Going to the sources for operational questions

A colleague whose responsibilities cover long-term care facilities in 28 states recently contacted me when a question arose about the necessity for environmental services staff to change disposable gloves when processing each patient’s side of a semiprivate room.

The staff always used clean reusable microdenier wipers for processing each patient’s area; however, the question never arose about the disposable gloves; that is, until a state surveyor indicated that gloves, like wipers, must be changed for each side of the room. (They always changed gloves when processing the shared bathroom.)

Wanting to be sure that I was able to provide documentation for what I believed, I contacted Lynne M. Sehulster, Ph.D., M(ASCP), Prevention and Response Branch, Division of Healthcare Quality Promotion with the Centers for Disease Control and Prevention (CDC). She, in turn, reached out to some of her colleagues.

I learned that there are two documents we can use to draw attention to the rationale for environmental services staff changing gloves when moving from one patient’s half of a semiprivate room to the other patient’s half.

The first is the CDC’s “Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings,” which includes two recommendation statements from IV.B.2 Gloves, on Page 79. Although the statements do not specify private vs. semiprivate, they indicate that “space” isn’t the defining criterion — it’s the individual patient. That was the rationale I shared with my colleague, both on the glove issue and the shared restroom. It should be noted that the Centers for Medicare & Medicaid Services (CMS) incorporated the CDC’s recommendations on glove use and it speaks to the cleaning cloth strategy for environmental cleaning.

The second is the CMS surveyor’s checklist for infection prevention, which has more information that can be beneficial; in particular, Section 2.C Personal Protective Equipment/Standard Precautions.

Keep in mind the following two criteria for changing gloves and any other personal protective equipment: (1) leaving the patient’s environment; and (2) moving to the next patient.

Both the CDC isolation guidelines and the CMS surveyor checklist speak to changing gloves when moving between patients, and the CMS takes this notion further by indicating movement out of one patient’s environment and into another patient’s environment. This supports the use of separate cleaning cloths as found in the AHE Practice Guidance for Healthcare Environmental Cleaning.

John Scherberger, CHESP, REH, is president of Healthcare Risk Mitigation Inc., Spartanburg, S.C.

Valuable resources available from AHE

AHE represents, defines and advances the professionals responsible for care of the health care environment to ensure high-quality outcomes and healthy communities. The following resources can be found at www.ahe.org/ahe/learn/tools_and_resources/publications.shtml.

• Recommended Practice Series: Environmental Services Equipment and Supplies. The equipment and supplies covered in this booklet are essential, discrete components of safe, efficient and productive environmental services operations.

• Practice Guidance for Healthcare Environmental Cleaning, second edition. This manual provides evidence-based research, guidance and recommended practices that should be considered for inclusion in health care environmental services departments. Because each health care facility has its own needs, this resource has been designed to enhance an existing program.

Sustainability certificate program offered by AHE

AHE has launched a new certificate program to acknowledge the ongoing and outstanding environmental and ecological sustainability efforts of environmental services departments.

The resources discussed in this column can be accessed through the following links:

• CDC’s “Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings”

• CMS surveyor’s checklist for infection prevention