I think we
can all agree there has been a significant focus on trying to reduce HAIs. I’m sure we can all agree that there is not
one single magic bullet. Reducing HAIs
is a bundled approach where we need to ensure environmental surfaces and
medical devices are cleaned and disinfected, everyone cleans their hands, and
antibiotic stewardship programs are put into place. Unfortunately, we also know that hospitals
need to balance their budgets. HAIs and
outbreaks are expensive. There are times
when a hospital is forced to rob Peter to pay Paul. The ugly truth is that Environmental Services
staff are often on the chopping block when it comes to having to make cut
backs.
I realized
it may seem logical when you are just looking at numbers on a piece of paper,
but let’s think about the unintended consequences of such an action. Does the size of the facility change? No.
Can you cut back on cleaning and disinfection? No, there is a plethora of data linking the
fact that effective cleaning and disinfection can reduce HAIs. What then is the reality of cutting back on
the number of staff when the workload has not been reduced? Corners get cut. Short cuts are taken. The result is a potential increase in HAIs.
According to
a survey conducted in 2016, understaffing in environmental
services is getting worse, with reports of layoffs and cuts occurring regularly.
Concerns are growing among environmental
service workers that hospitals do not have the capacity and enough cleaning
staff to keep key surfaces like bedrails, mattresses, taps, door handles and
chairs clean. The survey revealed a
disturbing pattern of having to speed through the cleaning, being short staffed
due to vacations or sick days, employees admitting to having high levels of
stress and injuries occurring at work. In fact, a large majority reported that more
duties have been added to their already heavy workloads. Over half of the
respondents believe the situation is unsafe.
A study from 2014 noted that cleanliness in hospitals
can be characterized as less than optimal. Nearly 40% of respondents did not
judge their hospital to be sufficiently clean for infection prevention and
control purposes. If we admit the truth,
we know there is reams of data to support the fact that infection rates would
decline and fewer people would die if we just cleaned. The problem is determining how to apply the
science and the data generated into mathematical models that can calculate the
return on investment (ROI) and define what the value proposition is for
supporting a fully staffed Environmental Services department.
We know that
cleaning works. We know that cleaning is
time and labour intensive. We know that
having adequate staff will impact the budget.
Are we willing to risk the lives of patients when we know the harm that can
be prevented by improving our cleaning and disinfection programs? I’m hoping the answer is no.
Bugging Off!
Nicole
