Hospitals and assisted living facilities are more immersed in fighting infection than any other industries for two important reasons. First, their responsibility and their oath is to help their patients and residents. They are a caring industry.
Second, they have bottom lines like other businesses, and hospital-acquired infections are very expensive. More recent changes to medicare and medicaid payment regulations make HAIs more likely to be the hospital’s responsibility. If there is a lawsuit, the hospital or care facility is usually the main liable entity with the deepest pockets. If there are inspection issues, the expense is that of the hospital or care facility. If there are image issues, the potential loss is that of the facility.
So medical care facilities of all kinds have responded to increasing superbugs with broader ranges of approaches including, but not limited to:
- Behavior modification
- New technologies for infection control
- Increasing size of cleaning staffs
- Concentrating on “fomites,” those objects germs are transferred to and from
- Better training
A common color-coding scheme used in the cleaning industry.When it comes to better training, microfiber methods have a lot to offer. Not only do the microscopic “hooks” the polyamide and polyester fibers create clean better, but color-coding makes a visual impact on what is to be used where. That coding makes it possible at a glance to see if the right mop head or cloth is being used for the zone being cleaned.
Why Does it Matter?
Cross-contamination is the process of infectious agents, known as pathogens, moving from a “host,” the ill person, to a surface and then being picked up by a new host who becomes infected. Here is an illustration of what might happen with C. diff (Clostridium difficile), a super-potent gastro-intestinal bug.
How it Could Happen
Examination of an infected patient could result in transfer of contamination to the draperies pulled around the bed in the room. Following a routine check of vitals, the nurse simply closes the draperies with a contaminated gloved hand. Although he does remove the gloves and washes carefully and successfully before the next patient, the C. diff germs remain on the draperies and survive for a number of hours. When that room is used for another patient – let’s say this is an ER setting – a doctor checking in with a new patient who came in with a severe flu, slides the draperies open and contacts the earlier infection transferring some to her hands. During contact with the patient, some of the C. diff is transferred to the patient. Either directly or perhaps moved by the patient’s own hands, the infection enters a “portal,” such as the mouth, nose or eyes, in sufficient quantities to cause a secondary infection.
Because patients and residents are often weakened by their original infection, secondary infections are more easily transmitted.
In an Infection Control Today article, it was noted
“In a systematic review of the literature, German researchers explored the ability of infectious organisms to survive on inanimate surfaces. They found that most gram-positive bacteria, including vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and Streptococcus pyogenes can survive for months on dry surfaces.”
Severing the Cycle
This is one reason why in many care facilities, draperies are now laundered as part of the IC protocol following any patient being in the room who has C. diff. That superbug is so virulent, or infectious, it can survive on surfaces easily to infect another patient. Laundering the privacy drapes breaks the cycle.
Microfiber Also Helps Cut Cross-Contamination
By keeping certain colors in certain cleaning “zones,” microfiber mops and cloths and equipment can also break cross-contamination cycles, just like removing the draperies. Supervisory staff can see instantly if cross-contamination is taking place at a glance. Mops for use on patient-room floors (blue), for example, are never used in foodservice areas, which use green color-coded mops and handles. In restrooms, red mops are used on toilets, whereas sinks and areas that come directly in contact with users are cleaned with yellow color-coded microfiber.
Note that color-coding can vary between organizations and industries.
For an EPA case study of the cost-effectiveness and cleaning-effectiveness in medical care settings, click here.