New Opportunities for Cleaning - PowerPoint PPT Presentation

1 / 47
About This Presentation

New Opportunities for Cleaning


New Opportunities for Cleaning & Restoration Professionals In Healthcare Facilities Presented By Wonder Makers Environmental Michael A. Pinto, CSP, CMP – PowerPoint PPT presentation

Number of Views:34
Avg rating:3.0/5.0
Slides: 48
Provided by: swa690


Transcript and Presenter's Notes

Title: New Opportunities for Cleaning

New Opportunities for Cleaning Restoration
Professionals In Healthcare Facilities
Presented By Wonder Makers Environmental Michael
A. Pinto, CSP, CMP CEO
2010 Business Mentors Summit Chicago, Illinois
Your Speaker
  • Michael Pinto
  • CEO, Wonder Makers Environmental
  • CSP, CMP
  • Author of 5 books and 140 articles
  • Contributor to standards and courses
  • Experience
  • 29 years in safety, health, and environmental
  • MIOSHA, NSC, Consulting, FEMA MAT Team

2010 Business Mentors Summit Chicago, Illinois
The Most Important Fact About Your Speaker
  • No financial tie to any of the companies/products
    mentioned in the program
  • Other than Wonder Makers

2010 Business Mentors Summit Chicago, Illinois
A Talk About Healthcare Facilities
Methodist Hospital In Chalmette, Louisiana
Do You Really Want Hospital Staff Tackling
This?Nor Is It A Job For A Regular Carpet
Presentation Outline
  • The unique nature of healthcare environments
  • Healthcare acquired infections
  • Controlling hospital acquired infections during
    restoration or construction activities
  • Practical tips on how to prepare your
    organization to offer services to healthcare

2010 Business Mentors Summit Chicago, Illinois
1. Healthcare Is A Different Type Of Client
  • Consolidation of ill and injured individuals
  • Priority of patient care
  • Facility operation 24/7
  • Security/traffic concerns
  • Special building practices and systems
  • Detailed regulatory restrictions
  • High profile - Liability target

2010 Business Mentors Summit Chicago, Illinois
Have You Ever Wondered From A Business
  • Do we have critical skills and experience that we
    can bring to
  • Hospitals
  • Out patient treatment facilities
  • Medical offices
  • Nursing homes

Have You Ever Done Work In A Healthcare Facility?
  • Water restoration
  • Pump out, dry down, replacement of finish
  • Fire restoration
  • Clean-up, deodorizing, blasting, replacement
  • Mold remediation
  • Replace water stained ceiling tiles
  • Duct cleaning

Have You Seen A Poster Like This?
Does It Make You Wonder?
  • About the safety of yourself your crew
  • Exposure causing infection
  • About the impact your activities may have on the
    building occupants
  • Activity increasing infection potential for high
    risk groups such as sick, elderly, recovering
    surgery patients, etc.
  • Bacterial and fungal contaminants

2. Healthcare Acquired Infections
  • Are so common that they have their own name
    nosocomial infections
  • Estimated two million hospital-acquired
    infections per year
  • Estimated 100,000 deaths every year
  • 5 billion spent on hospital-acquired infections
    each year

Germs Hygiene Practices
  • Isnt the problem germs and personnel hygiene
  • If 50 of the nosocomial infections are caused by
    improperly washed hands or other touching
    (staphylococcus), what is the cause of the
    remaining 50?
  • Environmental cross contamination

Common Construction Contaminants
  • Bacterial
  • Legionella, Pontiac fever
  • Fungal
  • Aspergillus Aspergillosis
  • Penicillium Penicilliosis
  • Fusarium Fusariosis
  • Mucor Mucomycosis
  • Trichoderma Trichosporonosis

Contractors Poor Work Kills People!
  • 2001 Canadian Study
  • 32 cases, 154 deaths
  • Basis for many regulations and guidelines
  • CSA
  • APIC
  • Joint Commission

Was It The Construction?
  • On January 25th, 2005, a 29-week-old baby "died
    of an infectious disease''
  • Montreal Hospital moved premature babies out of
    neonatal wing as it scrambled to locate the
    source of infection
  • Fourth floor infant intensive care unit area
    undergoing renovations

18 Avoidable Deaths
  • Improper demolition controls
  • Removing false ceilings, HVAC ductwork, window
    frames and wall insulation
  • Aspergillus fumigatus exposure led to
  • 22 critical care patients sickened
  • Poor isolation of the work area identified as
    causing the spread of spores

Bad Work in Hospitals Still Happens
  • 2/4/09 AP Story
  • Florida lawsuit claims 3 kids died from hospital
  • St. Joseph's Hospital in Tampa
  • Pediatric cancer patients
  • Fungal infections at the facility
  • Hospital failed to properly seal off an area
    under renovation

Matthew J. Gliddon
Is There A Pattern?
  • Transplant HMO mortality rate in liver patients
  • 13 in health care facility undergoing renovation
  • no documented cases where no renovation was
    taking place
  • A tertiary care center
  • Average 9 rate in aspergillosis
  • No documented cases after development and
    enforcement of an extensive dust containment

Lawyers Understand the Connection
  • Spike in infection rates in patient care areas
    adjacent to a construction site
  • A containment or an impermeable barrier had not
    been erected windows had not been properly
  • Construction company was held partially liable

2009 University Of South Florida Study
  • Aspergillus infection deaths associated with
  • hospital construction,
  • maintenance,
  • demolition and renovation
  • contaminated fireproofing
  • air filters in hospital ventilation systems, and
  • via contaminated carpeting.

3. Proactive Prevention of Infections During
  • The American Institute of Architects advocates
    the use of
  • Infection Control Risk Assessments (ICRA)
  • Infection Control Risk Mitigation Recommendations
  • Plan your work, work your plan

Multiple Documents Standard of Care
  • Rules for facilities and patients
  • Center for Disease Control and Prevention (CDC)
  • Healthcare Infection Control Practices Advisory
    Commission (HICPAC)
  • Joint Commission on Accreditation of Healthcare
    Organizations (JCAHO)
  • American Institute of Architects (AIA)
  • Rules for Construction Workers
  • OSHA
  • Health Canada

Choosing Appropriate Safety Steps
  • Association of Professionals for Infection
    Control (APIC) Guidelines
  • Consider risk groups impacted by activities
    conducted in medical facilities
  • Four groups
  • Consider the type of work activity
  • Four categories
  • Matrix of procedures

Patient Risk Groups
Low Risk Medium Risk High Risk Highest Risk
Office Areas Cardiology Echocardiography Endoscopy Nuclear Medicine Physical Therapy Radiology/MRI Respiratory Therapy CCU Emergency Room Labor Delivery Laboratories (specimen) Newborn Nursery Outpatient Surgery Pediatrics Pharmacy Post Anesthesia Care Unit Surgical Units Any area caring for immuno-compromised patients Burn Unit Cardiac Cath Lab Central Sterile Supply Intensive Care Units Negative pressure isolation rooms Oncology Operating rooms including C-section rooms
Categorizing Construction Activity
  • Type A Inspection, non-invasive activities
  • Type B Small scale, short duration, minimal
    dust-generating activities
  • Type C Activities that generate moderate to high
    levels of dust, require greater than one work
    shift to complete
  • Type D Activities that generate high levels of
    dust, major demolition and construction
    activities requiring consecutive work shifts to
  • APIC definitions

(No Transcript)
Class I - Infection Control
  • Minimize dust
  • Replace ceiling tiles
  • Clean work area

Class II - Infection Control
  • Seal doors, vents, HVAC components
  • Air scrubber or filter
  • Dust control (mist or vacuum)
  • while working
  • Dust mat at entry
  • Covered waste during transport through building
  • Wet wipe with chemical
  • Wet mop and/or HEPA vacuum floors

Class III - Infection Control
  • Complete isolation of work area (room enclosure
    or control cube)
  • Negative pressure work via HEPA equipment
  • Waste in containers, then in covered carts
  • HEPA vacuum and wet wipe (HEPA sandwich)
  • Visual inspection by owner or third party
  • Controlled tear down

Class IV - Infection Control
  • Extra effort to seal all penetrations (do not
    rely on negative pressure to prevent dispersal of
  • Minimum 1 stage decontamination chamber
  • Use of shoe covers or disposable suits (new
    shoe/body covering every time in/out)

4. Practical Tips
  • Some important points for individuals and
    organizations working in, or planning on
    marketing to, healthcare facilities

Your Experience Is Valuable
  • There are many concepts, procedures, and pieces
    of equipment that restoration/remediation
    contractors use daily that are critical for
    infection control
  • Many general contractors are years behind the
    dust control curve
  • General contractors are often reluctant to use
    appropriate personal protective equipment
  • Verification of project cleanliness is not
    typical for construction but accepted for
    remediation and necessary for infection control

Educate Your Staff
Beth, I Need To Leave Early Today, Lets Clean
Just The White Squares!
2010 Business Mentors Summit Chicago, Illinois
90 Right Is Still 100 Wrong
  • Understand and appreciate the differences between
    restoration, mold remediation, and infection
  • Similar approach and equipment
  • More significant consequences for poor
    performance literally life and death
  • Do your homework
  • One 60 minute presentation does not make you an
  • Collect and read relevant resources

Plus Up
  • Adapt an ASARA attitude
  • As Safe As Reasonably Achievable
  • Go beyond the minimums
  • Substitute efficiency for higher costs to bring
    better value to the project
  • Clear and detailed company policies for work in
    healthcare facilities allows standardization that
    creates efficiency

Begin Your Marketing Now
  • Approach both contractors and healthcare
  • Explain that you understand the unique aspects of
    infection control
  • Become a pre-selected vendor for emergency
  • Sell your expertise
  • Set up and clean up while the contractor handles
  • Post-construction cleaning for the facility if
  • their staff is stretched
  • Specialized services such as duct cleaning

Remember Keep Your Priorities Straight
  • Protect yourself and your crew
  • Blood borne pathogen training and medical
  • Appropriate PPE every time
  • Hand sanitizing emphasis
  • Protect the occupants and patients
  • Effective isolation
  • Dust-free work, clean as you go
  • Control costs
  • Do it once, do it right!

If you would like more information, please
contact Wonder Makers Environmental P.O. Box
50209 Kalamazoo, Michigan 49005-0209 (888)
382-4154 fax (269) 382-4161
2010 Business Mentors Summit Chicago, Illinois
Shocking Statistics
  • Aspergillosis mortality rates have been reported
    as high as
  • 95 in bone marrow transplant patients
  • 13-80 in leukemia patients 
  • 8-30 in kidney transplant patients
  • Despite use of anti-fungal drugs, the outcome of
    transplant patients with aspergillosis continues
    to be grim

They Deserve the Best
  • Most susceptible people are those with
  • Immunosuppressive conditions (e.g., bone marrow
    or solid organ transplants)
  • Immunodeficiencies, AIDS
  • Dialysis, renal failure
  • Chronic pulmonary disease
  • Surgery
  • Diabetes
  • Age (e.g., neonates and very old)

General Guidelines Resources
  • APIC and Health Canada use a similar process to
    define minimum infection control practices for
    various types of restoration/construction
    projects in healthcare facilities
  • Categorize each construction activity (A through
  • Identify affected patient risk group for each
  • Follow minimum protocols

Dont Get Caught With Your Pants Down
Now I Know Why They Call It ICU!
(No Transcript)
(No Transcript)
Write a Comment
User Comments (0)