Healthcare-Associated Infections (HAI)

Healthcare-Associated Infections (HAI)

While healthcare specific, HAIs are valuable to note for all cleaning organizations as they illustrate the fundamental correlation between clean environments and reduced cross-contamination cases. The same principles apply in an office or public setting in which cleaning activities can reduce the spread of illness, thus reducing health-related personnel costs, including lower health insurance costs and lower absenteeism, all leading to higher profits.  The following data can be related to results such as the aforementioned study of The Healthy Workplace Project*, showing significant impact of improved cleaning for health.

There are innumerable studies in the healthcare arena related to cleaning, proper sanitation, hand hygiene, and best practices to reduce healthcare-associated infections (HAIs).  Drawing on dozens of medical research papers and textbooks published by leading associations as well as the United States Department of Health and global health organizations that represent the interests of the healthcare market, this white paper summarizes a fraction of the many medical and scientific studies performed over the last twenty years to validate the financial ROI of improved sanitation and hygiene practices.

HAIs are infections that people acquire in a healthcare setting while they are receiving treatment for another condition. HAIs can be acquired anywhere healthcare is delivered, including inpatient acute care hospitals, outpatient settings such as ambulatory outpatient clinics, and long-term care facilities such as nursing homes and rehabilitation centers. In hospitals, HAIs lead to extended hospital stays, contribute to increased medical costs, and are a significant cause of morbidity and mortality (Edwards, 2007).

HAIs may be caused by any infectious agent, including bacteria, fungi, and viruses, as well as other less common types of pathogens.  These infections are associated with a variety of risk factors, including:

  • Contamination of the healthcare environment
  • Transmission of communicable diseases between patients and healthcare workers
  • Use of indwelling medical devices such as bloodstream, endotracheal, and urinary catheters
  • Contaminated surgical procedures
  • Contaminated injections

Annually, approximately 2 million patients suffer with HAIs in the United States, and nearly 90,000 are estimated to die. The overall direct cost of HAIs to hospitals in the United States is estimated at $28-45 billion. While this range may appear to be wide, one thing is certain: HAIs are expensive. In addition, most HAIs are thought to be preventable.  Important policy changes include a mandate that hospitals publicly report HAI rates and a federal pay-for-performance measure that will no longer allow United States Medicare to reimburse healthcare providers for costs incurred as a result of HAIs (Stone, 2009).

Importance of Cleaning

Cleaning and proper sanitation is the removal of soil and contaminants from surfaces.  It is recognized as a vital component of a comprehensive intervention program needed to reduce HAIs.  Proper chemistry, cleaning friction, and the capillary effect of cleaning textiles remove soil and pathogens from contaminated surfaces, touch points and identifiable areas of transfer.

Effective cleaning and disinfection will decrease the number of environmental pathogens and reduce the risk of transmission and potential infections.  Professional cleaning techniques and modern cleaning materials always play an integral part of a hospital’s infection prevention and control plan.

Langone Medical Center Study

The increased incidence of hospital-acquired C. difficile (HA-CDI) has heightened the need to define effective control measures.  Dr. Michael Phillips of New York University’s Langone Medical Center performed a controlled study to measure the effect of enhanced environmental cleaning on HA-CDI using the 3M™ Clean-Trace™* Hygiene Management System.  This study was presented at the 2011 Society for Healthcare Epidemiology of America (SHEA) Conference in Dallas, Texas.

The preliminary data points to a reduction in HA-CDI by using specially trained cleaners in lieu of conventional housekeeping units.  The adoption of best cleaning practices averted approximately 85 cases of HA-CDI annually, resulting in an estimated annual savings of $413,000 in direct hospital costs (Phillips, MD, 2011).    The results of the study are expected to be published in 2013.

Mt. Sinai’s Medical Center Study

In 2012, Crothall Healthcare published a white paper detailing their integrated Infection Prevention Approach to reducing HAIs in healthcare facilities.  Their study used the 3M™ Clean-Trace™ ATP monitoring device to document the cleaning performance of highly touched objects (HTO) in Mount Sinai’s Medical Center in New York (Crothall Healthcare, 2012).  This 1,171-bed hospital deployed new cleaning technology, technical training of cleaning personnel, and scientific measurement for quality assurance and improved cleaning practices.

Mt. Sinai’s Medical Center findings:

  • 57% reduction in C. difficile infection rates
  • HCAHPS cleaning scores increased 60%
  • 50% reduction in OSHA incidents

HAI Prevention Resource

The Association for the Healthcare Environment of the American Hospital Association (AHE) has published the second edition of its Practice Guidance for Healthcare Environmental Cleaning.  AHE is recognized as one of the premier resources on the healthcare environment.  This manual is an essential resource for environmental cleaning and disinfection.  AHE guidance is based on industry research, peer-reviewed clinical evidence and best practices from other leading healthcare organizations, including the Centers for Disease Control and Prevention (CDC), the Association for Professionals in Infection Control and Epidemiology, the Society for Healthcare Epidemiology of America and the Infectious Disease Society of America.   This valuable manual defines the transmission of infectious agents, healthcare-specific cleaning procedures, standards, infection prevention techniques and the basics of microbiology (Association for the Healthcare Environment, 2012).


 

* 3M and Clean-Trace are trademarks of 3M


About ISSA

The leading trade association for the cleaning industry worldwide, ISSA has a membership that includes more than 6,100 distributors, manufacturers, building service contractors, in-house service providers, and others interested in the cleaning industry. ISSA helps its members and their employees make valuable contacts through the industry’s largest cleaning shows, produced in conjunction with Amsterdam RAI, under the brand name ISSA/INTERCLEAN®.

ISSA also helps increase professionalism and networking opportunities through its global Web site, ISSA.com, and by offering business tools, industry standards – including the popular CIMS/CIMS-GB program – and legislative and regulatory services. It is through these initiatives that ISSA increases awareness of the true value of clean and its impact on human health, the environment, and a better bottom line. The association is headquartered in Lincolnwood, IL, USA. For more information, visit www.issa.com.

 

Dan Wagner

Dan Wagner is ISSA's Director of Facility Service Programs and has been with ISSA since November of 1999. He is primarily responsible for leading the association's sustainability and facility service programs, including the Cleaning Industry Management Standard & CIMS-Green Building Certification Program and Transpare. Dan has published numerous articles and spoken at various conferences, workshops and seminars on CIMS, standardization, management principles, and the true value of clean.

Dan is also a noted "subject matter expert" on green cleaning and a sought after speaker on environmental preferability, sustainability and green operations and maintenance. He has served as an SME for the International Facility Management Association and IFMA Foundation and is a co-author of the Foundation's "Global Guide on Green Cleaning," as well as a primary contributor to the "Business of Green Cleaning" manual.

Dan is also the association's Director of Facility Service Legislative Affairs and in-house legal counsel, having received his Juris Doctor degree from DePaul University in 1998. He is also a licensed attorney in the State of Illinois; a member of the American Bar Association, the Illinois Bar Association, the American Society of Association Executives; and serves on the Board of Directors of the National Floor Safety Institute.

About ISSA

The leading trade association for the cleaning industry worldwide, ISSA has a membership that includes more than 6,100 distributors, manufacturers, building service contractors, in-house service providers, and others interested in the cleaning industry. ISSA helps its members and their employees make valuable contacts through the industry’s largest cleaning shows, produced in conjunction with Amsterdam RAI, under the brand name ISSA/INTERCLEAN®.

ISSA also helps increase professionalism and networking opportunities through its global Web site, ISSA.com, and by offering business tools, industry standards – including the popular CIMS/CIMS-GB program - and legislative and regulatory services. It is through these initiatives that ISSA increases awareness of the true value of clean and its impact on human health, the environment, and a better bottom line. The association is headquartered in Lincolnwood, IL, USA. For more information, visit www.issa.com.

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