information about illnesses that may happen in the facility. This information is vital so you can respond immediately and effectively. The Criticality Of Understanding First, acknowledge what you are dealing with, if possible, as to the potential infec-tious outbreak possibilities. Second, prepare for a possible MDRO event. Third, analyze the response to the out-break. Fourth, train the staff thoroughly on their response. Finally, establish protocols for the daily cleaning process. The “what if” analysis must be activated and all scenarios developed and remedies established, not unlike any Operational Plan a military unit would have in place to stra-tegically and tactically respond to a given situational event. These superbugs lie in wait for an oppor-tunity to move to a host whom they can infect and further spread. Research has discovered that several of these superbugs can live outside a host on an inanimate surface for several days. They are waiting for a hand to pick them up from a countertop, a handle or a railing. Such surfaces are referred to as fomites: Any inanimate object that can carry an infectious organism. A majority of us understand this as cross-contamination; in a health care environ-ment, it is called a nosocomial or hospital-acquired infection. Since none of us are scientists, there is a need to approach any situation with an understanding that the pathogen/MDRO is contagious and can cause tremendous injury if contracted. In health care environments, knowledge as to the type of pathogen/MDRO will be usually known in two to four days; in an office environment, it may not be known until much later. The management team may only under-stand that someone on the tenth floor has a staph infection or that a staff member was diagnosed with the influenza virus and they went home sick. This is where, in an office environment, floor coordinators must be aware and share information with the property management team. Training And Preparation It is imperative to prepare for a MDRO. Primary consideration should be given to the selection of a disinfectant for the facility. The U.S. Centers for Disease Control and Prevention (CDC) has good selection crite-ria for choosing a disinfectant. The effective use of disinfectants, which will vary depending on facility type, is a major part in the strategy for mitigating these pathogens. A disinfectant for use in a surgical suite may not be needed in an office facility. Select a disinfectant based on probable pathogens you may encounter. Your local supplier can help with the selection of a good disinfectant for your facility. It is imperative that you obtain the proper disinfectant for the appropriate situation and that you use the disinfectant as per manufacturer recommendations. It might be helpful to enlist the help of your vendor, industry associations or col-leagues in similar facilities to see what oth-ers are doing to combat outbreaks. After establishing a plan, train the per-sonnel that will be required to respond to a MDRO. Keep in mind training is not a one-time event, but rather an ongoing process. There are mandatory annual training requirements in U.S. Occupational Safety and Health Administration (OSHA) codes. We all hope that an event does not occur, but we all know when you least expect it, “it” will happen. The process of training should be as real as possible and practical in scope. The personnel that have been designated to perform the cleaning should understand why they are doing things. Systematically cover assembling the nec-essary equipment, putting on personal pro-tective equipment (PPE), detailing the area that needs to be disinfected, etc. Critical to the training process is under-standing the dwell time needed for a disin-fectant to work effectively. By using a microfiber cloth, with vigorous application of the cloth to clean the surfaces then applying the disinfectant as prescribed by the manufacturer, you should success-fully defeat the pathogen. Observe the cleaner performing their tasks and emphasize what is expected of their effort. Keep the training fresh and updated and ensure cleaners recognize they are being exposed to a serious situation. Their training is critical for their safety as well as those who are using the area. Also not to be overlooked during train-ing is how to remove personal protection equipment (PPE), dispose of the contami-nated debris and properly wash hands after completing the process. Final Thoughts It is quite easy to overlook the daily opera-tions of the cleaning staff. Observing daily activities of the cleaning staff will insure that a certain level of disin-fection happens every day. Seriously look at the performance of the cleaning crew and determine if proper cleaning habits and processes are happen-ing or not. This must be an objective appraisal of the cleaner in the performance of their assigned duty. Is how they clean the proper method and with the right equipment; are they washing their hands when needed? Throughout the day, all cleaners must adhere to a strict discipline of handwashing — something of simplistic criticality. Look for gaps in their cleaning activities, disinfecting practices and personal hygiene. Perform a walk-through and look for high touch points. Are they being cleaned and disinfected daily to remove potential pathogens? Train employees to remove their deficien-cies and to improve their efficiencies. Some of the points herein may seem like minute aspects of cleaning and disinfecting to prevent and conquer superbugs. But, remember that the little things can get you. CM www.cmmonline.com 31
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