The Most Overlooked Area for Infection Prevention in Nursing Homes

What is one of the most overlooked areas of infection prevention and control in nursing homes? Unsure? I see this area being done incorrectly often and it can have a huge impact on reducing harms when done right. It is an easy, preventable measure that with some simple training can literally save lives. Any guesses?

            (Drumroll please) …Housekeeping! Our infection control program is everybody’s business. The entire industry is understandably focused on infection preventionists, nurses, and visitors, yet our housekeeping staff touch every part of resident rooms.  They largely go unnoticed and are unfortunately undertrained.

            When cleaning and disinfecting a room, order of operations is everything. When I see an extremely high percentage of housekeepers cleaning a room out of order, it is bothersome, but I know with a little effort we can save many residents from harm. They typically begin in the restroom, and even the toilet first. Without doffing or changing gloves, they move on to the room, cleaning the resident table, remote control, and other high-touch areas.

            We want to see the rooms cleaned by starting with the cleanest areas and moving to the dirtiest areas. Starting in the resident room, high to low, and in a circular manner around the room. The restroom should be last, and the toilet in the restroom the final thing cleaned. After the toilet is cleaned, doffing gloves and conducting hand hygiene is critical. New gloves should be donned before any sweeping or mopping.

            Improving our EVS services also includes looking at our cleaning and disinfecting products. There are countless products out there, and we must ensure that those used in our facilities are EPA registered for healthcare use, and more recently ensure that they are effective against COVID-19. This information can be found on the EPA’s N List of disinfectants for COVID-19. With these products it is important to know the contact times. This is simply how long a chemical must remain on a surface to kill the germs. While many have 10 to 30 second dwell times, others can be as long as 5 or even 10 minutes. Please be vigilant in knowing the contact times and apply them appropriately. Consider soaking the cleaning with the chemical instead of spraying the surface and wiping.

            In having a properly trained EVS staff we can feel confident that the hard work and maximum effort being put forth by our healthcare staff isn’t being undone. Thank you to all our healthcare (and housekeeping!) superheroes out there. Be safe and be well.

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