ACTION STEPS FOR INCORPORATING SOFT SURFACE BACTERIAL MANAGEMENT IN A COMPREHENSIVE INFECTIONPREVENTION BUNDLE.
Even though she was having a busy day, a CNA in a step down ICU unit was glad to help her favorite patient with her basin bath. While cleaning up afterwards in a hurry she tipped the basin of dirty water and spilled some on the front of her uniform. She wiped it off as well as she could and continued her day of direct patient care activities. She often nonchalantly touched her hands to the contaminated gown and then hard surfaces and other patients. At least one time she touched the contaminated part of the uniform and grabbed tape out of her pocket to seal up a wound dressing.
The above scenario is just one example of a breakdown in infection prevention practice. Everyone in the healthcare setting is responsible for patient safety; however, the infection preventionist has the duty of educating the larger staff on how we can collectively save lives through effective reduction of healthcare associated infections. I recently read that the number of lives lost each year from HAIs is equivalent to one passenger airplane crashing and killing everyone on board every day. Looking at this problem from this perspective is appalling! Why should we stand by and allow 99,000 people each year to die needlessly from our care in hospitals? While we have made great strides in improving hand hygiene and hard surface disinfection, these surfaces only constitute 10 percent of the immediate patient environment. We are leaving the rest – soft surface fabrics – unprotected.
BACTERIAL CONTAMINATION OF SOFT SURFACE FABRICS IS PROVEN
Multiple studies have shown that soft surfaces—lab coats, scrubs, uniforms, privacy curtains, patient apparel and bed linens— in the healthcare environment are contaminated and cross contamination from other surfaces to skin and other surfaces are proven to frequently occur. This evidence underscores the important role soft surfaces can play in the transmission of microorganisms in the healthcare environment and reveals a potentially dangerous gap in our current infection prevention practices.
Current practice does little to address the issue of soft surface bacterial management in a standardized, effective way. One way we do address fabrics is through laundering; however, evidence shows that laundering alone is not a complete, permanent solution. Many facilities rely on staff to wash uniforms at home, where it isn’t possible to regulate proper practice like washing between every use. In some cases, home laundering using just a washing machine has also been proven to be ineffective at rendering clothing hygienically clean – or free from pathogens . In addition, recontamination of fabrics is proven to happen quickly after being put back in use.
Even with proper laundering, if you think about how frequently healthcare staff touch soft surface fabrics like privacy curtains in the process of patient care, or the frequency with which soft surface fabrics, like bed linens, are touching the patient, it’s really eye opening. It’s easy to imagine a nurse who washes her hands, but then pulls back a contaminated curtain or reaches into her pocket before touching a patient.
While the evidence is clear, there is still a lack of guidance from regulatory agencies in this area and standardized best practices are sparse among infection prevention, patient/employee safety, industrial hygienists and environmental services professionals. It will require collaboration between these departments to close this gap in infection prevention protocol.
To keep reading this white paper click here Soft Surface Fabrics: THE OTHER HIGH TOUCH SURFACES