HOW CAN WE PREVENT INFECTIONS? The Clean Environment

1. HOW CAN WE PREVENT INFECTIONS?The Clean Environment .

2. Hospitals were dirty, smelly, over-crowded places, full of disease Hospitals were places where poor people went to die. Hospitals in the Past

3. Women and children died from infection because doctors went straight from doing autopsies to delivering their babies without washing their hands. Hospitals in the Past

4. Florence Nightingale devoted her life to improve health by improving the environment. Proved that clean environment, warmth, air quality, sunlight and quiet led to good health. Things started to Change

5. Doctors began to learn about how germs are spread. Doctors like Holmes and Pasteur realized that the simple thing like a doctor washing his hands led to less people getting sick and dying. Others Followed

6. Today we expect hospitals to be very clean places of healing. Hospitals Today

7. Specialized Team • Today we have created a specialized team devoted to making sure the environment is clean enough. • To promote healing • To prevent the spread of disease

8. YOUare the SpecializedTeam

9. Tell us what you know… • Handout copy for everyone • We will walk through questions together but please answer on your own • Hand in your copy of your answers when you finish

10. Tell us what you know…Question 1 • People who live in a long term care setting are not at a greater risk for infections. • TRUE • FALSE

11. Tell us what you know…Question 2 • MRSA bacteria can live on surfaces in a patient’s room or a resident’s room. • TRUE • FALSE

12. Tell us what you know…Question 3 • Cleaning a surface removes germs and kills them. • TRUE • FALSE

13. Tell us what you know…Question 4 • When cleaning a patient’s room or a resident’s room you must clean from the dirtiest area to the cleanest area in the room. • TRUE • FALSE

14. Tell us what you know…Question 5 • Environmental staff play as important a part in preventing the spread of infection as nurses and doctors do. • TRUE • FALSE

15. Tell us what you know…Question 6 • Disinfection on its own will prevent the spread of infection. • TRUE • FALSE

16. Tell us what you know…Question 7 • When cleaning a patient’s room or a resident’s room you must clean from the lowest area to the highest area. • TRUE • FALSE

17. Tell us what you know…Question 8 • Environmental cleaning is an important part of infection control in SCHR. • TRUE • FALSE ALL DONE PLEASE HAND IN YOUR ANSWERS

18. The Clean Environment GERMS • Found in places that look dirty and found in places that look clean • Can cause illness, especially in those who are already sick or weak (newborns, elderly, dialysis and cancer patients)

19. Cleaner than Your Own Home • The hospital and nursing home must be cleaner than your home. • Our patients and residents are vulnerable and need to be protected from MRSA and other germs that may come into the hospital or long term care facility.

20. Cleaner than Your Own Home • Remember germs are there even though we cannot see them

21. Host, Agent, Environment ENVIRONMENT HOST (Residents & Patients) AGENT (Bug/Germ, MRSA)

22. Transmission Portal of Exit Portal of Entry Reservoir (HCW, Environment, Patient) Host Susceptibility (older, immunocompromized) Infectious Agent (MRSA) Chain of Infection

24. Team Work • There are many different tools required to provide the best protection for our residents/patients and employees • Preventing infections: • Takes team work • Is like putting together the pieces of a puzzle

25. Preventing Infections Name some important things you do to prevent infections like MRSA….

26. ENVIRONMENTAL CLEANING Education & Training Cleaning Equipment Masks Handwashing Vaccination Gowns Gloves De-cluttering Infection Control Puzzle

27. High Touched Spots (HTS) Can you name some high touch spots in the patient or resident’s room?

28. Bed: Footboard Window Sill Bed Rails Bedside Tables Bed: Adjustment Clothing Storage Handle High Touched Spots (HTS)

29. Sink Tap Toilet Seat Towel Dispenser Light Switch High Touched Spots (HTS)

30. Cleaning HTS How do we know we have done a good job? Let’s try it out…..

31. Environmental Services are One of Our Most Important lines of Defense in Infection Control

32. Environmental Cleaning Vaccines Treatment Personal Protective Equipment Hand Hygiene Lines of Defense

33. How Do We Prevent Infections? • Educate about infection prevention and control • Update cleaning procedures • Focus on High Touched Spots

34. How Do We Prevent Infections • Standard Precautions are used with every patient or resident. -Hand washing/Hand antiseptics -Gloves -Gowns -Masks/Eye protection -Care of equipment

35. Tell Me About MRSA • Staphylococcus aureus is a bacteria/germ • Up to 30% of us carry it on our body • Can cause infections such as boils, impetigo and blood infections • Methicillin Resistant Staphylococcus aureus (MRSA) is same Staph. aureus bacteria/germ that has become resistant to some of the most common antibiotics we use to treat Staph infections.

36. Tell Me About MRSA • MRSA can survive in the environment (door knobs, bed rails, bathroom faucets, etc… high touch). • There is evidence MRSA could survive more than 38 weeks on sterile goods. (Infection Control and Hospital Epidemiology May 2003 SHEA Guideline for Preventing Nosocomial Transmission of Multidrug-Resistant Strains of Staphylococcus aureus and Enterococcus – see page 368)

37. Definition of Cleaning • Cleaning is defined as the physical removal of foreign material • For example - dust, soil such as blood, secretions, excretions and microorganisms • Cleaning physically removes microorganisms/germs. It does not kill germs. • Cleaning is accomplished with water, detergents and mechanical action.

38. Definition of Disinfection • Disinfection is stopping/killing germs that cause disease. • We use special products for disinfection.

39. Clean and Disinfect • We must clean first and then disinfect to prevent the spread of infection and stop germs in their tracks. • Disinfectants are not effective when used on items or areas that are soiled with organic material including microorganisms.

40. Operation Clean Sweep • Where do you start??

41. Director and Chief ofOperation Clean Sweep

42. Cleaning Principles • Cleaning goes from clean to dirty

43. Cleaning Principles • Clean from top • to bottom

44. De-Cluttering • Assess your environment • Minimize supplies in room • Reduce clutter and remove unnecessary equipment in the room

45. How to Measure Cleanliness • Past practice has been to measure cleanliness by what we can see (e.g. dust, litter, dirt)…. …but it is important that the measurement of cleanliness be extended to what we can not see with the naked eye.

46. Approaches that Have Proven Successful • How do we know we have done a good job? • By assessing the effectiveness of cleaning with an environmental tracer (e.g. Glitterbug Lotion) that can highlight surfaces that were skipped or not completely done during the cleaning process.

47. Approaches that Have Proven Successful • Use improved cleaning protocols. • Use checklists to document that all areas were cleaned as per schedule, especially high touch areas. • Educate about cleaning High Touched Spots (HTS) • Develop tools to measure if policies/procedures are being followed

48. Hand Hygiene Activity

49. Cleaning Protocols

50. Let’s Try Them Out Let’s go back up to the patient/resident’s room….