleaning performance had declined to 57-66%. In an effort to restore cleaning performance, ICE began reporting data including the room number, the date the room was marked, the date the room was read, and the cleaning results for the 15 marked items to EVS supervisors on a monthly basis. This allowed follow up with individual EVS staff on their cleaning performance. Also, the number of rooms marked and read per quarter was increased to 45. The next two quarters showed an increase in performance to 74% and 71% respectively. With results being less than anticipated, and below optimum, a return to face-to-face reporting was instituted. Lesson Learned: PIP can be effective in achieving desired results, but maintenance requires ongoing vigilance. Although quarterly feedback to EVS administration was initially thought to be adequate maintenance, we found this method to be inadequate in maintaining cleaning performance. With the reporting of data to staff supervisors, cleaning performance was not restored to previously observed levels. Face-to-face monthly reporting with EVS front-line employees has been reinstituted with hopes this collaborative approach will increase cleaning performance to optimum levels.
Presentation Number 15-217 State Public Health Department Performs External Observations of Hand Hygiene Compliance in All Maine Acute Care Hospitals, 2011 Donna Dunton RN, BSN, CIC, Director of Infection Prevention and Control, Eastern Maine Medical Center; Ms. Stefanie DeVita BSN, RN, MPH, CDC/CSTE Applied Epidemiology Fellow, Maine Center for Disease Control and Prevention
APIC 39th Annual Educational Conference & International Meeting j San Antonio, TX j June 4-6, 2012