Nosocomial Infections
NOSOCOMIAL INFECTIONS
75,000 deaths per year
I worked in Environmental services in 250 bed hospital for a time and wrote this article in 2008. Sending notices of it to various places.
I was invited to speak to an infection control conference in India, if I self-paid my travel,
so that didn't work out.
Yet the invitation tells me that this article has some value.
I'm including it here because of the tie to our friend, the Horseshoe Crab.
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Besides medical information malfunctions, another needless cause of medical deaths is nosocomial infections -in short, being hospitalized for one problem and dying of something else acquired while in the facility.
British Dr. Joseph Lister (1827-1912) was criticized by peers when he stated that med students should change smocks and wash when, say, leaving an autopsy - to deliver a baby.
British Dr. Joseph Lister (1827-1912) was criticized by peers when he stated that med students should change smocks and wash when, say, leaving an autopsy - to deliver a baby.
So many women died of 'childbed fever', now called 'puerperal infection'
But childbirth deaths dropped when doctors took his advice.
Contaminated hands and garments brought diseases into the delivery room.
But childbirth deaths dropped when doctors took his advice.
Contaminated hands and garments brought diseases into the delivery room.
Nosocomial infections.
Nosocomial infections cost lives and dollars.
Nosocomial infections cost lives and dollars.
Those most prone are children under 2 years-old and seniors over 70.
About 100,000 deaths per year, says the CDC.
(This was in 2008. In 2024, the figure is about 75,000)
Again, i was an Operations Manager for an Environmental Services Department
in a 250-bed hospital.
Here are a few items to consider:
1) Housekeepers or EVS techs (Environmental Service Technicians) may go into an occupied room and ask the patient if they want their room cleaned today.
Always say 'yes'. EVS techs should never be allowed to ask that question.
Every occupied room should be cleaned every day.
Each hospital room has a unique biological environment,
(This was in 2008. In 2024, the figure is about 75,000)
Again, i was an Operations Manager for an Environmental Services Department
in a 250-bed hospital.
Here are a few items to consider:
1) Housekeepers or EVS techs (Environmental Service Technicians) may go into an occupied room and ask the patient if they want their room cleaned today.
Always say 'yes'. EVS techs should never be allowed to ask that question.
Every occupied room should be cleaned every day.
Each hospital room has a unique biological environment,
and the rooms' biologies intermingle.
Rooms that aren’t cleaned become fermentation vats for germs and viruses.
Some cleaners also check for scheduled discharges and not clean those rooms.
What if a discharge is delayed or cancelled?
And some patients refuse room cleaning.
This should be reported by the EVS tech to management.
(Very recently, September of 2023, I visited a female relative in a hospital in Omaha.
The EVS tech, a female, walked in, made considerable small talk with my relative,
Rooms that aren’t cleaned become fermentation vats for germs and viruses.
Some cleaners also check for scheduled discharges and not clean those rooms.
What if a discharge is delayed or cancelled?
And some patients refuse room cleaning.
This should be reported by the EVS tech to management.
(Very recently, September of 2023, I visited a female relative in a hospital in Omaha.
The EVS tech, a female, walked in, made considerable small talk with my relative,
wrote her own name on the board, emptied the bedside trash, and left.
Intentionally-inadequate room care.
2) The rooms of long-term patients are the worst.
The bed is often the most infected part of the room and the hardest to clean.
Patients should have their beds regularly swapped out, so the bed will be sanitized
Intentionally-inadequate room care.
2) The rooms of long-term patients are the worst.
The bed is often the most infected part of the room and the hardest to clean.
Patients should have their beds regularly swapped out, so the bed will be sanitized
every ‘x’ days to lessen the number of germs that nurses and EVS staff can transfer to the next patient room.
3) Ideally, rooms on each floor should be cleaned daily from least-to-most infectious.
It makes sense. At the least, Isolation Rooms should be cleaned last, yet daily.
4) EVS employee turnover rates are high everywhere, yet it can take weeks to hire new EVS staff, because of background checks (and the priority of hiring nurses?)
Even so, hospitals hesitate to adjust the FTE numbers to compensate for inevitable churn in the EVS department. This reluctance = increased nosocomial infections.
When this shortage exists, EVS workers sense it, and some begin to direct their own workloads.
This downgrades room quality and safety.
5) EVS training is often incomplete, abbreviated.
Professional, dedicated trainers should be used.
And the trainer should not be counted as an FTE for employee workloads.
6) ‘Isolation Room’ Is the term used for a room that holds highly contagious patients.
When the patient leaves, special cleaning is necessary to keep the next patient and personnel from being infected.
In the hospital where I worked, nurses, not EVS Techs, removed isolation signage and equipment. If this removal was done between shifts, then the next shift might go unwarned into an infected room and acquire especially potent germs, and then carry those germs into other rooms. I worked to track Isolation Rooms more effectively.
7) Some hospitals expect EVS techs to offer to refill patient coffee cups or water glasses.
NO! They are not hospitality staff!
3) Ideally, rooms on each floor should be cleaned daily from least-to-most infectious.
It makes sense. At the least, Isolation Rooms should be cleaned last, yet daily.
4) EVS employee turnover rates are high everywhere, yet it can take weeks to hire new EVS staff, because of background checks (and the priority of hiring nurses?)
Even so, hospitals hesitate to adjust the FTE numbers to compensate for inevitable churn in the EVS department. This reluctance = increased nosocomial infections.
When this shortage exists, EVS workers sense it, and some begin to direct their own workloads.
This downgrades room quality and safety.
5) EVS training is often incomplete, abbreviated.
Professional, dedicated trainers should be used.
And the trainer should not be counted as an FTE for employee workloads.
6) ‘Isolation Room’ Is the term used for a room that holds highly contagious patients.
When the patient leaves, special cleaning is necessary to keep the next patient and personnel from being infected.
In the hospital where I worked, nurses, not EVS Techs, removed isolation signage and equipment. If this removal was done between shifts, then the next shift might go unwarned into an infected room and acquire especially potent germs, and then carry those germs into other rooms. I worked to track Isolation Rooms more effectively.
7) Some hospitals expect EVS techs to offer to refill patient coffee cups or water glasses.
NO! They are not hospitality staff!
They need to spend their time creating healthy rooms for new patients.
8) I do not drink out of hospital water fountains,
but will drink their brewed coffee in waiting areas.
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There is another disturbing side to this issue.
8) I do not drink out of hospital water fountains,
but will drink their brewed coffee in waiting areas.
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There is another disturbing side to this issue.
I have been told that insurance companies will not pay charges for nosocomial infections, claiming it is the hospital's fault.
This claim seems reasonable to many. But there is dark side to this:
When a patient begins to present symptoms that could be labeled as a nosocomial infection, the patient may be quickly discharged, with the decision-makers knowing full well the patient isn't ready to be discharged, but will be re-admitted two or three days later,
This claim seems reasonable to many. But there is dark side to this:
When a patient begins to present symptoms that could be labeled as a nosocomial infection, the patient may be quickly discharged, with the decision-makers knowing full well the patient isn't ready to be discharged, but will be re-admitted two or three days later,
with new symptoms and a clean slate for insurance reimbursements.
So, nosocomial deaths are actually higher than reported.
And ... infections might be carried home to other immune-compromised family members.
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Properly done, EVS work is hard work.
The crew is usually short-handed.
They work every-other weekend and half of the holidays each year.
They work with all types of body fluids, contaminated products,
So, nosocomial deaths are actually higher than reported.
And ... infections might be carried home to other immune-compromised family members.
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Properly done, EVS work is hard work.
The crew is usually short-handed.
They work every-other weekend and half of the holidays each year.
They work with all types of body fluids, contaminated products,
and occasionally cranky patients and demanding schedules.
It’s a tough life.
Appreciate the good ones, but if you need to ask a question,
ask for the EVS manager, unless other contact info is provided.
The Environmental Services Department too, has a chain-of-command,
and the Charge Nurse on duty is not the EVS tech’s boss.
Appreciate the good ones, but if you need to ask a question,
ask for the EVS manager, unless other contact info is provided.
The Environmental Services Department too, has a chain-of-command,
and the Charge Nurse on duty is not the EVS tech’s boss.
