scholarly journals Engaging Veterans in Identifying Key Elements of Environmental Cleaning: The Patient Perspective

2021 ◽  
Vol 1 (S1) ◽  
pp. s62-s62
Author(s):  
Kelsey Baubie ◽  
Linda McKinley ◽  
Julie Keating ◽  
Rosemary Bartel
Keyword(s):  
Qualitative Interviews ◽  
Healthcare Setting ◽  
Time Of Day ◽  
Pathogen Transmission ◽  
Patient Perceptions ◽  
Environmental Services ◽  
Environmental Cleaning ◽  
Healthcare Settings ◽  
Hospital Cleanliness ◽  
Cleaning And Disinfection

Background: Contaminated surfaces in healthcare settings contribute to the transmission of pathogens. Environmental cleaning and disinfection are important for preventing pathogen transmission and reducing healthcare-associated infections (HAIs). Hospital cleanliness plays a large role in patient perception of the healthcare setting and, consequently, of patient satisfaction. However, patient perceptions of environmental cleaning remain unclear. To engage patients as part of achieving patient-centered care, we undertook a qualitative study to examine patient perspectives on environmental cleaning and disinfection in healthcare settings. Methods: We conducted semistructured qualitative interviews with 14 hospitalized patients at a large midwestern Veterans’ Administration hospital. Interviews were audio recorded, professionally transcribed verbatim, summarized in a “key domains” template developed by the research team, then coded for emerging themes. Results: Patients reported feeling satisfied with hospital cleanliness and especially the daily cleaning they observed while hospitalized. Cleaning activities highlighted included mopping and disinfecting high-touch surfaces, bathrooms, and floors. Despite this overall positive response, some patients expressed worries of being “in the way” or burdensome if they were in their rooms while staff were cleaning. One interviewee stated, “It’s easier for them if there isn’t a patient in [the room] … it’s hard to do any endeavor when you’ve got a complete stranger watching you.” Patients also acknowledged the importance of careful cleaning, especially during the COVID-19 crisis; “It’s got to be something you take seriously, especially during this pandemic.” Some patients spoke of the relationship which can develop between environmental services staff during daily hospital room cleaning. Conclusions: Patient perceptions of environmental cleaning are important to understand and incorporate into clinical practice. Overall, patients felt that their environments were clean, and they expressed confidence in the staff’s work. Interviewees additionally spoke of their own self-efficacy, saying they try to clean up after themselves and would feel comfortable speaking up if something needed to be cleaned. However, some patients acknowledged feeling burdensome to the environmental services staff if patients were present in rooms while staff cleaned. Cleaning activities may become more patient-centric if they are better planned (eg, while patient is out of the room) or based on patient preferences on time of day.Funding: NoDisclosures: None

scholarly journals Environmental Contamination of SARS-CoV-2 in a Non-Healthcare Setting

2020 ◽  
Vol 18 (1) ◽  
pp. 117
Author(s):  
Judith Chui Ching Wong ◽  
Hapuarachchige Chanditha Hapuarachchi ◽  
Sathish Arivalan ◽  
Wei Ping Tien ◽  
Carmen Koo ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Environmental Contamination ◽  
Healthcare Setting ◽  
Chain Reaction ◽  
Air Samples ◽  
Surface Disinfection ◽  
Healthcare Settings ◽  
Virus Contamination ◽  
Polymerase Chain ◽  
Cleaning And Disinfection

Fomite-mediated transmission has been identified as a possible route for the spread of COVID-19 disease caused by SARS-CoV-2. In healthcare settings, environmental contamination by SARS-CoV-2 has been found in patients’ rooms and toilets. Here, we investigated environmental presence of SARS-CoV-2 in non-healthcare settings and assessed the efficacy of cleaning and disinfection in removing virus contamination. A total of 428 environmental swabs and six air samples was taken from accommodation rooms, toilets and elevators that have been used by COVID-19 cases. By using a reverse transcription polymerase chain reaction assay, we detected two SARS-CoV-2 RNA positive samples in a room where a COVID-19 patient stayed prior to diagnosis. The present study highlights the risk of fomite-mediated transmission in non-healthcare settings and the importance of surface disinfection in spaces occupied by cases. Of note, neither air-borne transmission nor surface contamination of elevators, which were transiently exposed to infected individuals, was evident among samples analyzed.

Understanding Barriers to Optimal Cleaning and Disinfection in Hospitals: A Knowledge, Attitudes, and Practices Survey of Environmental Services Workers

2016 ◽  
Vol 37 (12) ◽  
pp. 1492-1495 ◽  
Author(s):  
Daniel A. Bernstein ◽  
Elizabeth Salsgiver ◽  
Matthew S. Simon ◽  
William Greendyke ◽  
Daniel P. Eiras ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Online Survey ◽  
Environmental Services ◽  
Prevention Strategies ◽  
Environmental Cleaning ◽  
Attitudes And Practices ◽  
Additional Education ◽  
Cleaning And Disinfection ◽  
Knowledge Attitudes And Practices ◽  
New Strategies

In this study, we used an online survey to assess knowledge, attitudes, and practices related to environmental cleaning and other infection prevention strategies among environmental services workers (ESWs) at 5 hospitals. Our findings suggest that ESWs could benefit from additional education and feedback as well as new strategies to address workflow challenges.Infect Control Hosp Epidemiol 2016;1492–1495

scholarly journals Quantitative Characterization of High-Touch Surfaces in Emergency Departments and Hemodialysis Facilities

2020 ◽  
Vol 41 (S1) ◽  
pp. s364-s366
Author(s):  
Tina Wang ◽  
Alana Barofsky ◽  
Matthew Simon ◽  
Lisa Saiman ◽  
E. Yoko Furuya ◽  
...  
Keyword(s):  
Emergency Departments ◽  
High Volume ◽  
Pathogen Transmission ◽  
Transmission Risk ◽  
Healthcare Personnel ◽  
Single Patient ◽  
Healthcare Settings ◽  
Observation Tools ◽  
Cleaning And Disinfection ◽  
Multiple Patients

Background: The healthcare environment can serve as a reservoir for many microorganisms and, in the absence of appropriate cleaning and disinfection, can contribute to pathogen transmission. Identification of high-touch surfaces (HTS) in hospital patient rooms has allowed the recognition of surfaces that represent the greatest transmission risk and prioritization of cleaning and disinfection resources for infection prevention. HTS in other healthcare settings, including high-volume and high-risk settings such as emergency departments (EDs) and hemodialysis facilities (HDFs), have not been well studied or defined. Methods: Observations were conducted in 2 EDs and 3 HDFs using structured observation tools. All touch episodes, defined as hand-to-surface contact regardless of hand hygiene and/or glove use, were recorded. Touches by healthcare personnel, patients, and visitors were included. Surfaces were classified as being allocated to individual patients or shared among multiple patients. The number of touch episodes per hour was calculated for each surface to rank surfaces by frequency of touch. Results: In total, 28 hours of observation (14 hours each in EDs and HDFs) were conducted. 1,976 touch episodes were observed among 62 surfaces. On average, more touch episodes were observed per hour in HDFs than in EDs (89 vs 52, respectively). The most frequently touched surfaces in EDs included stretcher rails, privacy curtains, visitor chair arm rests and seats, and patient bedside tables, which together accounted for 68.8% of all touch episodes in EDs (Fig. 1). Frequently touched surfaces in HDFs included both shared and single-patient surfaces: 27.8% and 72.2% of HDF touch episodes, respectively. The most frequently touched surfaces in HDFs were supply cart drawers, dialysis machine control panels and keyboards, handwashing faucet handles, bedside work tables, and bed rail or dialysis chair armrests, which accounted for 68.4% of all touch-episodes recorded. Conclusions: To our knowledge, this is the first quantitative study to identify HTSs in EDs and HDFs. Our observations reveal that certain surfaces within these environments are subject to a substantially greater frequency of hand contact than others and that a relatively small number of surfaces account for most touch episodes. Notably, whereas HTSs in EDs were primarily single-patient surfaces, HTSs in HDFs included surfaces shared in the care of multiple patients, which may represent an even greater risk of patient-to-patient pathogen transmission than single-patient surfaces. The identification of HTSs in EDs and HDFs contributes to a better understanding of the risk of environment-related pathogen transmission in these settings and may allow prioritization and optimization of cleaning and disinfection resources within facilities.Funding: NoneDisclosures: None

scholarly journals Environmental Contamination of SARS-CoV-2 in a Non-Healthcare Setting Revealed by Sensitive Nested RT-PCR

2020 ◽  
Author(s):  
Judith Chui Ching Wong ◽  
Hapuarachchige Chanditha Hapuarachchi ◽  
Sathish Arivalan ◽  
Wei Ping Tien ◽  
Carmen Koo ◽  
...  
Keyword(s):  
Environmental Contamination ◽  
Healthcare Setting ◽  
Disease Spread ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Air Samples ◽  
Surface Disinfection ◽  
Healthcare Settings ◽  
Cleaning And Disinfection

AbstractFomite-mediated transmission has been identified as a possible route for disease spread of the COVID-19 pandemic. In healthcare settings, evidence of environmental contamination by SARS-CoV-2 has been found in patients’ rooms and toilets. Here, we investigate environmental contamination of SARS-CoV-2 in non-healthcare settings and assessed the efficacy of cleaning and disinfection in removing SARS-CoV-2 contamination. A total of 428 environmental swabs and six air samples was taken from accommodation rooms, toilets and elevators that have been used by COVID-19 cases. Through the use of a sensitive nested RT-PCR assay, we found two SARS-CoV-2 RNA positive samples from the room resided by a COVID-19 case, highlighting the risk of fomite-mediated transmission in non-healthcare settings and the importance of surface disinfection of spaces occupied by cases. Of note, we did not find evidence for air-borne transmission, nor of environmental contamination of elevators, which were transiently exposed to infected persons.

scholarly journals A Continuously Active Antimicrobial Surface Coating Reduces Bioburden in a Healthcare Setting

2020 ◽  
Vol 41 (S1) ◽  
pp. s439-s439
Author(s):  
Valerie Beck
Keyword(s):  
Surface Coating ◽  
Geometric Mean ◽  
Healthcare Setting ◽  
Aerobic Bacteria ◽  
Healthcare Settings ◽  
Additional Layer ◽  
Clostridioides Difficile ◽  
Sustained Reduction ◽  
Before And After ◽  
Healthcare Associated

Background: It is well known that contaminated surfaces contribute to the transmission of pathogens in healthcare settings, necessitating the need for antimicrobial strategies beyond routine cleaning with momentary disinfectants. A recent publication demonstrated that application of a novel, continuously active antimicrobial surface coating in ICUs resulted in the reduction of healthcare-associated infections. Objective: We determined the general microbial bioburden and incidence of relevant pathogens present in patient rooms at 2 metropolitan hospitals before and after application of a continuously active antimicrobial surface coating. Methods: A continuously active antimicrobial surface coating was applied to patient rooms in intensive care units (ICUs) twice over an 18-month period and in non-ICUs twice over a 6-month study period. The environmental bioburden was assessed 8–16 weeks after each treatment. A 100-cm2 area was swabbed from frequently touched areas in patient rooms: patient chair arm rest, bed rail, TV remote, and backsplash behind the sink. The total aerobic bacteria count was determined for each location by enumeration on tryptic soy agar (TSA); the geometric mean was used to compare bioburden before and after treatment. Each sample was also plated on selective agar for carbapenem-resistant Enterobacteriaceae (CRE), vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridioides difficile to determine whether pathogens were present. Pathogen incidence was calculated as the percentage of total sites positive for at least 1 of the 4 target organisms. Results: Before application of the antimicrobial coating, total aerobic bacteria counts in ICUs were >1,500 CFU/100 cm2, and at least 30% of the sites were positive for a target pathogen (ie, CRE, VRE, MRSA or C. difficile). In non-ICUs, the bioburden before treatment was at least 500 CFU/100 cm2, with >50% of sites being contaminated with a pathogen. After successive applications of the surface coating, total aerobic bacteria were reduced by >80% in the ICUs and >40% in the non-ICUs. Similarly, the incidence of pathogen-positive sites was reduced by at least 50% in both ICUs and non-ICUs. Conclusions: The use of a continuously active antimicrobial surface coating provides a significant (P < .01) and sustained reduction in aerobic bacteria while also reducing the occurrence of epidemiologically important pathogens on frequently touched surfaces in patient rooms. These findings support the use of novel antimicrobial technologies as an additional layer of protection against the transmission of potentially harmful bacteria from contaminated surfaces to patients.Funding: Allied BioScience provided Funding: for this study.Disclosures: Valerie Beck reports salary from Allied BioScience.

scholarly journals Fire Risk Assessment in Healthcare Settings: Application of FMEA Combined with Multi‐Criteria Decision Making Methods

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Fateme Omidvari ◽  
Mehdi Jahangiri ◽  
Reza Mehryar ◽  
Moslem Alimohammadlou ◽  
Mojtaba Kamalinia
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Fire Risk ◽  
Fire Detection ◽  
Healthcare Setting ◽  
Multi Criteria Decision Making ◽  
Intuitionistic Fuzzy ◽  
Healthcare Settings ◽  
Fire Risk Assessment ◽  
Risk Parameters

Fire is one of the most dangerous phenomena causing major casualties and financial losses in hospitals and healthcare settings. In order to prevent and control the fire sources, first risk assessment should be conducted. Failure Mode and Effect Analysis (FMEA) is one of the techniques widely used for risk assessment. However, Risk Priority Number (RPN) in this technique does not take into account the weight of the risk parameters. In addition, indirect relationships between risk parameters and expert opinions are not considered in decision making in this method. The aim is to conduct fire risk assessment of healthcare setting using the application of FMEA combined with Multi‐Criteria Decision Making (MCDM) methods. First, a review of previous studies on fire risk assessment was conducted and existing rules were identified. Then, the factors influencing fire risk were classified according to FMEA criteria. In the next step, weights of fire risk criteria and subcriteria were determined using Intuitionistic Fuzzy Multiplicative Best-Worst Method (IFMBWM) and different wards of the hospital were ranked using Interval-Valued Intuitionistic Fuzzy Combinative Distance-based Assessment (IVIFCODAS) method. Finally, a case study was performed in one of the hospitals of Shiraz University of Medical Sciences. In this study, fire alarm system (0.4995), electrical equipment and installations (0.277), and flammable materials (0.1065) had the highest weight, respectively. The hospital powerhouse also had the highest fire risk, due to the lack of fire extinguishers, alarms and fire detection, facilities located in the basement floor, boilers and explosive sensitivity, insufficient access, and housekeeping. The use of MCDM methods in combination with the FMEA method assesses the risk of fire in hospitals and health centers with great accuracy.

scholarly journals A Systematic Review of Librarian-Provided Services Delivered in Healthcare Settings Finds a Positive Effect on Clinician and Patient Relevant Outcomes and Identifies Gaps in the Evidence

2015 ◽  
Vol 10 (1) ◽  
pp. 95
Author(s):  
Elizabeth Margaret Stovold
Keyword(s):  
Systematic Review ◽  
Conference Proceedings ◽  
Data Collection ◽  
Literature Search ◽  
Healthcare Setting ◽  
Risk Of Bias ◽  
Randomised Trials ◽  
Inclusion Criteria ◽  
Healthcare Settings ◽  
Positive Effect

A Review of: Perrier, L., Farrell, A., Ayala, A. P., Lightfoot, D., Kenny, T., Aaronson, E., . . . Weiss, A. ( 2014). Effects of librarian-provided services in healthcare settings: A systematic review. Journal of the American Medical Informatics Association, 21(6), 1118-1124. http://dx.doi.org/10.1136/amiajnl-2014-002825 Abstract Objective – To assess the effects of librarian-provided services, in any healthcare setting, on outcomes important to patients, healthcare providers, and researchers. Design – Systematic review and narrative synthesis. Setting – MEDLINE, CINAHL, ERIC, LISA, and CENTRAL databases; library-related websites, conference proceedings, and reference lists of included studies. Subjects – Twenty-five studies identified through a systematic literature search. Methods – In consultation with the review team, a librarian designed a search to be run in MEDLINE that was peer-reviewed against a published checklist. The team then conducted searches in the five identified databases, adapting the search as appropriate for each database. Authors also checked the websites of library and evidence based healthcare organisations, along with abstracts of relevant conference proceedings, to supplement the electronic search. Two authors screened the literature search results for eligible studies, and reached agreement by consensus. Studies of any librarian-delivered service in a healthcare setting, directed at either patients, clinicians of any type, researchers, or students, along with studies reporting outcomes relevant to clinicians, patients, or researchers, were eligible for inclusion. The authors assessed results initially on the titles and abstracts, and then on the full-text of potentially relevant reports. The data from included studies were then extracted into a piloted data extraction form, and each study was assessed for quality using the Cochrane EPOC risk of bias tool or the Newcastle-Ottawa scale. The results were synthesised narratively. Main Results – The searches retrieved a total of 25 studies that met the inclusion criteria, comprised of 22 primary papers and 3 companion reports. Authors identified 12 randomised trials, 4 controlled before-and-after studies, 3 cohorts, 2 non-randomised trials, and 1 case-control study. They identified three main categories of intervention: librarians teaching search skills; providing literature searching as a service; and a combination of the teaching and provision of search services. The interventions were delivered to a mix of trainees, clinicians, and students. None of the studies examined services delivered directly to patients or to researchers. The quality assessment found most of the studies had a mid- to high-risk of bias due to factors such as lack of random sequence generation, a lack of validated tools for data collection, or a lack of statistical analysis included in the study. Two studies measured patient relevant outcomes and reported that searches provided by librarians to clinicians had a positive impact on the patient’s length of stay in hospital. Five studies examined the effect of librarian provided services on outcomes important to clinicians, such as whether a literature search influenced a clinical decision. There was a trend towards a positive effect, although two studies found no significant difference. The majority of studies investigated the impact of training delivered to trainees and students on their literature search skills. Twelve of these studies found a positive effect of training on the recipients’ search skills, while three found no difference. The secondary outcomes considered by this review were satisfaction with the service (8 studies), relevance of the answers provided by librarians (2), and cost (3). The majority reported good satisfaction, and relevance. A cost benefit was found in 2 of 3 studies that reported this outcome. Conclusion – Authors report a positive effect of training on the literature search skills of trainees and students, and identified a benefit in the small number of studies that examined librarian services to clinicians. Future studies should use validated data collection tools, and further research should be conducted in the area of services provided to clinicians. Research is needed on the effect of librarian-provided services to patients and researchers as no studies meeting the inclusion criteria examining these two groups were identified by the literature search.

scholarly journals Patient perceptions and preferences of physicians’ attire in Saudi primary healthcare setting

2018 ◽  
Vol 8 (6) ◽  
pp. 326-330 ◽  
Author(s):  
Khaled Mohammed Al Amry ◽  
Maha Al Farrah ◽  
Saeed Ur Rahman ◽  
Imad Abdulmajeed
Keyword(s):  
Primary Healthcare ◽  
Healthcare Setting ◽  
Patient Perceptions

scholarly journals Multidisciplinary Treatment for Headache in the Canadian Healthcare Setting

2008 ◽  
Vol 35 (1) ◽  
pp. 46-56 ◽  
Author(s):  
Khara M. Sauro ◽  
Werner J. Becker
Keyword(s):  
Multidisciplinary Treatment ◽  
Healthcare Setting ◽  
Management Program ◽  
Patient Perceptions ◽  
The Self ◽  
Self Management ◽  
Patient Treatment ◽  
Treatment Programs ◽  
Public Healthcare ◽  
Management Workshop

Background/Objectives:Multidisciplinary treatment programs are seen as an effective way to treat patients with chronic illness. The purpose of this study was to describe a multidisciplinary headache program which was developed in the Canadian public healthcare setting, and to report on patient perceptions of the program and patient treatment outcomes.Methods:The Calgary Headache Assessment and Management Program (CHAMP) was developed with initial funding from Alberta Health, and continued with function from the Calgary Health Region. Patient perceptions of the program were obtained with questionnaires. Outcome measures for a cohort of patients who completed the Self-Management Workshop were obtained using standard headache related disability measures.Results:Patient perceptions of the education session, the Lifestyle Assessment, and the Self-Management Workshop were very positive. Headache Disability Inventory scores fell from 56.2 to 46.3 from baseline to three months post Self-Management Workshop (p<.001). Corresponding scores for the HIT-6 were 63.6 and 58.2 (p <.001).Conclusions:Multidisciplinary headache treatment programs can be developed in the Canadian public healthcare system. The program described here was well accepted by many patients and perceived to be useful by them. Headache related disability as measured by standard measures was significantly reduced after participation in the program.

scholarly journals Weight Stigma in Healthcare Settings in the United Kingdom: A Review

2017 ◽  
Vol 9 (10) ◽  
pp. 155
Author(s):  
Osinachi Akanwa Ekeagwu
Keyword(s):  
Policy Implementation ◽  
Crucial Role ◽  
Healthcare Setting ◽  
Weight Stigma ◽  
Health Conditions ◽  
Public Attention ◽  
The Public ◽  
Healthcare Settings ◽  
The United Kingdom ◽  
Perception Of Health

Due to weight stigma, obese and overweight individuals are stereotyped, rejected and victimised by the public. The pervasion of this discrimination in healthcare settings is concerning given that the healthcare setting plays a crucial role in influencing health and shaping perception of health conditions. Without adequate support and little public attention, obese individuals are primarily left on their own to deal with ongoing prejudice unless addressed through vigorous research and strategic interventions at individual, interpersonal, organisational and community levels, and through policy implementation.

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