Making a Clean Sweep to Reduce HAIs
Janice Schandel, BSN
Mountainview Specialty Care Center
As director of nursing at a 137-bed long-term care facility, Janice Schandel, BSN, makes it her business to treat her residents like family. Her 2009 program to prevent an outbreak of H1N1 virus at the Mountainview Specialty Care Center (MSCC) resulted in long-term improvements in hand hygiene and surface cleaning, significant cost savings, and, most importantly, tremendous benefits to residents’ health.
Working with MSCC Infection Control Coordinator Kimberly Thomas, Schandel reviewed current practices on hand hygiene, as well as environmental cleaning and disinfection. Schandel and Thomas discovered that accessibility to both surface- and hand-germicidal products was an issue. Working closely with an interdisciplinary team, they identified key areas for surface- and hand-hygiene wipe installation. These included medication, treatment carts and housekeeping carts, as well as nursing stations, dining, therapy, activity, and public areas.
“Involving the staff was the key – once nurses are involved in a project, they take ownership,” said Schandel. A lid-color coding system, “red for the bed and blue for you”, made wipe identification easy. Following installation, three days of intensive educational outreach to staff, patients, and visitors brought the program to life.
“Project Clean Sweep” reduced the MSCC HAI rate from 2.42 percent to 0.55 percent between 2008 and 2009. The number of acute transfers due to infection dropped from 30 to eight, and antibiotic costs declined by more than 40 percent, totaling nearly $34,000 in savings. The program also reduced employee absenteeism from 1,349 hours to 792 hours over the same period. This resulted in significant cost savings for the facility, despite the expense of additional hygiene supplies.
Supplies for Project Clean Sweep cost approximately $600-700 per month, and cover 200 staff, patients and visitors. “Our annual return on investment in antibiotic cost alone was 4:1,” said Schandel. This successful pilot program has now been replicated at many Fundamental-owned facilities nationwide.
“Our facility is home for our residents. If we have an outbreak we have to close down dining facilities, activities, everything,” said Schandel. “This isolates the residents – and that’s something we try to avoid at all cost.”
Schandel presented a summary of her Project Clean Sweep program at the APIC 2010 annual conference in New Orleans (Abstract 8-080).