Research, EBP, Quality Improvement?

Which is it???

Let’s look at some of Fairview’s projects

Infection Control

Question

Steve Bush asked the question: Could the housekeeping department be doing more to prevent cross contamination of patient rooms?

Protocol

Cotton mop 3-5 gallons of water and sanitizer Change water/sanitizer after every 3 rooms,

or after each Contact Precaution room

Is there a better way???

Possible Solution

Change mop for each room

This would eliminate cross contamination from one room to the next

BUT:

4 gallons of water weighs 32 pounds This would triple the amount of water handled by the

housekeepers each day This would triple the amount of sanitizer needed This would also triple the amount of clean water

required and waste water put into the system each day

Now What?

Steve started to look at alternatives, microfiber mops in particular

UC Davis Medical Center

Published in 2002, this case study compared the use of cotton loop and microfiber mops for cleaning patient care areas.

Findings

Reduced chemical use and disposal

Conventional practice requires solution change after every third room vs no change with microfiber mop

Reduced cleaning time between patient rooms

No need to clean and wring the mops between rooms and no need to change water/solution

Reduced staff injuries and worker’s comp claims Lighter mops, less handling of heavy buckets

Infection Control Today July, 2004

Findings, cont:

Elimination of cross contamination from mops New mop for each room Microfiber mops clean better than cotton Fibers are 1/16th the size of human hair and can hold six times

their weight in water * Dust- They do a better job than cotton mops in picking up

dust particles. Positively charged microfibers attract negatively charged dust particles.

* Bacteria- culture of an area after cotton wet mop cleaning showed 30% reduction, but after microfiber mop cleaning showed 99% reduction

How it works

Up to 20 mops placed in up to 1 gallon of solution

Individual mop is taken out of the bucket and placed on the floor.

Mop handle /frame is placed on the mop (Velcro)

After use, the soiled mop head is placed in a laundry bag

US EPA

Published “Using Microfiber Mops in Hospitals” under Environmental Best Practices for Health Care Facilities

Barriers

“Old Mops Die Hard” David Polonsky, Infection Control Today, July 2004

Cost of Change- although economic gains are shown in the long run there is significant initial investment that must be made.

Resistance to change- human nature

Endorsements

US EPA- Environmental Best Practices for Healthcare Facilities

Hospitals for a Healthy Environment US Dept of Labor-OSHA Sustainable Hospitals Project- UMass Lowell Association for the Healthcare Environment

Results

New carts allow housekeeping staff to keep all chemicals locked when carts are unattended- safer for patients and visitors

Staff satisfaction- less lifting and handling heavy buckets, less time.

Less water used Less sanitizer used Faster drying time- safer for patients and staff

Thank you, Steve

For bringing this innovation to Fairview