By SARA ARTHURS
Sure, the doctors and the nurses get the credit for taking care of patients at a hospital, but without a dedicated housekeeping staff, it would be difficult to restore patients to health.
Behind the scenes, dozens of housekeepers at Blanchard Valley Hospital follow a strict series of steps designed to thoroughly kill viruses and bacteria. The environmental services department, as it’s known, has been recognized nationally for the work of its staff.
The department’s main purpose is to make sure the hospital is “a clean, safe environment” for patients, visitors and staff, said Robin Cramer, manager of environmental services and communication. Blanchard Valley Hospital has the equivalent of 59 full-time housekeepers responsible for 587,697 square feet on a daily basis.
Colleen Abrams, infection preventionist, said cleaning a hospital means getting not just dirt, but also disinfecting. After all, sick people come into the hospital with all types of germs.
Cramer said there are strict rules as to how an area is disinfected. The staff uses bleach and there are protocols for how they enter a room or an area, going left to right through the room consistently to make sure no areas are missed. Particular attention is paid to “high-touch areas” — areas people touch often, such as bed rails, light switches and doorknobs.
Abrams said there are many approved disinfectants but Blanchard Valley chooses to use bleach based on studies that found that it kills most organisms within one minute and will kill Clostridium difficile, or C. diff., spores in five minutes. C. diff. is a common infection found in hospitals that can be deadly.
That means, Cramer said, keeping the surface wet with bleach for that entire amount of time, not just wiping it off quickly.
Abrams said technology has improved many aspects of health care but so far nothing has replaced the action of wiping down surfaces with disinfectant.
“That hard physical labor, that hasn’t changed,” she said.
If a new patient is admitted, the staff must clean the room and get it ready. And there is a process for thoroughly cleaning the room when a patient is discharged. So environmental services staff perform two types of cleaning, the everyday cleaning and the discharge cleaning.
Michael Neill, a supervisor of environmental services, said the workers use a black light to check out rooms after they have been cleaned. The light will show if there is any soil left. They also swab areas to measure levels of adenosinetryphosphate, or ATP, which is a breakdown of bacteria. Looking at the level of ATP in a particular area shows how effectively bacteria has been removed.
Abrams said people come to her office with pride at having gotten a good score when specific areas were swabbed for ATP.
“They will come by and they will go, ‘Yes! I nailed it!'” she said.
For the past two years, Blanchard Valley Hospital has been the runner-up for the Environmental Services Department of the Year award from Health Forum’s Health Facilities Management magazine and the Association for the Healthcare Environment.
The national competition looks at 14 areas including infection control and prevention, patient safety initiatives, customer service, waste reduction and recycling initiatives, employing advanced technologies to improve efficiency, staff education and training, patient satisfaction and engaging senior management in the department’s success.
The environmental services team was recognized in areas such as patient satisfaction in room cleanliness and courtesy, reducing room turnaround times, maintaining hand hygiene compliance rates and continual improvement to meet organizational needs. For these efforts, the hospital earned the competition’s top score among hospitals with 150 beds or fewer. Blanchard Valley Hospital was profiled in the September 2013 issue of Health Facilities Management.
One factor in the award was scores on the Hospital Consumer Assessment of Healthcare Providers and Systems survey, a standardized survey that inpatients take after leaving the hospital. The survey includes a question about hospital cleanliness.
The goal is to get an “always” in response to the question of whether the room is left clean, said Suzanne Guerrieri, another supervisor of environmental services.
She said when hiring a housekeeper she looks for not only conscientiousness in cleaning but also good people skills. Housekeepers interact with patients and often they’re among the people the patients have a chance to chat with.
A housekeeper may enter a room while a patient is groggy, and is encouraged to speak to the patient and describe what they’re doing such as “I’m going to take out your trash.” If the patient is out of the room when the housekeeper comes, such as for a medical test, they leave a card saying that they were there and cleaned.
“They really need to have good communication skills,” Guerrieri said.
She said some patients may have a lot of family visiting but others don’t. The housekeeper is someone the patient may see a few times throughout the day and it can help to have someone to talk to, even if it’s about the weather.
“They will sit with these patients on holidays,” said Ryan Shoemaker, director of facility and support services.
He said sometimes in the surveys patients will recognize their housekeeper by name. Blanchard Valley Health System has even received gifts and donations in housekeepers’ names.
Guerrieri said some housekeepers are a natural when it comes to people skills and are “phenomenal” with the patients. After one woman died at the hospital, her husband wrote to say how much it meant that the housekeeper sat with him immediately afterward, Guerrieri said.
Cramer encourages staff to imagine that they themselves are in a hospital bed, and to think about how clean they’d like it to be if they were the patient.
Cramer has been at the hospital for 33 years, starting as a nursing assistant before moving over to housekeeping. Neill is also a long-timer, having started in 1981.
Neill said his work cleaning was very rewarding, and gave him the sense that he was helping patients. He said the biggest challenge is time constraints.
Cramer added that, once a housekeeper cleans an area, it could become messy again 30 seconds later. But she too found it rewarding and felt a sense of accomplishment.
Abrams said people perceive hospitals as being full of germs and it’s a challenge to combat that fear.
“Media coverage in general has said hospitals are dirty,” she said.
Cramer said the hospital strives not only to actually be clean but also to be perceived as clean. It used to be that, when you walked into a room, if the floors were shiny it would be considered clean, she said.
Abrams said using bleach, which has a distinctive odor, as the primary disinfectant does help contribute to the perception of cleanliness. Abrams said she hopes housekeeping staff feel recognized for their role in helping stop the spread of infections.
“They are so, so important,” she said.
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