Infection Prevention: The Role of Environmental Hygiene

Infection Prevention: The Role of Environmental Hygiene

The industry-wide focus on reducing healthcare-associated infections (HAIs) is causing hospitals to shine the spotlight on environmental hygiene procedures. Contaminated hospital surfaces can play a role in the spread of dangerous pathogens, including C. difficile and methicillin-resistant Staphylococcus aureas (MRSA). The goal of environmental hygiene is to reduce the number of infectious agents on surfaces to minimize the risk of transferring them to patients, especially those who are immune-compromised.

Unfortunately, research shows that most hospitals are using sub-optimal cleaning and disinfecting processes. A rather dramatic study was done by epidemiologist Philip Carling, who sprayed patient rooms in several hospitals with a fluorescent solution and then let housekeeping staff perform a terminal cleaning. Going back over the rooms with a black light allowed housekeepers to see exactly which surfaces they were cleaning ineffectively, and helped to boost compliance with environmental hygiene procedures.

Infection preventionists are now working more closely with the environmental services department (housekeeping) to implement evidence-based environmental hygiene procedures, with an emphasis on effective terminal cleaning of rooms that were occupied by a patient in isolation for a known pathogen. Environmental hygiene includes the cleaning of hospital surfaces; decontamination of medical equipment and devices; and safe handling of spills, waste, and linens.

Cleaning is a mechanical process. It physically removes foreign material (dust, soil, blood, etc.) from a surface or an object, through the use of water, detergents, and friction. The efficacy of the cleaning process depends completely on mechanical action, as soap and detergents do not have inherent antimicrobial properties. Thorough cleaning can remove the majority of pathogens from a surface, while careless cleaning can actually spread pathogens over a wider area. For this reason, the CDC is urging all hospitals to develop standardized cleaning methods, incorporating checklists, evaluation measures, and ongoing education of housekeeping staff.

Disinfection is a chemical process. Hospitals generally rely on germicidal chemicals (like bleach or paracetic acid) that are toxic to pathogens, but there are also disinfection processes that use heat or UV light. Even with these chemical tools, infection preventionists have distinct challenges, because certain organisms can survive for a long time on surfaces – like the spores of C. difficile.

Environmental hygiene is a cornerstone of infection prevention. Even so, it is just one part of a bigger picture. Infection preventionists today are working in an environment that is quickly becoming more proactive and less reactive. They are now expected to collect data, implement quality improvement projects, and evaluate outcomes. Public reporting is also becoming more common, with websites like Hospital Compare listing rates of HAIs for healthcare consumers to scrutinize.

The current, industry-wide focus on reducing HAIs is expanding career opportunities for nurses who want to specialize in infection prevention. Are you interested in keeping patients safe from pathogens in a hospital environment? If planning, implementing, and evaluating infection prevention and control measures appeals to you, consider making this in-demand field your career specialty. As a first step, you can develop new skills and empower yourself with knowledge through an online RN to MSN degree with a specialization in infection control from American Sentinel University, an innovative, accredited provider of online nursing degrees.