Cleaning in health care facilities can be challenging due in large part to the unique needs of the building occupants. Health care patients potentially already have compromised immune systems, making them more sensitive and susceptible to strong smells and volatile organic compounds (VOCs), or even resistant organisms such as MRSA and nosocomial viruses.

It is up to the cleaning department to make sure exposure to these elements is minimal. In doing so, many departments have updated chemical usage to include healthier options and improved cleaning procedures to reduce exposure.

Controlling Odors

“In response to strong smells, using chemicals with less toxicity and less fragrance is a constant goal,” says Dennis Owens, CHESP, director of environmental services at Memorial Hospital of Rhode Island in Pawtucket, R.I. “A clean hospital should have no detectable odors.”

Although ideal, achieving an odorless environment can be difficult, especially when faced with cleaning challenges that require the use of multiple chemicals or disinfectants. In these situations, it might be best to evaluate many product options.

Owens tests out a variety of products before determining which is best for his facility and its building occupants. After careful review, he purchases the products that limit the offensive odors that are often blamed on cleaning chemicals.

Even with the most carefully selected products, odor-related complaints might not cease. In fact, many complaints come as a result of cleaners improperly mixing chemicals for specific cleaning tasks. In these situations, it might behove cleaners to utilize dilution control systems, which will minimize the potential for inaccurate mixing — often a common culprit of odor.

Focusing On Indoor Air Quality

Often confused with odor, poor indoor air quality (IAQ) can have a lasting effect on both building occupants and cleaners. Poor IAQ can result from chemicals that have become airborne — whether from overuse or from inaccurate use of spray bottles — or improperly controlling airborne dust and allergens within the facility. These particles can be difficult to combat, but many health care cleaners have embraced the challenge.

Sue Weister, the housekeeping assistant manager at Marshfield Clinic in Marshfield, Wis., focuses on improved filtration to combat airborne particles.

“We use HEPA filters on our vacuum cleaners and we have a preventative maintenance program to monitor filters in our air handling units, notifying us when a change is required,” she says.

To maintain high expectations for IAQ, the Marshfield cleaning department also vacuums and shampoos carpeting regularly, making sure to use lightly scented disinfectants to reduce the potential for strong smells during the cleaning process.

“Stronger chemicals, when needed, are used after the patients are out of the building,” says Weister. This minimizes a patients potential exposure to harmful VOCs.

Training For Infection Control

Air quality aside, health care facilities are also challenged with combating the introduction and spread of resistant organisms such as MRSA, Norovirus and other nosocomial viruses. To do so, managers recommend starting with an improved training program.

At the Marshfield Clinic, Sharyn Juneau, infection preventionist, is in charge of providing in-services to staff as needed; offering PowerPoint on MRSA, hand hygiene and respiratory hygiene; updating infectious disease information for online users; and providing written policies and procedures for cleaning exam, procedure and surgical rooms, as well as cleaning toys.

“It is the responsibility of the infection preventionist to develop a clinic-wide policy regarding how to manage infectious disease exposures and outbreaks,” says Juneau. “This includes requiring patients, staff and providers to wear masks if coughing, practice frequent hand hygiene, cohort patients with similar symptoms, etc.”

She emphasizes that cleaning procedures, including following standard and transmission-based precautions, are critical to reducing the spread of infection through the facility.

With both the building occupant and cleaner in mind, it is important for every facility manager to focus on issues such as improved indoor air quality, odor reduction, infection control and eliminating cross-contamination.




POSTED ON: 9/1/2008