The findings come from an online survey completed in 2012 and the first half of 2013 by infection control professionals at 119 hospitals nationwide. The survey was designed to assess how well infection control programs collaborate with environmental services ” the people responsible for disinfecting patient rooms.
Questions focused on staff training, hospital cleanliness and infection rates for organisms such as C. difficile, which can cause lethal diarrhea, and methicillin-resistant Staphylococcus aureus , or MRSA, the drug-resistant superbug that can cause life-threatening pneumonia and blood or wound infections.
Nearly 40 per cent of respondents said their hospital should be cleaner. One-third said their cleaning staff isn’t adequately trained to do a proper cleaning and disinfection job and clean rooms to standard.
Based on the findings, the cleanliness of Canadian hospitals is “less than optimal,” Zoutman and co-authors write in the American Journal of Infection Control .
An estimated 220,000 Canadians a year treated in hospital end up with a hospital-acquired infection. Bacteria that are highly resistant to at least one type of antibiotic cause more than half.
“We have a huge burden of disease that we haven’t solved,” Zoutman said.
For example, C. difficile spores are shed through feces. People can get infected if they touch contaminated surfaces, including “high-touch” surfaces such as toilets, bed rails, bedside tables, call bells and door handles, and then their mouths. Hospital staff can spread the infection between patients if their hands are contaminated.
Hand-hygiene campaigns have led to more conscientious hand washing . “Hospitals now report hand-hygiene in the 80 to 90 per cent range,” Zoutman said. “We started at 30 per cent, which was pretty bad. It was downright embarrassing.”
But, “We haven’t realized the importance of the environment,” he said.
Three to five per cent of a hospital’s operating budget is spent on cleaning. “That’s hundreds of millions of dollars,” Zoutman said. “Clearly we’re not getting all the results we want.”
The survey asked infection control leaders to rate their input (from “never” to “always”) into cleaning and disinfecting procedures and products, as well as how much they share the latest scientific findings on infection control with cleaning staff.
Overall, two-thirds of respondents reported that their cleaners were adequately trained; 62.4 per cent said their hospital is sufficiently clean. But one-fifth said they don’t frequently collaborate on cleaning protocols.
Greater cooperation between the two hospital services was associated with lower rates of antibiotic-resistant organisms.
Improved collaborations involving not just cleaning services but all frontline staff at Vancouver Coastal Health have led to a 30 per cent reduction in C. difficile cases, said Sydney
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