Welcome to module 4, Environmental Disinfection. The learning objectives for this module are, discuss the role of the environment in disease transmission. Understand how improving environmental disinfection can reduce healthcare-acquired infections. Until recently, the role of the environment in disease transmission has been thought to be insignificant. Recent studies have shown that several major pathogens, like MRSA, VRE, C.difficile, and norovirus are shed by colonized, and then infected residents, and contaminates surfaces at levels sufficient for transmission. In fact, several items closest to residents, including bed lines, side rails, overbed tables, and other surfaces are extensively contaminated. On average, about one-third of surfaces harbor pathogens when sampled. In addition to extensive contamination, these pathogens can also survive on surfaces for extended periods of time. And can remain on these surfaces despite attempts to disinfect, and remove them. Incomplete cleaning and disinfection procedures, combined with the persistence of pathogens in the environment, increase the likelihood that healthcare worker hands will be unknowingly contaminated. Poor hand hygiene, delayed recognition and isolation of colonized or infected residents, and insufficient environmental cleaning disinfection can lead to contact with, and transmission of pathogens. Pathogen transfer from a colonized, or infected resident to a susceptible resident occurs most commonly by way of healthcare provider hands. But contaminated surfaces and equipment can be involved in the transmission pathway, either directly via direct resident contact with a contaminated surface, or indirectly through healthcare providers contacting contaminated surfaces, and then contacting residents. Let's join Charlie as he makes the rounds at Sunny Side Nursing Home, sharing his tips for achieving the ultimate clean. >> [SOUND] Are you tired of struggling with cleaning supplies? Are all those products just too much to handle? [SOUND] Well, turn that frown upside down, there's a better way! [MUSIC] >> Triple P. >> Hey, Sara! Welcome to the Environmental Service Crew here at Sunnyside Nursing Home. It's good to see a new face around here. I'm Charlie, I got your name from the nurses' station, and I wanted to see how your day was going. >> It's going well here so far, and you? >> It's going great, just working on the three Ps. >> The three what? >> Sarah, don't tell me you don't know the three Ps of environmental disinfection? Product, practice, and perfection? Say it with me. Product, practice and perfection. >> Practice and perfection. [LAUGH] What do you mean? >> All right, Sarah. Since you don't know, I'll let you in on a secret to my success. Let's talk about product first. >> Well, I have this solution here, what else is there to know? >> Oh, Sarah, there is so much more that you need to know. Do you know how to apply it, or how long it needs to stay on the contact surface? >> I can't say that I do. I think they may have skipped that part in class. [LAUGH] >> You were sleeping, but never mind. We use an EPA approved hospital disinfectant to clean rooms here at Sunnyside. There are two important things you need to know. You need to know how to disinfect appropriately, how to apply it, and the contact time. >> Well, I've been using this microfiber mop to clean the floors, and these cloths to clean surfaces. >> That's a start, but have you been changing the mop and cloths for every room? >> Wow, Charlie, I didn't know I need to do that. Well, the mop didn't look dirty, and neither did the cloths. >> You need to change the mop for every room, and you should change the cloth four to seven times per room every cleaning. You also need to make sure that the mop and the cloths are wet enough to achieve the necessary contact time. >> I don't understand contact time. >> Contact time is the time it takes for the disinfectant to kill certain germs. This is anywhere from one to ten minutes depending on the disinfectant you are using. If you're wipers not wet enough, the surface won't stay wet long enough to kill the germs. You will be spreading germs around the surface, but not removing them. >> [SOUND] Wow, Charlie, I had no idea. I have been doing this all wrong. >> It's not a matter of right versus wrong. Oh, wait, [LAUGH] yes, it is. [LAUGH] >> Are you confused about which product to use? Does cleaning a room just scare you? Well, say goodbye to fright, and think of cleaning in a positive light. Gone are the days when you doubt what you are doing makes a difference. With fresh disinfectant solution, each room and each item you clean [SOUND] will be clean. Overtime your mop, cloths, and disinfectant become more, and more contaminated during use. And become less, and less effective. If you don't change them appropriately, you end up contaminating surfaces, and not cleaning them. It's the science of pure technology that you can not clean something with something that's not clean. [MUSIC]
