Research, EBP, Quality Improvement?

1. Research, EBP, Quality Improvement? Which is it???

2. Let’s look at some of Fairview’s projects • Infection Control

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

4. 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???

5. Possible Solution • Change mop for each room This would eliminate cross contamination from one room to the next

6. 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

7. Now What? • Steve started to look at alternatives, microfiber mops in particular

8. UC Davis Medical Center • Published in 2002, this case study compared the use of cotton loop and microfiber mops for cleaning patient care areas.

9. 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

10. Infection Control Today July, 2004

11. 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

12. 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

13. US EPA • Published “Using Microfiber Mops in Hospitals” under Environmental Best Practices for Health Care Facilities

14. 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

15. 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

16. 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

17. Thank you, Steve • For bringing this innovation to Fairview