There was a time when certain so-called superbugs were thought to be a problem that only healthcare facilities needed to worry about.
But, for these dangerous bacteria, the line between healthcare facilities and everywhere else is becoming increasingly blurred.
Traditionally healthcare-associated infections (HAIs) are becoming community-acquired and have found their way into other public spaces, presenting challenges to cleaning professionals regardless of where they work.
Because of their increasing prevalence and ability to be picked up in non-traditional places, the way facilities managers of all kinds look at their infection control practices needs to change.
Not Just For Hospitals
It’s all too easy for facilies managers and their employees to turn a blind eye to what could potentially be lurking in unseen cracks and crevices.
For too long it was thought, maybe accepted, that the germs found in their facilities were completely different from the germs that their counterparts in healthcare facilities were tasked with dispatching.
But, the truth is that this is no longer certain and, as such, facilities of all shapes and sizes need to ensure that they are properly prepared to fight in the infection prevention game.
“Preventing the spread of infections should be a priority for all organizations, especially those that allow large groups of people to interact and share common items,” says Salah Qutaishat, Ph.D., senior clinical advisor of infection prevention at Diversey Inc.
In order to implement an infection prevention program that is comprehensive and effective, facilities need to pull from the situations experienced in the healthcare setting.
“Pulling from these experiences will allow for the implementation of effective infectious diseases transmission prevention strategies in non-healthcare settings like schools and higher education organizations, athletic clubs, restaurants and lodging facilities and cruise ships," adds Qutaishat.
The Non-healthcare Commonality
What all these non-healthcare facilities have in common is that they fit the description of a facility that allows for large groups of people to interact.
We know that germs and bacteria are spread far too easily, and when they are given ample opportunities to be passed around, they will take advantage of this.
For example: Germy students and teachers come in contact with one another, and with items such as shared textbooks or computers from computer labs, every day; and fitness centers encourage members to wipe down their equipment after use, but there is only an honor system in place when it comes to whether or not this equipment is disinfected between uses.
Just like healthcare facilities, every facility listed by Dr. Qutaishat potentially services individuals who harbor a plethora of bacteria.
What those in charge of caring for these facilities don’t necessarily consider is how dangerous those bacteria could be.
Besides the common cold and the ever popular norovirus, individuals are becoming increasingly exposed to superbugs in settings that were once thought to be “safe” from such outbreaks.
“Plans for these non-healthcare facilities should have clear policies and procedures for environmental and hand hygiene. Most importantly, these plans should have processes to identify ill individuals who have the potential to spread infections and to prevent them from interacting with others at the facility,” explains Dr. Qutaishat.
Every facility, regardless of size or purpose, should have in place a set and standardized plan to protect both employees and customers from the inadvertent spread of germs.
These plans should include:
- General hygiene procedures for all common places.
- A section that addresses employee illness. It is well known that sick employees who do not stay home while ill add to the burden of illness within an organization.
- A high-level mitigation plan for epidemics and pandemics. This plan should address continuation of services by the organization, but most importantly the protection of its employees.
“Facilities should be aware of different superbugs that could potentially spread in their buildings, such as community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) and norovirus, and how to prevent them,” says Les Dock, category development manager for Clorox Professional Products. “Cleaning crews should disinfect frequently touched areas where germs can thrive such as faucets, door handles, bathrooms, lockers and especially soap, shampoo and towel dispensers.”
Know When Bugs Could Be Lurking
Germs and bacteria that have the potential to be dangerous to human health can, and will, find a way to become a menace and stay viable.
That they are commonly called healthcare-associated infections does not mean that they cannot be found anywhere.
A person who has happened to come into contact with one of the numerous superbugs found in a healthcare setting might not become infected themselves, but they can potentially carry that bacteria from one place and then deposit it elsewhere.
“The community-associated strain of MRSA (CA-MRSA) is newer and far less common than the strains typically found in healthcare settings,” explains Dock. “CA-MRSA is contracted by otherwise healthy people in settings such as schools, daycare centers, sports and fitness centers and locker rooms. This is why cleaning professionals need to pay close attention to surfaces in locations where there is frequent skin-to-skin contact.”
Each type of facility previously mentioned needs to be aware of their potential risk for spreading infection and needs to be responsible for attempting to keep traditional HAIs out of public settings.
“This should start at the individual level. Individual hygiene and understanding the risk of the transmission of infectious agents are the corner stone of prevention,” notes Dr. Qutaishat. “The next level of prevention comes through community organizations knowing that infectious agents exploit human behavior in order to spread.”
Quite simply, germs and bacteria will take advantage of bad habits or poor hygiene in order to spread and thrive.
Prevention Is Key
While the facilities that have been previously mentioned need to be cautious when it comes to the spread of superbugs, they may not have the same chemicals or equipment available to them as can be found in a traditional healthcare facility.
That being said, according to Les Dock, facilities should choose disinfectants that are U.S. Environmental Protection Agency (EPA)-registered with label claims to kill relevant superbugs such as MRSA, CA-MRSA and norovirus.
“Cleaning professionals should always follow the product manufacturer’s instructions and pay attention to how long a product must remain wet on a surface in order to kill pathogens of concern," proclaims Dock.
Dr. Qutaishat cautions that preventing transmission should not be limited to using chemicals.
“Chemicals should be used as a component of a comprehensive strategy to prevent transmission, but when one is speaking about environmental hygiene, one should consider chemicals as one of the four main components that lead to better environmental hygiene,” asserts Dr. Qutaishat.
The four components of environmental hygiene include:
- Optimizing policies and procedures based on accurate risk assessment
- Proper selection of products (including chemicals) and tools
- Competency-based training
- Validation of cleaning effectiveness.
Avoiding Unnecessary Mishaps
Because the employees largely responsible for the health, safety and cleanliness of facilities of the non-healthcare nature have likely been trained in different ways than their healthcare counterparts, there is a need for a certain level of education.
Training that is customized to the specific facility is the key.
The training should identify potential workplace risks or pathogens and their corresponding prevention strategies, which should be based on risk assessment and performed at least annually.
“Employers should be able to provide ‘in time’ training based on community profiles of seasonal or sporadic epidemics,” offers Dr. Qutaishat. “For example, cleaning professionals working on cruise ships should always be trained on the risk of norovirus transmission, whereas cleaning professionals working with sports teams should be knowledgeable in the transmission and prevention of MRSA.”
In order to provide adequate training and education, facilities managers should adhere to the following tips:
- Provide staffs with easy-to-read, multi-lingual cleaning protocols posted in supply closets or included on cleaning carts
- Implement simple processes and steps to ensure the job is done right the first time
- Select products that are intuitive, easy-to-use and provide multiple benefits, like cleaning and disinfecting on multiple surfaces, in order to reduce mistakes and simplify the cleaning process
- Examine current cleaning protocols with a best practices approach of what’s working and not working to ensure a clean and properly disinfected facility.
Cleaning professionals responsible for facilities of a non-healthcare nature will come into contact with equipment and hazards that their counterparts in traditional healthcare facilities may not face, and need to be up to speed on the proper ways to protect themselves from coming into contact with potentially contaminated surfaces.
As should be second nature by now, the first step in prevention is proper hand hygiene and the U.S. Centers for Disease Control and Prevention (CDC) states that “keeping hands clean by washing properly with soap and water is one of the best prevention methods for MRSA and other superbugs.”
Cleaning professionals should always use the proper personal protective equipment (PPE), including gloves, gowns and masks, when needed.
Just because they’ve always been known as infections associated with healthcare facilities, doesn’t mean they’re content to stay there.