"You can't look at something that is highly resistance and say 'there is another drug on the shelf to treat this patient,' because there aren't. As a result, prevention of these infections becomes much more important because there is no treatment on the back end," McKenna tells me.
"I don't think that that connection was really made or at least emphasized before. People thought it was important to have the hospital clean because a hospital should be clean. But the job performance of the environmental services staff actually having a direct effect on infection rates is a relatively new realization and institutions are still working their way through that."
The prevailing wisdom for a long time, McKenna says, was that cleaning staff was not important on the hospital hierarchy. "They are all the way at the bottom. People assume there is going to be high turnover. They don't pay them well or train them well. For a significant number of them English is a second language. Nobody thinks about the difficulties of that. They think of them as these faceless people chugging through the room doing these basic necessary tasks," McKenna says.
"Then all of a sudden they realize, 'Wow we have to turn our understanding of our hospital hierarchy on its head because these people who we have always taken for granted might turn out to be the key piece of the puzzle.'"