Environmental cleaning and disinfection: Sustaining changed practice and improving quality in the community hospital.

Objective: Short-term improvements in hospital room cleaning can readily be achieved but are difficult to maintain. This is particularly true for high-risk, "high-touch" surfaces. Therefore, we embarked on a process to sustain improvements in surface cleaning and disinfection to reduce hospital-acquired infection (HAI) rates. Interventions: Our environmental services (EVS) and infection prevention departments incorporated a formal education, monitoring, and feedback process for focused cleaning and disinfection of high-touch surfaces into their routine policies and procedures in 2011. Cleaning validation was performed by infection prevention liaison nurses using a fluorescent targeting method to evaluate the thoroughness of cleaning. Results: Surface cleaning performance on medical-surgical units in 2011 was 74.7%, but this rate incrementally increased in response to the interventions and has been sustained at >90% for the past 6 years. Similar patterns of improvement were observed in the operating room, labor and delivery, endoscopy suite and cardiac catheterization laboratory. Conversely, HAI rates, particularly C. difficile rates, decreased by 75% and surgical site infection rates decreased by 55%. Conclusions: EVS training, monitoring, and feedback interventions, instituted 10 years ago have enhanced our environmental cleaning and disinfection efforts in multiple areas of the hospital and have been sustained to the present. Although other concurrent initiatives to reduce infection rates also existed, the improvements in environmental cleaning were associated with dramatic reductions in HAI rates over the 10-year period.

Precipitous Fall in Common Respiratory Viral Infections During COVID-19.

In the midst of the coronavirus disease 2019 (COVID-19) pandemic, we were surprised to find that all other respiratory viral infections fell precipitously. The difference in respiratory viral infections during the 16-week period of our peak COVID-19 activity in 2020 (Centers for Disease Control and Prevention weeks 14-29) was significantly lower than during the same period in the previous 4 years (a total of 4 infections vs an average of 138 infections; P < .0001). We attribute this to widespread use of public health interventions including wearing face masks, social distancing, hand hygiene, and stay-at-home orders. As these interventions are usually ignored by the community during most influenza seasons, we anticipate that their continued use during the upcoming winter season could substantially blunt the case load of influenza and other respiratory viral infections.