The aim of the study, carried out by The Society for Healthcare Epidemiology of America, was to “sustainably improve cleaning of high-touch surfaces (HTSs) in acute-care hospitals using a multimodal approach to education, reduction of barriers to cleaning and culture change for environmental services workers”. Research was conducted in two academic acute-care hospitals, two community hospitals, and an academic paediatric and women’s hospital, and it involved frontline environmental services workers.
A five-module educational programme was developed, using principles of adult learning theory. Audience response system (ARS), videos, demonstrations, role playing, and graphics were used to illustrate concepts of and the rationale for infection prevention strategies. Topics included hand hygiene, isolation precautions, personal protective equipment (PPE), cleaning protocols, and strategies to overcome barriers. Evaluation involved ARS questions, written evaluations and objective assessments of occupied patient room cleaning. There were changes in levels of hospital-onset C.diff infection and methicillin-resistant S.aureus (MRSA). On average, 357 environmental service workers participated in each module. Most (93 per cent) rated the presentations as ‘excellent’ or ‘very good’ and agreed that they were useful (95 per cent), reported that they were more comfortable wearing PPE (91 per cent) and performing hand hygiene (96 per cent) and better understood the importance of disinfecting HTSs (96 per cent) after training. The frequency of cleaning individual high-touch surfaces in occupied rooms increased from 26 per cent to 62 per cent after the programme had been implemented. — ECJ