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Medical Practice

When Cleaning Is A Matter Of Life And Death

Environmental services worker Jeanna Hibbert scrubs the hospital room to get rid of C-diff bacteria.
Michelle Faust
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Side Effects Public Media
Environmental services worker Jeanna Hibbert scrubs the hospital room to get rid of C-diff bacteria.

It’s usually doctors and nurses who are seen as the life-savers at hospitals. But when it comes to preventing certain lethal infections, the hospital’s cleaning staff play a vital role.  

The most common hospital-borne infection in U.S. hospitals is a stubborn spore that’s spreads easily and is tough to remove.

Clostridium difficile is a bacteria that attacks the intestines, causing debilitating diarrhea. Nearly half a million people in a year catch it, and in 2011, the last year studied, 29,000 people died.

And C. difficile  has a way of spreading not just in one hospital, but throughout health care systems as patients get transferred from facility to another.

In Rochester, New York, a group of hospitals recognized they would need to collaborate to  fight this problem.  Starting in 2011, these hospitals decided to work together.  They started sharing processes, including procedures to diagnose the disease early and to limit the use of antibiotics that prime the body for C. difficile growth.  And key to their approach: the hospitals agreed to use a shared, scientifically-proven cleaning method.

The collaborative approach takes common sense measures and systematizes them to reduce infection rates, explains Dr. Ghinwa Dumyati, an infectious disease specialist at the University of Rochester Medical Center.

And it has paid off. From 2011 through 2015, the four Rochester hospitals saw a 36 percent decrease in C. difficile infections.

danielle_scott_checking.jpg
Credit Michelle Faust/Side Effects
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Danielle Scott checks a handheld monitor to see if the room has been exposed to enough UV-light to sanitize the room.

“We share rates of our infections. We share compliance with cleaning. So, you could see your rate compared to the other hospital, and the competition really drives improvement,” says Dumyati.  

“We're trying to aim for zero which is a goal, but it’s kind of hard,” she says. “But there are many evidence based, very simple things we could do to prevent these infections.”

C. difficile spores have a protective shell that makes them hard to clean. “You have to scrub like you’re really scrubbing a plate that has spaghetti sauce on it, to get rid of it,” says Dumyati.

The new cleaning process takes four staff members about an hour and a half. At a recent day at Rochester’s Strong Memorial Hospital, it started with removing curtains, dusting, sweeping and mopping.

After that, environmental services worker Jeanna Hibbert used bleach and scrubs hard. “Cleanliness is next to Godliness,” she said as worked. When she finished, staff trainer Chris Lapple checked the room for organic matter using a handheld electronic device.

He swabbed four places in the room, including the computer keyboard and mouse, and checked the swabs with his device. Hibbert scored a 23: perfect.  

Next team leader Danielle Scott did a visual check, looking for hidden surfaces that may have been missed. She inspected the bedside table closely. “This is another hotbed action spot,” she explained.  “You just give it a good check, down here.”

After reviewing the room, it was time for sterilization: Scott brought in a machine that blasted bacteria-killing UV-light from a five-foot tall column of light bulbs. She jokingly calls the robot-like machine “her friend,” and the two get a lot of attention around the hospital, especially from children.

Finally, Hibbert made  the bed and replaced the curtains. Dr. Dumyati says the cleaning team may have saved the next patient’s life.

“[Their] role is as important as a nurse and as a doctor, because [they] are capable of preventing infection,“ she says. “Before no one really paid attention to Environment Services, but now they're kind of at the same level as everyone else.”

This story was produced by Side Effects Public Media, a reporting collaborative focused on public health.