Infection Control Today - 03/2004: Fostering Communication

Fostering Communication Between the Guardians of the Hospital Environment

By Weston Thiss, CHESP, and Carolyn Bratcher, RN

Im the director of environmental services (ES), and I wantto talk about her. You know the one ... she quotes JCAHO standards and CDCguidelines, knows the health commissioner by first name, and even thinks thathandwashing will stop nuclear proliferation. She seems to believe that cubicalcurtains spread the plague. In fact, YOU are probably that one, and have I gotsomething to say to you: Thanks!

Im the infection control professional (ICP) and once againIm paging the director of environmental services. What product is being usedto clean in pediatrics? I saw linen being transported today and it wasuncovered. Are you certain the mop water is being changed at least every threerooms? I witnessed your staff member using perfect technique when entering anisolation room; let me come speak to the group at your next staff meeting.

Keeping a hospital clean, safe andsanitary is the job of all healthcare professionals. However it is the ICP andthe ES director who ultimately have ownership. Yet, why in so many situations dothose two professionals clash? How can effective infection control policies beenforced with reduced FTEs, demands for quicker bed turns, squeezing in one lastcase in the OR, and of course reduced supply expenses? Its easier than itsounds, through efficient communication, teamwork and most importantly a littlecommon sense.

ES professionals report to thousands of experts daily,including every visitor, physician and those mothers whose bathrooms areshrines. Dont forget the CEO who equates a shiny floor to a cleanhospital, or the nurse who cant figure out how all those paper punches gotonto the floor. Everybody knows what clean is, but do they know what is neededin a high-risk environment to reduce the opportunity of nosocomial infection?This team has to accomplish both, keeping the facility visibly clean andmicroscopically healthy.

Are you regularly attending ES staff meetings? Do ES personnelknow your name, and more importantly, do you know theirs? The basis of a strongalliance lies here, facilitating understanding to the front-line employees;helping them understand just what it is they are really doing not justgetting a bed ready or wiping a doorknob, but breaking the chain of infectionand stopping those bugs before they make somebody else sick. Thefront-line ES staff members are the guardians of the environment.

Have you ever been asked to do something and couldnt figureout why? To these guardians, some of our directions seem dumb; they may ask, what is the reason for doing it that way?Such as changing the mop water when it doesnt appear dirty? Or changing outcubical curtains in certain rooms when the patient couldnt even get out ofbed? Or removing my gloves when leaving the patients room? ES personnel canbe the eyes and ears of the ICP, and they cherish the responsibility once theyknow, understand and value the importance of their guardianship. The role of theICP is to embrace this staff, understand their value by creating an ES/ICPpartnership. Know them as they know you, attend their staff meetings and explainsimply, there are good bugs and bad bugs; I need your help keeping thebad bugs from our patients. The way to help is use the tools and guidelines weprovide to stop them where they are, not carry them down the hall. There neverare dumb questions, if you dont understand why, please ask; we are here tohelp you to help our patients.

At Bon Secours St. Marys Hospital in Richmond, Va.,environmental services and infection control are definitely friends, not foes.The ES staff eagerly rush to report breaks in the practice of infection control.They realize how important they are in breaking the chain of infection.

The rapport was established years ago and is maintainedthrough continuing education, personal contact and infectioncontrol/environmental rounds. Front-line staff are invited to participate inrounds and encouraged to point out what they see as potential infectioushazards. This role as messenger is rewarded through commendation letters,recognition at staff meetings and an occasional prize. Never forget to givethese important guardians praise and credit for the hard work they do.

Weston Thiss, CHESP, is director of environmental services andCarolyn Bratcher, RN, is infection control coordinator at Bon Secours St. MarysHospital. Thiss is 2003 president of the American Society for HealthcareEnvironmental Services (ASHES) and Bratcher is the legislative representativefor the Virginia chapter of the Association for Professionals in InfectionControl and Epidemiology (APIC).