The hospital’s Housekeeping Department is responsible for the regular and routine cleaning of all surfaces and maintaining a high level of hygiene in the facility in collaboration with the Infection Control Committee. The Housekeeping Department’s charge is:

1. Classifying the different hospital areas by varying need for cleaning;
2. Developing policies for appropriate cleaning techniques:procedures, frequency, agents used, etc. for each type of room, from highly contaminated to the most clean and ensuring that these practices are followed;
3. Providing appropriate training for all departmental staff, both initially and periodically to assess competencies are maintained or when a new technique, product or piece of equipment are introduced;
4. Establishing methods for the cleaning and disinfection of the patient’s bed, mattress and pillow;
5. Determining the frequency for the washing/disinfection of privacy curtains, walls, floors and furniture.

There should be a continuing program for staff training. This program should stress personal hygiene, the importance of frequent and careful washing of hands, and cleaning methods (e.g., sequence of rooms, correct use of equipment, dilution of cleaning chemicals and disinfectants, etc.)

Staff should also understand some basic microbiology including the transmission of disease, as well as understanding the causes of surface contamination and how to limit the cross-transmission of organisms.

On September 18, 2012, the National Public Radio (NPR) aired a segment titled, “Hospitals Fight to Stop Superbugs’ Spread”. Neal Conan, host, interviewed three guests: Maryn McKenna, author, Superbug: The Fatal Menace of MRSA; Dr. Eli Perencevich, professor, University of Iowa Carver College of Medicine; and Dr. Deverick Anderson, co-director, Duke Infection Control Outreach Network.

The topic centered around the so-called “NIH Superbug”, a Klebsiella pneumoniae that resists most antibiotics, recently killed a seventh patient at the National Institutes of Health Clinical Center in Maryland. Similar outbreaks of healthcare-associated infections spread in hospitals across the country every day.

McKenna said, “KPC and other bugs like it, which are generally known as the highly resistant gram-negatives, they don’t just live on skin. They live on surfaces that other bugs have difficulty surviving on, things that aren’t organic and that have very low nutrients and very low oxygen, like metal, like plastic, like the rails of a bed or the counter that a computer rests on...And we haven’t thought so much about the environment around the patient. It turns out that that’s what janitors know really well, or, to be more polite, building services people or environmental services people. When they go in the room, they’re not actually focusing on the patient, they’re focusing on all the stuff around the patient: the bedrails, the counters, the call buttons.”

All three guests agreed with scientific studies demonstrating the role that cleaning plays in saving lives. One well-trained, conscientious hygiene specialist (i.e., Housekeeper, Matron, etc.) given the proper tools, time and cleaning chemistry can prevent more infections than a room full of doctors can cure. Environmental surfaces that are clean and disinfected make it a safe environment in which patients can recuperate and go home-without something they didn’t come in with. Cleaning certainly does play a role in preventing infections and saving lives.

Darrel Hicks is the author of Wiley Publishing's "Infection Control For Dummies", and is nationally recognized as one of the top experts in infection control. Darrel is also the immediate Past President of the IEHA and is an active member in ASHES where he holds the designation of CHESP. Darrel started his career in the management of housekeeping services in 1981. He has worked in hospitals ranging in size from 20-500 beds, and knows what it takes to plan, set goals and provide guidance and consultation to the management team and department(s) staff. He has managed as many as 13 departments and 170 F.T.E.’s at one time in a 3-hospital system. In that healthcare system Darrel had to pioneer and discover ways to save money by cross training staff, job sharing, controlling overtime and putting a system of controls in place.