Healthcare hygiene is key to preventing hospital-acquired infections (HAIs). It has been well documented that inadequate hygiene practices can increase the risk of HAIs among patients and healthcare staff. HAIs pose a serious threat to patient safety and are a burden on the healthcare system, so they must be managed with effective infection prevention measures.
Recently, the World Health Organization (WHO) designed a multimodal strategy1 featuring an implementation guide that healthcare facilities can use to improve their infection prevention and control (IPC) measures. The multimodal strategy begins with building the infrastructure, followed by education and training initiatives for healthcare staff. This is reinforced by check ins and reminders, leading to a change in workplace culture that prioritizes intervention in IPC. With resources like these, healthcare hygiene has changed significantly over the past 20 years2; however, we continue to find areas that need improvement.
In March 2022, a pilot survey3 was published that assessed international healthcare environmental hygiene (HEH) practices. The study sought to understand the strengths and weaknesses in HEH practices and received responses from 51 healthcare facilities through a Healthcare Environmental Hygiene Self-Assessment Framework. The survey demonstrated that 98% of healthcare facilities were deficient in at least one of the five components of the WHO multimodal strategy.
Furthermore, the survey found that only 47% of respondents thought HEH budget allocation was sufficient, and only slightly more than 50% indicated that their practices were updated to the most current standards. Among the many metrics defined in the survey, the study found that many healthcare facilities faced similar challenges when it comes to implementing and improving HEH standards.
Common challenges were apparent across all levels of healthcare, regardless of income or geography. One common challenge is access to resources. Proper IPC depends on the ability to thoroughly clean the patient environment, which requires unrestricted access to cleaning agents and other supplies. When Environmental Services (EVS) personnel do not have the appropriate resources, patient surfaces may not be properly decontaminated, increasing the risk of HAIs. Another common challenge is a lack of training and education. The study found that only 22% of healthcare facilities required thorough HEH training, and 28% provided no training at all, making it difficult to set and maintain proper HEH standards. Altogether, the study demonstrated a need for the improvement and implementation of better HEH practices to reduce the risk of HAIs.
Despite constant challenges, promising advancements in EVS and HEH practices continue to emerge. Every year, the Association for the Health Care Environment presents awards to healthcare facilities for EVS Department of the Year, which recognizes improvements and innovation in the field. This year’s winners will be announced during EVS week which takes place from September 11 to 17.
Last year’s winners were awarded for their innovation, perseverance, and commitment to environmental sustainability. Geisinger Community Medical Center received the award in the <500 bed category, and Santa Barbara Cottage Hospital/Cottage Health was the recipient in the 500+ bed category. Geisinger Medical Center was recognized for patient experience initiatives, commitment to patient engagement, and a reduction in turn times. Santa Barbara Cottage Hospital was recognized for EVS employee retention, high rates of vaccinations amongst staff, and staff commitment to training and working in COVID-19 cohort units.
EVS plays an integral role in patient health and safety. Maintaining a clean healthcare facility is not an easy task but is it essential to reducing the spread HAIs and protecting the safety of patients and staff. The innovative efforts of the award nominees combat some of the challenges identified in the pilot survey and will be important factors in contributing to improved and more sustainable HEH practices.
- World Health Organization. Multimodal Improvement Strategy Summary. March 2021. Accessed June 22, 2022. https://www.who.int/publications/m/item/who-multimodal-improvement-strategy-summary
- Lotfinejad N, Peters A, Tartari E, Fankhauser-Rodriguez C, Pires D, Pittet D. Hand hygiene in health care: 20 years of ongoing advances and perspectives. The Lancet infectious diseases. 2021 Aug 1;21(8):e209-21.
- Peters A, Schmid MN, de Kraker ME, Parneix P, Pittet D. Results of an international pilot survey on health care environmental hygiene at the facility level. American Journal of Infection Control. 2022 May 26.