How Air, Hand, and Surface Hygiene Create Healthier Spaces


There are many facets to creating smarter, healthier health care spaces through infection control and prevention, but these tips can help generate a cohesive, adaptable and curative plan.

Health care facilities are designed to serve and protect vulnerable patients, but without proper air hygiene or disinfection and sanitization these facilities can quickly become a super-spreader of harmful bacteria, fungi, and other germs. With an influx of sick patients, overbooked hospital beds and limited access to personal protective equipment (PPE) the COVID-19 pandemic sparked an increase in health care-associated infections (HAIs), according to the Center for Disease Control and Prevention (CDC). Infection control practitioners (ICP), can use these key steps to help prevent cross-contamination in health care facilities.

Monitor Real-time Air Quality

According to The Environmental Protection Agency (EPA), indoor air can be 2-to-5 times more polluted than outdoor air. Despite the vulnerable nature of their occupants, hospital air can be of extremely poor quality due to the vast number of pollutants, gases, odors, and germs.

Clinical Microbiology and Infection lists viruses as the main cause of infectious diseases in indoor environments. Aerosolized viruses, including the coronavirus, spread through droplets that become airborne when people cough or sneeze and can remain in the air for up to 3 hours. A single cough or sneeze can expel germs as far as 27 feet at almost 100 miles an hour.

Matt Hayas

Matt Hayas

Airborne viruses are a known risk factor for indoor air pollution. The Journal of Healthcare Engineering identifies, biochemical aerosols from cleaning and disinfecting products, anesthetic gases such as nitrous oxide, formaldehyde and isoflurane as well as volatile compound organics (VOCs) emitted from flooring, paints, hospital curtains and many other materials are just a few of the many indoor air contaminants found inside health care facilities.

These risk factors are significant and they can lead to new and long-term health implications if not properly maintained. An immediate way to take control of indoor air pollution within health care facilities is through advanced air purifications systems with real-time air quality monitoring.

Specialized air decontamination units can be used to determine the state of indoor air and provide real-time protection against airborne contaminants. Air decontamination units that are designed to specifically target the breathing zone can help protect health care staff and patients by pulling harmful airborne particles down and away from the breathing zone. These units have the ability to deactivate 99.9999% of airborne pathogens including, viruses, VOCs, gases, fungi and more.

These free-standing units can be placed in patient’s rooms, operating and exam rooms, and throughout other high-traffic and communal spaces. When implementing these measures to improve indoor air quality, managers should also consider units with front-facing monitor displays to provide building occupants reassurance and peace of mind.

Build a Proper Hand Hygiene Culture

Adults touch as many as 30 objects in 60 seconds, and contaminated hands can transfer viruses to up to 14 other surfaces and subjects. The quickest and most effective way to stop the spread of hand-to-person cross-contamination is to ensure proper hand hygiene.

Building a proper hand hygiene culture starts with the health care staff. The CDC suggests that health care professionals may need to wash their hands as many as 100 times during a 12-hour shift. Studies show, however, that some health care providers practice hand hygiene less than half of the times they should.

Involving patients and visitors in the hand hygiene culture is also critical in stopping the spread of infections in health care facilities. Without proper hand hygiene solutions, hospital visitors can unknowingly bring in outside contaminants and patients who are bedridden can easily spread germs to hospital staff.

Start by placing mobile hand hygiene units around the facility, especially at entrances, in high-traffic areas and within reach of patient beds. These units will act as a visual cue of improved hygiene standards and will serve as a reminder that “right now” is a great time to sanitize.

Hand hygiene depends primarily on individual accountability. Whether or not a person washes their hands well or even on a regular basis is up to the individual. Educating staff and posting signs reminding staff and visitors of the importance of washing their hands will help further implement this hand hygiene culture.

Ensure Proper Surface Disinfection

Surface contamination is another major cause of HAIs and cross-contamination within health care facilities. The CDC links direct skin contact of contaminated surfaces, especially high-touch point areas, and the moving and reuse of patient care equipment as a main transmitter of harmful microorganisms.

To combat the spread of surface contamination, health care professionals can start by identifying the high-touch point and high-risk areas of surface contamination. These areas may include:

All bedding, including bed rails and handrails

Food trays and tables, both in patient rooms and in cafeterias

Patient call buttons

Curtains, room dividers and furniture

Patient and doctor monitors and tablets

Common or activity room tables and equipment

The next, most critical, step toward protecting health care staff and patients and fighting the spread of contaminated pathogens is to understand the harmful impact of chemicals typically found in antimicrobial and environmental cleaning products used in health care facilities.

The Massachusetts Nursing Association suggests that many common fragrances and chemicals emitted from disinfectants and cleaning products can have a direct and negative impact on respiratory and neurological health. Health care ICPs can refer to the EPA’s guide for safe cleaning when determining which products to use.

Allowing for proper dwell time of these products is another important step for proper surface disinfection. According to the CDC, most EPA-registered hospital disinfectants have a label contact time of 10-minutes. However, many scientific studies have demonstrated the efficacy of hospital disinfectants against pathogens with a contact time of at least 1 minute.

By identifying high-risk, high-touch point areas and implementing safe and effective cleaning procedures, health care professionals can significantly reduce the risk of HAIs and cross-contamination.

Invest in Third-Party Assessments

Redesigning operational processes to meet increased patient demand while working with fewer staff and limited resources can be a difficult task. Investing in third-party assessments can help address location specific factors in order to generate the most efficient plan for that particular facility.

Health and safety evaluations have been utilized in other industries for decades to ensure all quality, safety and public health guidelines are met. This same process can be used in any business to reinforce operational excellence, proper hygiene protocols and issue resolution capabilities. The ability for an organization to modify procedures, best practices and training in response to changing protocols or assessment data is a sign of an agile, resilient safety program.

Investing in third-party assessments provides businesses with valuable insights into the overall execution of current processes and how those processes match up with top industry standards. For multi-location facilities, this insight can be a critical step in ensuring the same exceptional brand standards are being executed across all locations.

There are many facets to creating smarter, healthier spaces through infection control and prevention, but these tips can help generate a cohesive, adaptable and curative plan. When health care facilities work to improve indoor air, hand and surface hygiene and invest in third-party assessments, employees, patients and visitors will feel less stress knowing their health and safety are not compromised.

Matt Hayas is the director of product and innovation at a company called Ambius.

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