Ms. Groven: I worry about staff feeling rushed. Since we do orthopedics,
sometimes the procedures are only 10 minutes long. We make sure
turnovers are being done properly by constantly auditing and observ-
ing staff. We've recently started ATP testing on high-touch surfaces in
the room, like the forced-air warmer cables, anesthesia cart and key-
boards.
Ms. Nucci: C. diff. spores are an underestimated problem. They live on
healthcare providers' hands and the environment, and you need soap
and water to get them off. There are studies supporting the idea that a
contaminated environment can lead to transmission of infection in a
healthcare facility. One study's findings suggest that after a patient
with
C. diff. is discharged, the subsequent patient admitted to that same
room has an increased risk of C. diff. Facilities need to standardize
cleaning with a bleach-based product for these rooms, and ensure
they have enough educated staff members to clean the rooms.
Ms. Hohenberger: One of the key foundations is making sure that the indi-
viduals doing the environmental cleaning are trained on how to do it
properly and that they know their roles. If you have multiple people
working in one room, sometimes things can get missed if roles are not
clearly delegated. For example, you might want to have a policy that
the anesthesia tech is in charge of cleaning the anesthesia cart, while
another tech is always in charge of the back table and floor.
Would whole-room disinfection help in these instances?
Ms. Patrick: Some facilities, particularly hospitals that are seeing C.
diff., MRSA and now CRE, have found that whole-room disinfec-
tion does help. I think the jury is still out on which one of the
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