The task force started with environmental care and looked at how clean the environment was, the cleaning products used, how often staff changed and washed cubicle curtains, and how they performed the C. diff isolation process.
The hospital started changing the curtains after all C. diff patients, increasing the frequency of the room cleaning from once to twice a day, changing cleaning product and equipment, and using dedicated equipment for the individual C. diff patient.
Educating, training, and adding staff
Due to environmental services constraints at Hunterdon, the C. diff task force asked nursing and support staff to take on some cleaning responsibilities of medical equipment, which initially was not a welcome change.
"In addition to environmental services cleaning, we had to convince [nursing] staff that it was part of their role to clean," says Roye-Horn. "People thought cleaning wasn't their job and didn't have time for it. Gradually it became accepted and people are no longer surprised if someone asks them to wipe the stethoscope."
This initiative was successful because the task force sought buy-in from physicians on down, Nash says.
"Now we have physicians looking for wipes to clean stethoscopes, and NPs and clinical staff are making sure they are cleaning devices before they take them into another patient's room," she says.
The Jewish Hospital didn't ask clinical staff to take on any additional cleaning, but it did need their help in better preparation of patient areas for environmental services.
"It was important for nursing staff to assist environmental services by de-cluttering the patient's area," Wedig says. "If the nurses removed stray objects, environmental services could come behind them and do a through cleaning of those areas. The teamwork there was very important."