I admit there are times I get a “bit” riled up but to be
fair, sometimes I get riled up because some people
find it amusing to “push my buttons”. I
will also openly admit there some topics that I am passionate about, probably
to the point of being a zealot. Tonight I was flipping through my latest copy
of Infection Control Today when I came across an article written by the editor
Kelly Pyrek “Room
Turnover Times: Trash-and-Dash Approach Jeopardizes Patient Outcomes”. One
a scale of 1 to 10 in terms of having strong feelings and opinions over
cleaning of patient rooms, I am about an 11, and just reading the title started
to make me quiver.
fair, sometimes I get riled up because some people
find it amusing to “push my buttons”. I
will also openly admit there some topics that I am passionate about, probably
to the point of being a zealot. Tonight I was flipping through my latest copy
of Infection Control Today when I came across an article written by the editor
Kelly Pyrek “Room
Turnover Times: Trash-and-Dash Approach Jeopardizes Patient Outcomes”. One
a scale of 1 to 10 in terms of having strong feelings and opinions over
cleaning of patient rooms, I am about an 11, and just reading the title started
to make me quiver.
I have long said that focusing on what a disinfectant
product kills is not the answer to our environmental hygiene issues. Certainly, choosing a product with contact
times faster than 10 minutes will help ensure contact time compliance which
will help ensure we are killing the bugs we are concerned with, but don’t be
fooled. A faster contact time is not the silver bullet we are looking for
either. The truth is there is no silver bullet. We have had the answer for
years. The answer is understanding that cleaning and disinfection is a process
that requires meticulous attention and sufficient time allowed to ensure
corners do not get cut. As one of the people interviewed by Pyrek had stated “When I talk about processing, this includes
cleaning and disinfection practices, because healthcare environmental services
(EVS) is process-driven, just as surgery and nursing is process-driven. EVS is
finally standing up and stating we cannot cut out parts of our process and
expect to get proper results. We must follow our processes, and we require
sufficient time to perform the job properly, and if we don’t, we risk poor
patient outcomes.”
product kills is not the answer to our environmental hygiene issues. Certainly, choosing a product with contact
times faster than 10 minutes will help ensure contact time compliance which
will help ensure we are killing the bugs we are concerned with, but don’t be
fooled. A faster contact time is not the silver bullet we are looking for
either. The truth is there is no silver bullet. We have had the answer for
years. The answer is understanding that cleaning and disinfection is a process
that requires meticulous attention and sufficient time allowed to ensure
corners do not get cut. As one of the people interviewed by Pyrek had stated “When I talk about processing, this includes
cleaning and disinfection practices, because healthcare environmental services
(EVS) is process-driven, just as surgery and nursing is process-driven. EVS is
finally standing up and stating we cannot cut out parts of our process and
expect to get proper results. We must follow our processes, and we require
sufficient time to perform the job properly, and if we don’t, we risk poor
patient outcomes.”
EVS staff genuinely want to do a good job and like doctors,
nurses and other clinical staff they want to be acknowledged for the work they
do and their role in improving patient outcomes. How often have you heard someone (or you
being that person saying) “Get this room done in 10 minutes!” I know how I feel when rushed and end up
cutting corners or producing work that is not to the standard that I set for
myself. I become frustrated. I become angry. I feel bad about myself. My invisible bucket tips over and big
invisible drips spill out.
nurses and other clinical staff they want to be acknowledged for the work they
do and their role in improving patient outcomes. How often have you heard someone (or you
being that person saying) “Get this room done in 10 minutes!” I know how I feel when rushed and end up
cutting corners or producing work that is not to the standard that I set for
myself. I become frustrated. I become angry. I feel bad about myself. My invisible bucket tips over and big
invisible drips spill out.
As the article states if you were to tell a surgeon to
remove a gall bladder in 10 minutes or a nurse to insert a central line in 5
minutes they would revolt. They would
push back stating they cannot do it properly or safely in that length of
time. They would cite the fact that they
have standards and a code of conduct they must adhere to. It’s interesting that we do not allow EVS
staff to do the same. It’s interesting
that there is a plethora of published data supporting the importance of
cleaning and disinfection and the importance that achieving compliance (e.g.
contact times, wiping all high touch surfaces, etc) has on improving the status
of environmental hygiene, reducing bioburden, reducing HAIs and improving
patient outcomes.
remove a gall bladder in 10 minutes or a nurse to insert a central line in 5
minutes they would revolt. They would
push back stating they cannot do it properly or safely in that length of
time. They would cite the fact that they
have standards and a code of conduct they must adhere to. It’s interesting that we do not allow EVS
staff to do the same. It’s interesting
that there is a plethora of published data supporting the importance of
cleaning and disinfection and the importance that achieving compliance (e.g.
contact times, wiping all high touch surfaces, etc) has on improving the status
of environmental hygiene, reducing bioburden, reducing HAIs and improving
patient outcomes.
It’s interesting that we acknowledge the work of our
doctors, nurses and other clinical staff.
We’re quick to fill their buckets.
Similarly, it’s also interesting that we do not applaud and celebrate
the important work that our EVS staff does.
We’re quick to empty their buckets by pushing them to do more with less
and by pointing fingers and blaming them for environmental transmission of
HAIs. We’re less apt to applaud them for
their work and ensure their buckets are full.
doctors, nurses and other clinical staff.
We’re quick to fill their buckets.
Similarly, it’s also interesting that we do not applaud and celebrate
the important work that our EVS staff does.
We’re quick to empty their buckets by pushing them to do more with less
and by pointing fingers and blaming them for environmental transmission of
HAIs. We’re less apt to applaud them for
their work and ensure their buckets are full.
What is this bucket I talk of? We all have an invisible bucket. It’s that part of you that when it’s empty
you feel bad and when it’s full you feel great.
It’s that happy feeling you get when you’ve helped someone or have been
nice to someone and that sad feeling you get when you’ve been hurt by someone
or know that you’ve done something wrong.
If you still don’t get it read “How
full is your bucket – for kids” by Tom Rath and Mary Reckmeyer. It’s a favorite bedtime story of my son’s and
tonight he rightly told me I make him feel bad when I rush him in the
morning. He doddles...I get
impatient....our buckets start emptying.....
you feel bad and when it’s full you feel great.
It’s that happy feeling you get when you’ve helped someone or have been
nice to someone and that sad feeling you get when you’ve been hurt by someone
or know that you’ve done something wrong.
If you still don’t get it read “How
full is your bucket – for kids” by Tom Rath and Mary Reckmeyer. It’s a favorite bedtime story of my son’s and
tonight he rightly told me I make him feel bad when I rush him in the
morning. He doddles...I get
impatient....our buckets start emptying.....
I’ll leave you to read the full ICT article. It’s well worth the read and I hope will
change your attitude on the time it takes to clean the room, and if you have
the authority I hope you’ll help your EVS team to strengthen the importance of
their roles. I hope you’ll solidify the
importance of following processes and not cutting corners. I hope you’ll help EVS justify their budgets
and FTE levels the next time they are told to cut their budgets and fire some
staff. I hope you’ll start filling the buckets of your EVS staff!
change your attitude on the time it takes to clean the room, and if you have
the authority I hope you’ll help your EVS team to strengthen the importance of
their roles. I hope you’ll solidify the
importance of following processes and not cutting corners. I hope you’ll help EVS justify their budgets
and FTE levels the next time they are told to cut their budgets and fire some
staff. I hope you’ll start filling the buckets of your EVS staff!
Bugging Off!
Nicole
