A “Washing Prescription” Is Required For Effective Infection Prevention
The message may be applied to any building... Home, School, Church, Office, Gym, Restaurant, etc.
The other day, our local newspaper featured a story about how our local hospitals and nursing homes are in a “you’re the problem” finger-pointing catch-22 professional squabble. The funny part (if something can be funny about deadly infections) is that everyone interviewed found fault with the answers of some of their peers—some thought the answer was just MORE MONEY from the State. In fact, one of the administrators interviewed for the story was someone with whom I met about five years ago over my concern with the sanitation of his nursing home. A relative of mine was a resident and every time I paid a visit, I would cringe over the way housekeeping misused their cleaning chemicals. When I presented my concerns to the administrator and explained the seriousness of the sanitation problem in relation to being the root cause of infections, he thought for a minute, realized that I was on to something for which he lacked knowledge, and literally, as they say in street lingo, “blew me off”. He looked at his watch, said he was late for an appointment, and saw me to the door.
Recently, a relative told me about her aging sister who lives at a well-respected nursing home who acquired an infection that placed her in quarantined status—visitors had to gown up, wear booties, a mask, and gloves in order to enter the resident’s room. I happen to know the president of the nursing home. The president has nursing and management degrees but, most likely, never took a class in the art of cleaning. A few years ago, I tried to engage that particular president in a discussion about facility sanitation issues and the subject was abruptly changed and never re-visited.
Let’s get back to the newspaper article. Twenty-nine percent (29%) of the people who should be released from all of the hospitals in our city cannot go home because they acquired infections during their stay at the hospital. Interviewed nursing homes said that “infectious disease was a problem in accepting patients 41% of the time”. The facts are detailed and the leadership people are interviewed and quoted, but the epidemic goes on. The New England Journal of Medicine reports that each year over two million people in America are inflicted with hospital-acquired infections and 90,000 of them die from their infection. My take is that we are having a Megademic.
Why does the Megademic continue without a solution in sight? Because facility managers have been misinformed and misguided by the giant chemical manufacturers and their sales forces for about a half century—the teachings of the Dirt Doctors at Gabriel, yet simple, may be hard to accept as being true because they fly in the face of what has been ingrained by the big guys—kill, kill, kill germs instead of the Dirt Doctors' message of wash, wash, wash the surface clean. If they were to share the truth and practice accordingly, the giant chemical companies would have to give up 70% (as we do) of their custodial chemical sales to each customer. Don’t hold your breath waiting for that moment to happen.
And, understandably, because the Dirt Doctors sell their own line of custodial chemicals, a manager’s mind may think the advice is slanted. But, if the healthcare facility managers with severe infection problems would spend an hour or two checking with the Dirt Doctors’ medical facility clients, they would see that the Dirt Doctors may be right in a real big way. For almost a half century, everyone has been listening to the “advice” of the giant chemical manufacturers and the problem has grown exponentially. Yet, the healthcare facilities that listen to the Dirt Doctors aren’t “cursed” with the infection Megademic.
My brother and I have had hundreds of conversations with medical doctors, physicists, biologists, chemists—anyone willing to talk with us about microorganisms. The parting words from most of those gracious and patient people, here paraphrased, "you have a most interesting perspective on germs and with all my years of education, I never looked at the facts from a janitor’s perspective. Thank you for the insight." My brother and I added what we learned from the science people to what we learned from being janitors and eventually the "I got it" light went on in our minds.
Why does the infection Megademic continue, you ask? Because the exalted healthcare leaders are convinced that the world is flat and that the answer for eradicating the infection Megademic will only come from the minds of medical people. No insult intended, but the subject seems to be quickly changed or we're told why we are wrong whenever we try to engage a healthcare leader in a discussion about preventing facility-acquired infections. Some times we did get smiles, pacification, and no follow through. I usually walk away from such conversations wondering why is a process so simple to perform so complicated for someone to understand. Germs must live with their food source (soil). So if you wash the soil away, so go the germs. Nothing is perfect, but it works—for Louis Pasteur, Grandma, and you.
Louis Pasteur discovered that germs cause infectious diseases. He offered a simple solution for medical sanitation by urging doctors to “wash their hands thoroughly with soap and water” in order to remove the soil containing deadly germs. After years of my chemist brother and I running a janitorial service and trying to use disinfectant detergents to clean “dirty” surfaces, we too came to the conclusion that Pasteur was “right on”. When we became a national cleaning products vendor, we carried the teaching to our customers—wash surfaces thoroughly with residue-free cold water detergents to end up with surfaces virtually free of infection-causing germ colonies.
We oppose cleaning chemical manufacturers who push the use of disinfectant detergent solutions for washing “dirty” surfaces because they leave an after-film that holds onto soil particles in the washing solution and helps collect new soil. We teach custodians that a disinfectant solution is only to be applied to medical treatment surfaces such as operating tables and only after the surface has been washed and rinsed well. Disinfectant-detergent solutions leave a germicide film that remains active for a few hours in order to zap airborne germs that land on the surface prior to it being used. The process needs to be repeated after each medical use—also referred to as a “one-time use surface”.
We teach to never use a disinfectant detergent solution thinking that one can simultaneously remove all of the soil and kill germs on a “dirty” surface. There would be too many germs to kill and the disinfectant film used to catch and hold airborne germs will cause some of the soil floating in the “dirty” wash water to stick back onto the surface. The “left behind” soil contains surviving germs that are resistant to the solution and exponentially more lethal. The next time the process is repeated, the surviving germs become even more resistant—and so on. Custodians trained and equipped to remove all of the soil are the FIRST line of defense against the spreading of potentially deadly germs. Ignoring nature’s law is a recipe for deadly epidemics.
For example, when a floor is not washed 100% clean (as humanly possible), “dirt” film remains behind and continues to build after each incomplete washing. Abrasion from facility traffic or polishing machines pulverize the “dirt” film into airborne micro-sized dust particles with dormant germ spores on board. The spores get ingested into someone’s bronchiole system and whammo—an infection. The dormant germs come alive when they make contact with a body’s moisture and nourishment—the host person can become a healthcare facility-acquired infection statistic. When open incisions or wounds make contact with a surface containing a “left behind” soil film, the germs in the soil (“dirt”) "make the jump" to where the nourishment is even better—the innocent victim’s body and again, whammo—a scenario for an infection. Important: Healthcare-acquired infections are usually the most deadly because healthcare facilities are notorious for using disinfectants as though they're "holy water" germ killers—thus the ratio of disinfectant-resistant germs is dangerously high when compared to the germ ratios of surfaces where disinfectants are not used. Couple the use of disinfectant-detergent for cleaning with the array of antibiotics found in healthcare settings and the potential for deadly infections are generally "off the charts". There is nothing more fateful than a custodian made to use a disinfectant washing solution to remove "dirt" in a kitchen or on a food service cart. Probably one of mankind's best ways to run a breeding farm for the deadliest germs—then comes bathrooms followed by floors and, lastly, all other surfaces.
Similar infection problems surface in schools, child care facilities, nursing homes, on airplanes, public lodging, restaurants, food processing plants, and health clubs. Also, think of the number of people who just visit a healthcare facility and go home to come down with infections and may never get counted into the statistics.
After proofreading a draft of this essay, a friend asked me, "With so many people going into hospitals with infections, how much do their germs contribute to infecting others? That was a great question, so here is how I feel the question needs to be answered: Once a germ leaves someone, it has to quickly attach to another living food source (somebody else) or land on soil so it can keep it's food stream alive. If healthcare facilities are not thoroughly removing soil "dirt" each time they "wash" a surface, germs take up residence in the "left behind" soil until they can make it to a new living host. So, the bottom line is that healthcare facilities need to wash soil from surfaces rather than perform the traditional routine of "trying" to kill the germs on "dirty" surfaces. They also need to make sure that their floors are free of soil or disinfectant film (should not be using a disinfectant solution for mopping floors) at all times in order to prevent the surface film from being pulverized by traffic and polishing machines. The pulverized dust carry germ spores that can wait virtually forever until a living host ingests it and then, whammo—an infection. Air filtration systems play a key roll in preventing the incident of infection—the cleaner the facility, the easier it is on the air filtration system. The next time you are walking down a hallway of a healthcare facility, pass your hand over the walls. If you find dust on the walls, remember that there are germ spores in that dust waiting for a living host—something like instant coffee waiting for hot water... Then, whammo—an infection! I realize that a facility cannot be made "perfectly" clean, but the cleaner a facility is, the less soil there will be to house germs until they find a living host. Keeping soil to a minimum will win the war against facility-acquired infections.
From a dollar and cents perspective, going to the root cause of infections and minimizing the number of incidents will free up billions of dollars for better healthcare, as well as reduce malpractice claims, facility upkeep costs, and lost work time. Think of the pain, suffering, and anguish that will no longer have to be endured by the inflicted and those losing loved ones.
Ending the infection Megademic is quite simple—If It’s Clean, It’s Sanitary® The Gabriel Art of Cleaning Starter Kit has Fast-1-2-3 all-purpose and Walls ‘N All bathroom cold water detergents (no disinfectant detergent), Crème Cleanser, brushes, other items, and Audio-Video Training Library that will help you achieve washing excellence for less than half of your present costs.
Gabe Zanche, Sr. - Co-Founder of Gabriel First Corp. Copyright © 2006 Gabriel First Corp.
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