An outbreak can occur at any time and it is rarely expected. However, there is much that every facility can do to plan in advance what they might need and how they will respond. Being prepared will remove uncertainty at a critical time and ensure the facility can respond quickly and effectively. Each situation will vary depending on the specific circumstances but every infection prevention programme will most likely be based on a core set of tasks such as those outlined in our checklist below.
- Preparation/Risk Assessment: the best infection prevention programmes are developed before a crisis. It is critical to build a team that meets regularly and is empowered to make decisions for the facility. This team will identify potential gaps in how the facility would respond to specific challenges, such as an outbreak of Influenza, Ebola, or MERS. With COVID-19, for example, Diversey has created a comprehensive knowledge database that is packed with useful information that facilities can use to prepare and implement preventative measures and enhanced hygiene guidelines. After completing the risk assessment, the team should make recommendations to the facility. These might include, for example, adding more handwashing stations or larger storage capacity for any infection prevention supplies that might be needed. Modifications like these take time which is why it is always best to plan well before any possible outbreak. The team’s recommendations can also include ensuring there will be enough supplies of items such as disinfectants, disinfectant wipes, hand hygiene products, facial tissues, toilet paper, and extra waste bins to use during an outbreak.
- Vaccinations: providing and/or requiring employee vaccinations, wherever possible, helps to protect staff and prevent transmission of pathogens to guests/customers. Healthcare facilities in many countries now require their employees to have annual influenza vaccinations, for example. We encourage this in other sectors where practical.
- Communication Materials: signs and other communication materials are essential if a facility wants its customers/guests to perform certain behaviours such as washing hands or using hand sanitizers. Good designs will help the facility maintain high levels of compliance, instill confidence and enhance its reputation.
- Stock Supplies: if an outbreak should occur or there is a new pathogen of concern the facility will be able to respond much more quickly if it knows in advance what supplies will be needed and their lead times. Items to consider include cleaning products, disinfectants, hand hygiene products, disposable wipes, paper towels, waste bags and bins, toilet paper, bottled water, gloves, gowns, masks, and so on. Planning should include not just the items needed but how much to order and when to ensure continuity of supply. It can also be useful to plan for extra waste collections to deal with increased volumes.
- Hand Hygiene: frequent hand hygiene is the simplest and most cost effective way to prevent the spread of pathogens. Studies in healthcare settings demonstrate that access to hand hygiene is the best predictor of whether people will perform it frequently. Washing with soap and water is effective at removing viruses and other pathogens. If additional products such as antimicrobial hand rubs or gels are used it is vital to ensure they meet relevant standards and are effective against pathogens of concern. For example, SARS-CoV-2, the virus that causes COVID-19, is an enveloped virus. This type of virus is generally easy to kill. Hand hygiene products that meet the international EN 14476 virucidal standard (either fully virucidal or effective against Vaccinia virus) are effective against enveloped viruses.
- Surface Cleaners/Disinfectants: clean hands will not help stop the spread of infections if they then touch a dirty or contaminated surface. It is therefore critical to clean surfaces regularly using suitable products, disinfectants, and tools (eg cloths, spray bottles, etc) as part of an established daily routine. In the event of an outbreak or new pathogen of concern, it may be necessary to change products or increase the frequency of cleaning in the event of a new outbreak or pathogen of concern. Disinfectants that meet the requirements of the EN 14476 (either fully virucidal or limited virucidal or effective against Vaccinia virus) for example are effective against enveloped viruses like SARS-CoV-2.
- Cleaning Practices, Standards and Schedules
All facilities should have standard cleaning practices that should detail:
- Materials needed.
- Cleaning methods to use.
- Surfaces or equipment to be cleaned/disinfected.
- How much the cleaning frequency will be increased or otherwise modified in the event of an outbreak or emergence of a new pathogen of concern.
- Checklists and other work management tools prepared in advance to introduce enhanced cleaning if needed. The aim is to make sure there is no question of what to do – only when to start doing it.
Cleaning should include standard recommendations such as:
- Maintain a constant flow in a room to avoid contamination of cleaned surfaces.
- Perform hand hygiene before and after cleaning a room.
- Use PPE to protect staff from products being used (if appropriate) and any potential pathogens in the environment.
- Clean from high to low when practical.
- Clean from dry to wet when possible.
- Clean from cleanest to dirtiest to minimize the risk of contamination to more hygienic surfaces.
- Personal Protective Equipment: workers may need gloves, gowns, masks, and eye protection depending on the pathogens of concern. As with other parts of the facility’s plan, any PPE required should be decided in advance so that there are no questions or delays when it is needed. Staff will need training on how to use the PPE, including the correct way to put it on and take it off. Staff should also understand they need to complete effective hand hygiene before and after using PPE.
- Compliance Monitoring: many healthcare facilities have well-designed programmes to monitor hand hygiene, surface cleaning, and PPE usage compliance. This means that they are able to hold themselves accountable not just for having the correct policies but for also following them. Non-Healthcare facilities should consider if a similar approach to compliance monitoring will ensure staff are performing as expected to protect themselves and those around them.
Diversey has created a comprehensive knowledge database called “Enhanced Cleaning and Disinfection During and Post-COVID-19”. This extensive library includes information about the virus and the processes and products that will be effective against it. It is designed to help facilities plan their cleaning operations create safer, cleaner and healthier environments as they continue their operations or reopen after lockdown.
Contents in this article are applicable for Europe. Please liaise with your local Diversey representative for further information.