Environmental Hygiene MythBusters! an Interactive Session to Distinguish Fact from Fiction

Session Description: The Centers for Disease Control & Prevention (CDC) promote various strategies to validate a healthcare facility’s environmental hygiene program. Examples include visual assessments of cleanliness, direct practice observations, adenosine triphosphate (ATP) bioluminescence and fluorescent marking (FM). While some validation measures are subjective and others considered objective, all have benefits and challenges. Additionally, most validation research is conducted after discharge or terminal cleaning. Much less research has been published to date on cleaning validation of an occupied patient room.

Overt practice observations inherently risk producing the Hawthorne effect and are not included in the CDC’s Level II options for evaluating environmental hygiene. Working side-by-side with Environmental Services (EVS) technicians is also highly resource intensive. Infection Prevention (IP) and EVS departments may understandably prioritize ATP and FM methods over direct practice observations. Our research, however, has demonstrated that direct practice observations are an untapped wealth of opportunity to assess occupied patient room cleaning—even when the observer is standing in the room with a clipboard!

While the Hawthorne effect could theoretically increase the amount of cleaning performed, we demonstrate that less-studied process variables can be identified and corrected. Examples include cleaning cloth counts, contact time achievement, identification of overlooked high-touch surfaces, and measured time to complete essential tasks.

This session will explore preliminary results of a multiregional, multicenter observational study, wherein trained observers performed hundreds of EVS direct practice observations during discharge and daily patient room cleaning. Presenters will use interactive polling to assess the audience’s expectations, and then provide data from our observations and published literature to find facts and bust common myths! An innovative patient area cleaning checklist will be provided to support standardized processes and protocols, self-assessments and internal validation of environmental hygiene programs.