Infection Control Is High Priority for Healthcare Facility Managers

Maple grove medical cleaning

For facility managers in healthcare facilities, working with an organization’s infection control staff to do everything possible to prevent HAIs — healthcare-associated infections — is of high priority, especially in light of the recent Ebola scare. Among the areas of primary concern to FMs in managing this problem is air pressure and airflow.

The fancy term for HAI is “nosocomial” — it means an infection a patient or visitor acquires at a healthcare facility. What’s frightening is that they’re amazingly common. According to the Centers for Disease Control and Prevention, 1 in 20 patients has a HAI on any given day, and there are about 1.7 million cases — leading to 99,000 deaths — of HAI in U.S. healthcare facilities each year.

Three main areas of an FM’s core competencies are directly related to infection control effectiveness: air filtration and room pressure relationships, cleaning and housekeeping, and waste management and disposal.

Pressure and Airflow

“The most important thing about infection control is air flow,” says Bert Gumeringer, assistant vice president for facility operations at Texas Children’s Hospital in Houston. “Do you have the right exchange rates? Is the pressure negative when it needs to be negative and positive when it needs to be positive?”

Isolation rooms for patients with very infectious diseases — like tuberculosis and Ebola — must be negatively pressured to prevent air (and airborne pathogens) from escaping and infecting others. Conversely, says Gumeringer, patients who are immune-compromised must be placed in rooms with positive pressure to keep contaminants away. Operating rooms must also be positively pressured, because “you don’t want dirty air to be sucked into a room,” says Alan Neuner, vice president of facility operations for Geisinger Health System.

Properly pressurizing these isolation rooms is standard operating procedure for any healthcare facility, but where things get more complicated in regards to airflow is when changes are made to building operating systems or when performing any level of facility work — from replacing ceiling tiles to full-scale renovations.

Making a change to the temperature in a patient’s room as a response to a hot/cold call can also change airflow rates and pressures. “The engineering staff is well-intended,” says Gumeringer. “They’re trying to meet the needs of the customer.” So identifying a way to monitor pressure and airflow in patient rooms is important.

For rooms where directional pressure and airflow can’t be compromised, Neuner says his facilities include devices that monitor pressure and flow, and alarms if something is amiss. For less critical areas, quarterly checks are performed to ensure airflow and pressures are within tolerance. At Texas Children’s, the largest pediatric hospital in the United States, Gumeringer says his staff performs spot checks, but also has contracted with a company to do monthly checks on airflow. Gumeringer says the cost of this contract more than pays for itself, citing CDC statistics that a single HAI can cost $20,000 to $40,000 to treat. As well, he says, more than 50 percent of hospitals in Texas have been cited for not having proper airflow. “We believe in this testing very strongly,” he says. “The duty we all have is not only to look at cost, but also to look at the impact to the patient and the family.

By Greg Zimmerman– January 2015 –

Stop the Norovirus!  How to protect your facility.

Stop the Norovirus! How to protect your facility.

As you may have heard here in MN we have had two norovirus outbreaks in the twin cities this month.   The first was at a Caribou Coffee in Brooklyn Park.   The next was at the VA in Minneapolis.   So we are ramping up disinfection in our buildings.   Here are a couple tips for individuals, facilities, hospitals and our senior housing clients.

Norovirus Quick Tips

Norovirus is highly contagious and can infect anyone.

  • There are an estimated 23 million norovirus cases each year.
  • Norovirus accounts for 65% of ward closures and 18.2% of all infection outbreaks.*
  • A norovirus outbreak can cost a facility $65,000.
  • Norovirus is the most common cause of acute infectious gastroenteritis in the U.S.

Graphic: Protect yourself from norovirus. Wash your hands often. Cook shellfish to 140 degrees Fahrenheit or higher. When you are sick, don't prepare food or care for others. Rinse fruits and vegetables thoroughly. After comiting or having diarrhea, immediately clean and disinfect surfaces and wash soiled laundry.

Protect yourself from norovirus. Wash your hands often. Cook shellfish to 140 degrees Fahrenheit or higher. When you are sick, don’t prepare food or care for others. Rinse fruits and vegetables thoroughly. After vomiting or having diarrhea, immediately clean and disinfect surfaces and wash soiled laundry.

 

Prevention: Hand Hygiene & Surface Disinfection
A recent study found increased hand hygiene and surface disinfection protocols greatly reduced the financial burden norovirus has on a facility: Increasing surface disinfection following the detection of a single case of norovirus was found to offset costs by as much as: $40,040When five cases of norovirus were detected, cost reduction increased to as much as $99,363. Increasing hand hygiene after the detection of a single case of norovirus was found to offset costs by up to: $21,394  Implementing similar procedures following the detection of five norovirus cases reduced costs by upwards of $104,273.Both influenza and norovirus circulate in the community during winter months. Annual seasonal influenza epidemics have an enormous impact on the U.S. population and regional outbreaks of norovirus can also exact a significant toll. Both influenza and norovirus can present significant challenges to hospitals in terms of handling and treating the surge of infected patients and the potential for nosocomial outbreaks of disease. Facilities can incur increased costs during outbreaks including expenses related to isolation precautions,supplemental environmental cleaning, personal protective equipment and increased sick time and staffing shortfalls. These costs can be offset by preventive influenza vaccinations, advanced planning and having well thought-out institutional control programs that can be rapidly deployed when the need arises.

SURFACE DISINFECTION BEST PRACTICES

– Clean visibly soiled surfaces with a detergent prior to disinfection with bleach or another U.S. Environmental Protection Agency (EPA) registered
disinfectant that is approved to kill influenza and norovirus.
– Always adhere to the manufacturer’s instructions for dilution (if necessary), application and contact time.
– Apply an EPA-registered disinfectant to the surface and ensure the surface remains wet for the duration of the manufacturer-recommended contact time.

Additional Steps:

– Perform routine cleaning and disinfection of frequently touched environmental surfaces and equipment such as toilets, faucets, hand/bed rails, telephones, door handles, computer equipment and kitchen preparation surfaces.
– Increase the frequency of cleaning and disinfection during outbreaks.  During norovirus outbreaks, frequently touched surfaces should be cleaned and disinfected three times daily.
– Always clean and disinfect reusable equipment such as stethoscopes between each patient use.
– Use Standard Precautions for handling soiled patient-service items or linens, including the use of appropriate PPE (e.g., gloves and gowns) to minimize the likelihood of cross-contamination.  Handle soiled linens carefully to avoid dispersal of norovirus particles.
– Launder privacy curtains regularly according to your facility’s protocol (e.g., when visibly soiled, patient discharge/transfer). Also consider use of an appropriate EPA-registered product to kill microorganisms on soft surfaces between launderings.
– Monitor and review the above practices regularly to ensure staff compliance.

 

Preventing Influenza & Norovirus:
ENVIRONMENTAL CLEANING CHECKLIST

  • Thoroughly clean and disinfect these frequently-touched surfaces in patients’ rooms and bathroomswith bleach or another EPA-registered disinfectant with influenza and norovirus kill claims:
  • Door knobs/handles and surfaces
  • Bed rails
  • Mattress
  • Call button
  • Phone
  • Overbed table & drawer
  • Countertop
  • Light switches
  • Furniture (ensure product compatibility with surfaces)
  • Chair arms & seats
  • Window sills
  • Bedside commode
  • Medical equipment (e.g., IV controls)
  • Mirror
  • Sink and faucet
  • Tub/shower
  • Bathroom handrails
  • Toilet surface, seat & handle

Thanks for reading.  Please post any comments or questions:)

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