Another study conducted in 2006 found that one out of every two high-touch surfaces within hospital rooms are not cleaned at time of discharge. “This persistent frequent contamination of the environment is a real problem,” said Dr. Calfee.
Contamination of the environment can lead to the contamination of healthcare workers (HCWs), which could lead to the transmission of pathogens to other patients and more areas within the environment. One study Dr. Calfee highlighted detailed how they had a HCW perform hand hygiene and then go into a patient room and put their hands on a bedrail and the bedside table for five seconds each. After these acts, hand cultures were then performed on the HCW. The findings were startling. After just five seconds of contact, the hand cultures tested positive for several pathogens (such as Staphylococcus aureus
, vancomycin-resistant Enterococci (VRE), gram-negative bacilli, and C. difficile
) in 53% of the occupied rooms and, even more unsettling, 24% of the rooms that were not occupied, or the “clean rooms.”
The process of achieving and maintaining a safe, clean environment is incredibly “complex,” said Dr. Calfee, “[And,] perhaps even more importantly, this relies on individual human behavior and effective communication.” Success in this goal depends on the cooperation of several groups, not just environmental service workers; doctors, nurses, and techs also need to clean equipment from time to time. In addition, these complex cleaning tasks need to be carried out frequently, sometimes even daily.
Similar to what plenary speaker Matthew Kreuter, PhD, MPH, discussed in his presentation
, Dr. Calfee also touched on behavior change techniques and the importance of understanding the drivers of human behavior in order to drive the change that is needed to improve cleaning and disinfection strategies.
After asking conference attendees to start thinking about how their own institutions or facilities go about improving quality in Environmental Services, Dr. Calfee shared the approach that he and his colleagues came up with to improve cleaning and disinfection practices to reduce HAI transmission. This approach is being used in five acute campuses of the New York Presbyterian Hospital which range in size from community hospitals to academic medical centers.