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In honour of 2016 International Housekeepers Week, Dr. Michael Gardam, Director of Infection, Prevention and Control at UHN, shares the important role environmental services staff play in keeping patients safe at healthcare institutions.
You will often see it reported in the media that roughly 8,000-12,000 Canadians each year die of healthcare associated infections, making these as a group the fourth leading cause of death in Canada.
This figure might seem surprisingly high, but it is similar to what we see from many of developed countries and has been shown in multiple studies.
Where do these infections come from?
In some cases, these infections arise from a person's own bacteria after they undergo a procedure or treatment, such as after surgery or having an intravenous line inserted, and in other cases they can be picked up from others, such as drug resistant superbugs; C. difficile; and many other contagious organisms that congregate in hospitals.
If we focus in on those organisms that we can catch from others, there are a limited number of ways these tend to spread in hospitals: through the air; on surfaces or equipment; or through contaminated hands.
Many worrisome organisms can live on surfaces for days or even weeks to months, available for someone or something to pick them up and bring them to the next patient. C. difficile for example, can live in the environment for months and environmental contamination of items like bed rails, bedside tables and telephones, and call bells is likely a very important route by which it spreads between patients.
The unsung heroes
Much of the focus on preventing spread over the past decade has concentrated on healthcare worker hand washing. While common sense tells us this is important, there has not been nearly enough emphasis on preventing contamination from the environment through good and thorough cleaning and disinfection.
Sadly, environmental services does not get nearly the attention it deserves for keeping patients safe. This may be perhaps because hospital cleanliness is so basic it is assumed, or because there are not good studies showing a clear link between contaminated rooms and patient infections (imagine trying to study the impact of dirty versus clean rooms on patient infection rates—nobody is going to volunteer for that research!).
It is a cliché in the world of infection control, but environmental services staff are truly the unsung heroes of patient safety. It is about time they get the recognition and support they deserve, and to be welcomed as important members of the healthcare team.