Infection Control Today

MAR 2019

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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Page 20 of 28

20 ICT March 2019 Occupational Health and Safety Administration (OSHA) requires personal protective equipment (PPE) for worker safety OSHA's standard 1910.138 requires the use of gloves to protect the hands of janitorial workers. To comply with this standard, the use of gloves has become an accepted practice in the cleaning industry. While OSHA regulations are concerned with worker safety, they don't address issues relating to cross contamination or infection control; that has been the province of the Centers for Disease Control and Prevention (CDC). CDC guidelines for infection control: standard precautions in medicine In the 1980s, the incidence of HIV and other communicable diseases were on the rise. In 1996, the CDC developed standard precautions3 for patient care with two goals in mind: • prevent the transfer of dangerous germs from patients to medical personnel • prevent the spread of germs from one patient to another through cross contamination Standard precautions that are used during patient care include the following: • Proper hand hygiene in accordance with WHO guidelines 4 • The use of various types of personal protective equipment (PPE) including gloves, masks and gowns • CDC protocols for environmental cleaning and disinfection 5 CDC guidelines concerning the use of gloves for patient care The following CDC guidelines refer to the use of gloves when treating patients: 1. Examination gloves should be changed as soon as possible when visibly soiled, torn or punctured. 2. A separate pair of gloves must be used for each patient to avoid cross- contamination. 3. Hands should be washed after gloves are removed. While standard precautions for the use of gloves makes sense for patient care, how can these principles be applied to prevent janitor-induced cross contamination? Janitorial Precautions: Suggested Protocols for Using Gloves While OSHA requires the use of PPE by janitorial workers it offers no specifi c guidelines as to how and when gloves should be used. The following protocols are suggestions based on CDC guidelines and can be modifi ed for different types of facilities: • Don gloves before performing cleaning tasks (use gloves that are appropriate for the task being performed); • Change gloves in the following situations: 1. When they become visibly soiled, torn or punctured Janitor-Induced Cross Contamination: Causes and Cures S tudies have shown that microorganisms can survive on inanimate objects or surfaces for hours, days, weeks or even months. 1 Cross-contamination is defined as the spread of germs from one surface or object to another and frequently occurs when performing janitorial tasks. Effective cleaning and disinfection protocols can reduce the prevalence of cross contamination in the facilities we clean. Infection prevention and control in hospitals has become a priority due to the emergence of life-threatening, multidrug-re- sistant organisms. While most research on cross contamination has been hospital based, the same principles can be applied to the cleaning of day care centers, schools, restaurants and most types of businesses. Causes of Janitor-Induced Cross Contamination There are many ways that cross contami- nation can occur while performing janitorial tasks. Contaminated mop heads and towels are common culprits. However, a recent study 2 has identifi ed a less recognized cause of cross contamination: janitorial worker's gloves. Researchers have found that germs can survive on gloves (like other surfaces) and can be transferred from one surface to another while cleaning. This raises the following questions: Do we have protocols for the use of gloves when performing janitorial tasks to prevent cross contamination? Can we learn anything from the Standard Precautions that were developed for patient care? By Robert Shor, DPM feature

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