Issue link: https://beckershealthcare.uberflip.com/i/517590
32 Executive Briefing: Infection Prevention Improvement Sealed Air Diversey Care is world leader in cleaning and hygiene solutions offering expertise in infection prevention with the integration of cleaning and disinfectant solutions, dosing and dispensing technologies, and training and consulting services. Diversey solutions include products, procedures, training and support, as well as cleaning compliance validation systems in total facility care and infection prevention. Our leading disinfectant lines have proven results in satisfaction and reduction of transmission, as we work with custom- ers to assess their facilities, practices, infection prevention needs, and develop best practices for consistent results, and helping them implement positive change. Diversey can help you achieve your goals. Disinfectants may not stay wet long enough. A disinfectant requires a specific contact time with a pathogen to kill it. This contact time is listed on the label of EPA- or Health Canada-registered disinfectants. Optimally, the disinfectant will stay wet and in contact with the pathogen for at least as long, or longer, than the required contact time. Unfortunately, many disinfectants dry before the contact time is achieved, espe- cially those with long contact times or high levels of alcohol. Are you confident that the required contact time is being achieved? Disinfectant and tool compatibility. Qua- ternary ammonium compound-based disin- fectants can bind with cotton and some mi- crofiber cleaning tools, which prevents the release of the disinfectant active on to the surface, inhibiting the disinfection process. This issue, called quat binding, is caused when quats, which have a positive charge, bind with cleaning tools that have a negative charge. Other studies have demonstrated that some cleaning cloths may be so absor- bent that it prevents the release of enough disinfectant on to the surface to do the job. Have you checked to make sure that your disinfectant and tools are compatible? Safety. A Matlow study demonstrated that staff may be less likely to use a dis- infectant that they feel is hazardous or un- pleasant for patients or themselves. Some disinfectants are irritating to eyes, skin or respiratory tracts, may require the use of personal protective equipment or be irritat- ing to patients, while others may have an offensive odor. Your staff may be reacting by minimizing use, or they may be using these products without the proper PPE, which can increase risk of injury or lost time. Patient and staff satisfaction are so important, is your facility providing a dis- infectant that is tough on pathogens, but gentle on staff and patients? Assets. Billions of dollars are invested in healthcare furnishings and equipment, and having disinfectants that can be used safely on these assets is important. Some disinfec- tants can harm surfaces or shorten the use- ful life of furnishings, equipment, clothing and other assets. Understanding compatibility with multiple assets can help address useful life, and unnecessary cost to the facility. Ease of use. If the goal is to get staff to clean and disinfect bed rails or patient care equipment between uses, yet if the prod- uct isn't in the right place at the right time, the odds of the cleaning and disinfection process happening decrease significantly. "It is highly unlikely that a staff member will leave the room and come back later to clean and disinfect," says Ms. Cooke. "If you want to improve cleaning and disinfect- ing compliance of environmental surfaces and shared patient care equipment, make sure that the product is available when and where they need it — at the point of care." As discussed, there are several barriers to proper cleaning and disinfection. Just be- cause you are using a disinfectant, doesn't necessarily mean that you are disinfect- ing. Unfortunately, it isn't enough to just provide a disinfectant, compliant cleaning and disinfection requires a programmatic approach. If your staff isn't motivated to use the product or the product or tools are ineffective, your success may limited. Addressing Cleaning and Disinfection Challenges In marketplace research, we identified the elements of a successful cleaning and dis- infection program. Clearly defined roles and responsibili- ties. There is no shortage of things to do. If you want cleaning and disinfection to hap- pen, it is critical that staff is clear on their roles and responsibilities. These need to encompass who is to clean what, when, with what and how often. Anything less won't get the job done. According to Ms. Cooke, there are a variety of tools that can be used to train and reinforce knowledge, including wall charts and cleaning cards that outline specifically who does what, when. Right product. The products selected need to meet the facility's needs, which includes addressing the pathogens of concern while ensuring it is safe for most of the facility's as- sets. As discussed, it is also important that the product selected helps facilitate compli- ance by staying wet long enough to do the job. The goal is to identify a disinfectant that can meet the needs in the majority of situa- tions; however, facilities may need to select more than one product to meet their needs, just as you do at home. You don't use bowl cleaner on the leather couch, and as such, it may be necessary to select certain task-ori- ented disinfectants for specific pathogens, such as Clostridium difficile. Safe and pleasant for staff and patients. Staff is more likely use products that are non- irritating to eyes, skin and respiratory tracts, which have no offensive odor. These products are also likely to reduce worker injuries and compensation issues, ensuring a more satis- fied and productive staff. There are now sev- eral disinfectants on the market that are not only effective, but significantly less hazardous to staff, and more pleasing for patients. Accessibility. Keeping cleaning products at the point of care in a place that is easily seen and accessed will increased the likelihood of the products actually being used, improv- ing cleaning and disinfecting compliance on touch surfaces or shared equipment. Validation. "The crowning element of any program is validating that the process is happening correctly," according to Salah Qutaishat, PhD, an epidemiologist at Sealed Air Diversey Care. Since patho- gens are invisible, it is often difficult to confirm proof of process. Implementing a program to monitor and measure clean- ing and disinfection effectiveness can help you ensure compliance with the process. There has never been a more compelling business case to improve cleaning and disinfection. From emerging pathogens to antibiotic resistant organisms, the risks are great, and cleaning and disinfection is one of the keys to cost-effectively reducing the risk. In some cases, it is one of the last defenses. Isn't it time to overcome the bar- riers to an effective program? Many infections are preventable and im- proved cleaning and disinfection has been demonstrated to reduce the risk. We all want to improve the quality of care, and by using a few simple steps, you can im- prove the effectiveness of your program to create a safer and more satisfying en- vironment of care, and create benefits for patients, families, staff and the facility. Hopefully the road map we have shared will help you continue to improve your program. n