Environmental Services

Infection Control Today surveyed infection preventionists regarding their opinions on key issues related to environmental hygiene and surface disinfection. This report presents the survey findings through charts and graphs as a quick snapshot of infection preventionists' perspectives and practices relating to surface cleaning and disinfection.

Water is essential for life, and we are fortunate to have safe, affordable drinking water from municipal sources. Though water meets drinking standards when it enters a building, the complexity of healthcare building water systems can create conditions that allow growth of microorganisms, including waterborne pathogens that have been linked to healthcare-associated infections (HAIs).

Quality improvement (QI) in healthcare is a noble initiative but an increasing number of clinicians and administrators are wondering if such efforts are paying off in terms of better outcomes and whether or not they can be sustained long-term. Some studies indicate an ongoing disconnect between QI program goals and actual results. As Schouten, et al. (2008) remark, "The multi-institutional, quality improvement collaborative is widely accepted as a strategy in healthcare. Its widespread acceptance and use are not, however, based on a systematic assessment of effectiveness."

From a disease-transmission perspective, medical waste is one important topic that should be within the purview of the infection preventionist. It is well understood that the unsafe disposal of medical waste such as contaminated syringes poses public health risks. Contaminated needles and syringes represent a particular threat, as the failure to dispose of them safely may lead to dangerous recycling and repackaging which lead to unsafe reuse. Contaminated injection equipment may be scavenged from waste areas and dumpsites and either be reused or sold to be used again. The World Health Organization (WHO) estimated that, in 2000, contaminated injections with contaminated syringes caused 21 million hepatitis B virus (HBV) infections (32 percent of all new infections); 2 million hepatitis C virus (HCV) infections (40 percent of all new infections); and at least 260 000 HIV infections (5 percent of all new infections). In 2002, the results of a WHO assessment conducted in 22 developing countries showed that the proportion of healthcare facilities that do not use proper waste disposal methods ranges from 18 percent to 64 percent.

Environmental hygiene can be addressed through process, product and practice, working in concert to address what should be done and with what tools, and in a manner congruent with best-practice recommendations and evidence-based guidelines.