Saturday, November 7, 2015

Hospital Room Disinfection- Many Unanswered Questions

I spent much of this rainy Saturday in my home office reading and listening to vinyl records. 

I fortuitously came across this excellent publication, a thorough review on cleaning hospital surfaces to prevent health care associated infections. 

This may be a surprise to some, but we have no slam dunk evidence to confirm that hospital room surface disinfection directly results in decreased health care associated infections. Comparative effectiveness studies with patient centered outcomes (health care associated infections) are exceedingly uncommon. To make matters even more unsettling, there is no clear definition of how to assess cleanliness or even how to best define a 'clean' hospital room.

The corresponding commentary to this article highlights a point which really makes sense to me. Although we clamor for heightened daily and terminal room disinfection, environmental service workers are frequently a marginalized part of the health care staff. 

We need to recognize and appreciate environmental service workers as critical and valued members of the healthcare team. Train them, compensate them fairly, and celebrate their work. Without their valued service, attempts to attain 'cleanliness' in the environment will fall short of expectations.