Infection Control Today - 07/2004: Environmental Services

Old Mops Die Hard
Should You Microfiber for Infection Controls Sake?

By David Polonsky, CHESP, and J. Douglas Roill, Dr.Mgt, MS,RD, CHESP

Whether you are an infection controlpractitioner (ICP), director of housekeeping or an administrator, a microfibermopping program may be one of the most significant floor-care innovationsavailable to your facility in the past century. Those who have implemented amicrofiber mopping system can appreciate not only the uniqueness of the systembut have been witness to the numerous benefits. For those who have not yetconsidered this new wave or those struggling with the question of how or if tomake the switch, this article will explain how one facility embraced thistechnology and how you too can microfiber.

The first test trials of microfiber mops in the U.S. took place almost 10 years ago, yet according torepresentatives from Nilfisk-Advance and Rubbermaid, two of the leadingmanufacturers of microfiber products, only 10 percent to 14 percent of all U.S.hospitals have implemented a microfiber mopping program.

It is hard to believe that at one time I was completelycontent with the traditional one- and twobucket cotton mop process that has beenthe industry standard for more than 100 years. Being resistant to change, notunlike most people, I wondered why anyone should fix something that was notbroken. It was no surprise to my my general manager J. Douglas Roill, D.Mgt, MS,RD, CHESP, who presented me with the idea of implementing a microfiber moppingprogram, to hear all my reasons why it would not work. Even after my reluctant capitulation, I truly did not thinkthis innovation would stand the test of time. The thought of converting to a completely new system, havingto spend time and energy in retraining staff and the expense of purchasing newproducts just seemed too risky and, in retrospect, a bit overwhelming.

It was almost a year later when the microfiber concept wasendorsed companywide and by my district manager, Douglas Cottingham. We endorsedthe new technology for two primary reasons. First and foremost was the desire tosupport patient safety and infection control initiatives. Microfiber technologycleans better, getting into all the nooks and crannies of the floor that theconventional cotton loop mop cannot reach. Just think, a new clean mop for eachpatient room can effectively reduce the potential cross contamination andpossible nosocomial rates in any hospital. Next and equally as important wasemployee safety. Based on a 22-bed unit, employees have to wring out cotton mopsmore than 75 times per shift. The process of using a heavy cotton-loop mop isalso strenuous. Utilizing microfiber mops can reduce the potential for back,shoulder, and elbow injuries.

It didnt take long to realize that the risk wasntimplementing the new technology, the risk was not implementing the newtechnology and loosing the economic, environmental, infection control, andergonomic advantages of a microfiber mopping system. The more one learns aboutMicrofiber technology, the more sense it makes.

The Technology

If you are not yet familiar with microfiber technology,according to an EPA report, it is densely constructed nylon fibers that areone-sixteenth the size of a human hair. Due to the small size and density, thesefibers are able to hold up to six times their weight in water. This makes thematerial much more absorbent than standard cotton-loop mops. In addition, thefibers are positively charged. Since dirt and other particles on your floors arenegatively charged, the particles are actually attracted to the mop. Thisupdated technology is a huge improvement over the conventional cotton-loop mop.

Microfiber vs. Cotton

The actual process of using the microfiber mops is a hugeimprovement over the conventional cotton-mop process. Table 1 illustrates asnapshot comparison between handling microfiber and cotton-loop mops.

This table is based on a 22-room unit including med room, dayroom, treatment room, etc. Information is also based upon a water change forevery three rooms for the cottonmop system. Inventory levels factor in mops inuse, soiled mops, and mops in process of being cleaned.
* Microfiber mops need to be rung out by hand but no mopbucket ringers are required.
** Some industrial cost benefit analysis found in theliterature indicate as few as one cotton loop mop utilized per eight-hour shift.(Environmental Best Practices for Health Care Facilities, November 2002.)

How It Works

Roll up microfiber mops from end to end and place themstanding up into the empty bucket (from an aerial view it would resemble acinnamon bun or sandwich wrap). Fill a clean mop bucket to the top of themicrofiber mops with diluted cleaning solution (approx one gallon depending onthe capacity of the bucket). Remove one mop, wringing out the excess solutionback into the bucket with a twist of the wrist. (no need for a mop bucketwringer). Place the microfiber mop flat on the floor with the Velcro side facingup. Place the mop frame (head) directly onto the microfiber mop. Begin moppingdesired floor area. When finished, remove the soiled mop head and place in alinen bag for laundering. Start the process over again. If more mops are needed, simplyplace them into the remaining clean solution.

The advantages of this procedure over that of the cotton-loopmop procedure include but are not limited to:

• The amount of cleaning solution and water needed has been dramatically reduced.

• The mop water only has to be prepared once; if you run out of mops, simply add more to the clean solution.

• The mop water will remain clean. Imagine conducting roundsand noticing clean mop water at all times in your mop buckets. Unlike the microfiber mops that do not re-enter the buckets once used, wringing out cottonmops even once can turn your clean water into an unidentifiable brown liquid.

• There is less wear and tear and soiling of the mop bucket.

Implementation

Once the decision is made to adopt a microfiber moppingprogram, several actions need to be initiated. First complete a cost benefitanalysis. This is critical in managing your budget and selling the ideato justify financial support. Table 2 illustrates an example of some data thatcan be included in a cost benefit analysis. Other factors such as implementationcost, initial inventory purchase, and training can also be included.

This table is based on: a 22-room unit including med room, dayroom, treatment room etc; a water change for cotton loop mop of once for everythree rooms; utilization of a half-ounce of cleaning solution per gallon dilutionratio. Laundering is based on a standard 12- pound to 15-pound dry weightnon-commercial washing machine. Cost may vary depending upon source and quantitypurchasing discounts.

To promote acceptance of this new technology, consider placingan article in the hospital monthly publication, or enlist the assistance ofdepartment heads to secure some poster space. Informing the customers of the newproduct will help the transition phase. Informed employees will be more likelyto support the program and enlist others.

Identifying the right person to start phasing in this newsystem may be one of the most critical steps. Find out who is sincerelyinterested in the product and make them part of the implementation. With buy-infrom staff, the opportunity for success is greater. Change can be difficultespecially for front-line staff. Look to someone who is outspoken and somewhatof a leader among the front-line staff. Assure that you meet with key staffmembers, explain the program in detail, the importance of making the programsuccessful and any difficulties that may present themselves. Incorporating thesesteps may help you avoid some unnecessary delays. Remember, microfiber may ormay not be the best program for every facility.

Develop a program Gantt Chart to graphically display the timerelationships to the implementation steps. Upon completion of the Gantt Chart,you will be able to see the minimum total time required for the project, theproper sequence of implementation steps and which process steps can besimultaneously performed. A well-planned implementation is crucial to thesuccess. Table 3 illustrates an example of a Gantt Chart.

Infection Control Advantage

How much more sanitary is it to use a fresh mop for each room?Can you imagine the impact on your infection control initiatives? Reducing therisk of nosocomial infections in hospitals is of utmost importance. According to the Centers for Disease Control and Prevention(CDC), there are an estimated 2 million incidences related to nosocomialinfections annually. There are 80,000 deaths from nosocomial infectionsannually; 20,000 occur in the United States alone. The costs per year fornosocomial infections since 1992 is in excess of $4.5 billion, according to theCDC. How about the reduced risk of infection for your staff? The literaturecurrently documents that reducing the nosocomial infection rate is supported bythe utilization of a new mop head for use in each patient room. From a cleaningperspective, something as simple as always having clean water in the bucket isalso more appealing to staff, patients, and visitors.

Housekeeping staff must utilize personal protective equipment(PPE), such as rubber gloves, masks, and gowns while performing duties. Reducing the frequency of touching soiled mop heads canfurther reduce the risk of exposure and cross contamination.

Environmental Impact

Clean-water usage is reduced and less soiled water is put intothe waste stream. With the microfiber mopping system, you prepare your wateronce one gallon of water per cleaning cycle per 22 rooms. The noisepollution from wringing out a mop is virtually eliminated, which is lessdisruptive to patients and staff. The durability of the microfiber mop willresult in a decrease in solid waste from worn-out cotton loop mops. Less wear and tear on the mop buckets will also increase theiruseful life.

Ergonomic Implications

A research of the body of knowledge which has accumulated onthis technology, as well as in more than 49,000 Web site references onmicrofibers, on this technology supports the argument that, if used according tomanufacturers guidelines, microfiber mops can contribute to the overalldecrease in employee injuries. From a risk-management perspective, this onefactor warrants further consideration in deciding if a microfiber mopping systemis the right choice for your facility.

Employee Benefits

Be sure to orient staff to the benefits of the new product.Lifting heavy mops as well as the cumbersome job of constantly changing mopwater are very tiresome. At the end of the day, employees should experience lessexhaustion due to reduced lifting using microfiber mops. Discuss microfiber mopsat your employee meetings and during safety meetings. Be sure to distribute copies of articles about the product andsuccesses as they occur.

After implementation, be sure to communicate with housekeepingemployees on how the new technology is working out. The robust dialogue betweenemployees will help them adjust to the change in technology. Housekeeping staff will be impressed with the one-timecleaning solution preparation, as compared to eight to 10 exchanges per shift,as well as not utilizing the bulky wringers. The mop bucket for microfiber mopsonly requires a one-gallon capacity as compared to a cotton-loop mop thatrequires three gallons or more. The cotton-loop mop bucket requires a heavierconstruction (heavier weight) as compared to the bucket for microfiber mops. Askfor testimonials from employees; some of the comments we heard from frontlinestaff were, I can go home at the end of the day pain-free! and I cannot believe how easy it really is.

Economic Gains

Cost savings can be quite substantial, considering that asingle 100- percent microfiber mop will last up to 500 launderings. Somemanufacturers claim as many as 750 lifetime washes. When was the last time acotton-loop mop lasted 16 to 24 months? Consider yourself lucky if your cottonmops make it through two months before replacement is necessary. According to aproject by the Lowell Center for Sustainable Production, University ofMassachusetts Lowell, microfiber mops last about 10 times as long as a loopmop. In addition to the wear from daily use, cotton mops are also susceptibleto damage during laundering. Since there are no loops on microfiber mops, nothing getscaught on an agitator, reducing wear and tear on both mops and agitator. Moremicrofiber mops can be washed each laundering cycle, thus reducing laundrydetergent and associated chemical usage. It is estimated that the chemicalsavings (by volume) is 95 percent and water savings (by volume) is also 95percent.

The cost benefit of reducing injuries and improved cleaningtechniques should not be discounted. Additional savings can be generated by setting up an in-housemicrofiber mop laundering program. Microfiber mops do not have to be launderedin commercial washing machines or with commercial grade detergents. In fact, life expectancy can actually be decreased throughcommercial laundering. Look for opportunities to launder your own microfibermops. The estimated net savings on using a microfiber mop in placeof a cotton-loop mop exceeds $35 per 100 rooms cleaned.

Old Mops Die Hard

As you can probably imagine, not all personnel will embracethe new technology as readily as others. Critical to the programs overallsuccess is continually supporting and training on the process. Old mops diehard; do not be too anxious to rid yourself of all your looped-end mops. These mops will still be necessary to strip and wax floors aswell as bulk cleaning of infectious matter. Holding supervisors accountable forimplementing the program is a necessary step to ensure compliance. Eventually,even the most resistant staff will realize the benefits of the microfiber mopsystem. Amazingly, you may find that the most resistant staff will become yourgreatest supporters once they experience the new process.

In todays changing healthcare environment, managers need tocontinually seek out new and innovative ways of doing business. Microfibers areone of those innovations that may very well be the floor-care process of choicefor hospitals in the near future.

David Polonsky CHESP, is the director of environmentalservices and J. Douglas Roill, Dr.Mgt, MS, RD, CHESP, is the general manager ofhospitality services at Arizona State Hospital, a Sodexho Healthcare-managedaccount in Phoenix. Both are certified healthcare environmental servicesprofessionals (CHESP) and a members of the American Society for HealthcareEnvironmental Services (ASHES).