enhancing leadership and facilitation skills relative light unit (rlu) readings ... 400 500 600 700...

Diane G Dumigan RN BSN CIC FAPIC

Consultant DGDumigan Consulting LLC

George G Dumigan MS

Vice President of Sales and Marketing

New Haven Consulting Group Inc

Enhancing Leadership and

Facilitation Skills

8TH ANNUAL ILLINOIS

STATEWIDE CONFERENCE ON

HEALTHCARE-ASSOCIATED

INFECTIONS

SESSION ONE

CREATING EFFECTIVE AND SUSTAINABLE HOSPITAL

POLICIES THE WHO WHAT WHEN AND HOW

This session will discuss ways to facilitate policy

development educational programs and methods to

sustain success

Learning objectives

At the completion of this session participants will be able to

Describe at least two quality tools used to analyze healthcare

environmental cleaning problems

Create effective policy development teams

Adapt methods to sustain success

FOCUS-PDCA

bull Find a process to

improve

bull Organize a team that

knows the process

bull Clarify current

knowledge of the

process

bull Understand sources

of process variation

bull Select the process

improvement(s)

Plan

Improvement(s)

Do

data collection

data analysis

Check

data analysis

team voiceopinions

lessons learned

Act

to hold gain

to continue

improvement(s)

QUALITY TOOL 1

SYSTEM SKILLS

Use data to find failures

Opportunities to improve

Devise solutions

Staff responsibilities standardize process

measure for results

Implementation

The great challenge

FIND A PROCESS TO IMPROVE


Be Brave bring data to CEO CFO CNO

andor Medical Director

Need support from the very top of the organization

to make change

000

100

200

300

400

EXAMPLE OF A PROCESS TO IMPROVE

ENVIRONMENTAL CLEANING

Infect Control Hosp Epidemiol 2007 Oct28(10)1142-7 Epub

2007 Aug 3

Widespread environmental contamination associated

with patients with diarrhea and methicillin-resistant

Staphylococcus aureus colonization of the

gastrointestinal tract

Boyce JM1 Havill NL Otter JA Adams NM

Infect Control Hosp Epidemiol 2008 Aug29(8)723-9 doi

101086589906

Impact of hydrogen peroxide vapor room

decontamination on Clostridium difficile environmental

contamination and transmission in a healthcare setting

Boyce JM1 Havill NL Otter JA McDonald LC Adams

NM Cooper T Thompson A Wiggs L Killgore G Tauman

A Noble-Wang J

ATP Bioluminescence Method

Step 1 Step 2 Step 3

Use special swab Place swab in reaction tube Place tube in luminometer

to sample surface

MEDIAN RELATIVE LIGHT UNIT (RLU) READINGS

AFTER DAILY CLEANING PHASES I

0

100

200

300

400

500

600

700

800

Bedrail OverbedTable

TVRemote

Grab bar ToiletSeat

Re

lati

ve

Lig

ht

Un

its

Phase I

Boyce JM et al ICHE 200930678

ORGANIZE A TEAM THAT KNOWS THE PROCESS

Facilitator - IP- Manage logistics keep team on task

Chair - Hospital Epidemiologist Chief Medical or Nursing

Officer CEO CFO-Someone with AUTHORITY to make

change

Directors of departments that will be affected by change

Frontline workers that know the problems and how the

system ldquoreallyrdquo works ldquothe tip of the spearrdquo

Caveat Diversify donrsquot be afraid of complainers you will

learn the most about yourself as a leader from them

A FEW WORDS ABOUT

PLANNING EFFECTIVE MEETINGS

Who will do what Pre-plan so roles are clear

IP as facilitator

Set goals and communicate clearly

Get agreement from team on frequency of meetings

Weekly or bi-weekly to start

Use sub-committees for effective time management

Get commitment from sub-committee chairs

Plan agendas

Assign speakers

Assign time for each topic (and a timekeeper)

HOUSEKEEPING TEAM

CLARIFY CURRENT KNOWLEDGE OF THE PROCESS

Infection Preventionist

Hospital Epidemiologist

Directors of Nursing

Nursing Care Coordinators

Nurse Educators

Director of Environmental Services

Environmental Services Supervisors

Housekeepers

QUALITY TOOL 2

CHOSE A QUALITY IMPROVEMENT MODELISHIKAWA DIAGRAM CAUSE AND EFFECT DIAGRAM FISHBONE DIAGRAM

CHOSE A QUALITY IMPROVEMENT MODEL

AFFINITY DIAGRAM QUALITY TOOL 3

UNDERSTAND SOURCES OF PROCESS VARIATION

Easy to use

Handout post-it notes

Everybody gets to participate

Done in silence

Take about 15 minutes to write out each concern One concern per post-it note

Sort and group concerns

Get agreement from group they are sorted correctly

Vote on most important concerns to work on first

Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning

bull We donrsquot have

enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time

bull How will managers

allow extra time if

needed

bull How will everyone

be trained to do

the same thing

bull Where will soiled

ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated

bull Will we be fired

SELECT THE PROCESS IMPROVEMENTS

EXPANDED TEAM





Nurse Educators



Housekeepers

Biomedical Engineers

Pharmacist (Manager of Infusion Pumps)

Materials Management Personnel

OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE

ITEMS TO BE CLEANED PRODUCTS USED TO

CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge

2spot clean furniture (chairs)

3wipe down over-bed table

4wipe down side rails

5wipe down TV control

6wipe down bathroom fixtures (faucets grab bar

shelf etc)

7clean sink and toilet

8wipe down door handles (room and bathroom)

9mop bathroom and patient floor

10remove trash

1 ndash 9 EPAICC hosp quat

or

1 - 8 EPAICC hosp

bleach wipe for Contact

CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services

1clean bed frame side rails mattress (after nursing

has stripped bed of all linen)

2clean bedside table over bed table phone call bell

TV control

3wipe down flow meters

4wipe down regulators

5dustclean lighting fixtures

6clean outside canister (clean) of suction container

7clean and wipe down IV poles and pumps that need

to remain on the unit apply sani-strip para

8wipe down furniture

9dust all ledges

10clean around sharps containers and glove boxes

11wipe down step stools

12wipe down walkers

13wipe down canes

14clean bedside commode (once emptied by

nursing) apply sani-strip

15clean bathroom fixtures sink shower and toilet

apply sani-strip


17pull trash

18change out privacy curtains if soiled or on request

1 - 16 EPAICC hosp

quat

or

1-15 EPAICC hosp bleach

wipe for Contact CD and

Enteric Precautions

16 EPAICC hosp quat

para see cleaning

instructions provided by

Clinical Engineering

below

apply sani-strip see

notes below

8 Step

Discharge

cleaning process

CLEANING CHART FOR ENVIRONMENTAL AND

NURSING SERVICES

Dumigan DG et al AJIC 200938387

EQUIPMENT TAG

Method Advantages Disadvantages

Visual inspection Simple Not reliable measure

of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed

Can improve practices

Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive

Results not available

for 48 hrs later

ATP

bioluminescence

assay systems

Provides quantitative

measure of cleanliness

Quick results


More expensive

Requires special

equipment

ACT TO CONTINUE TO IMPROVE PROCESS

Methods for Assessing Cleaning Practices




to sample surface

Fluorescent Marker System

ACT TO CONTINUE TO IMPROVE PROCESS Median Relative Light Unit (RLU) Readings After Daily

Cleaning Phases I and II


P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)

Samples taken Chronologically

Table

Light

Moniter

Phone

Handle

Surfaces lt 200 RLU are considered clean

OR Manager Vol 27 No 7 July 2011

ACT TO CONTINUE TO IMPROVE PROCESS ATP RLU VALUES OF FIVE HIGH TOUCH SURFACES SAMPLED

OVER THREE MONTHS IN AN OPERATING ROOM

MULTIPLIER DIMINISHER

Talent Magnet

Attracts talented people and uses them

at their highest point of contribution

Liberator

Creates an intense environment that

requires peoplersquos best thinking and

work

Challenger

Defines an opportunity that causes

people to stretch

Debate Maker

Drives sound decisions through

rigorous debate

Investor

Gives other people the ownership for

results and invests in their success

Empire Builder

Hoards resources and

underutilizes talent

Tyrant

Creates a tense environment

suppresses peoplersquos thinking and

capability

Know-It-All

Gives directives that showcase

how much they know

Decision Maker

Makes centralized abrupt

decisions that confuse the

organization

Micro-Manager

Drives results through personal

involvement

Wiseman L Multipliers How the best leaders make everyone smarter HarperCollins 2010

RESOURCES

Centers for Disease Control and Prevention Guideline for Disinfection and Sterilization Available at

httpswwwcdcgovinfectioncontrolguidelinesdisinfectionindexhtml Accessed July 26 2017

Centers for Disease Control and Prevention Guideline for Environmental Infection Controlvailable at

httpswwwcdcgovinfectioncontrolguidelinesenvironmentalindexhtmle Accessed July 26 2017

Minnesota Hospital Association Environmental Services Cleaning Guidebook Available at

httpwwwmnhospitalsorgPortals0DocumentsptsafetyCDICleaning420Environmental20Services20C

leaning20Guidebookpdf Accessed July 26 2017

Shore Health System University of Maryland Medical System Administrative Policy amp Procedure for Cleaning Environment Patient

Equipment and Medical Devices Sample Policy Available athttpcleanspacessiteapicorgfiles201202Equipment-cleaning-policy-

LDpdf Accessed July 26 2017

Centers for Disease Control and Prevention Options for Evaluating Environmental Cleaning Available at httpswwwcdcgovhaitoolkitsevaluating-environmental-

cleaninghtml Accessed July 26 2017

Guh A Carling P Environmental Evaluation Workgroup Division of Healthcare Quality Promotion National Center for Emerging Zoonotic and Infectious Diseases Options

for evaluating environmental cleaning Available at httpswwwcdcgovhaipdfstoolkitsEnviron-Cleaning-Eval-Toolkit12-2-2010pdf Accessed July 26 2017

Virginia Department of Health Frequently Asked Questions about Cleaning and Disinfection Fact Sheet Available at

httpwwwvdhvirginiagovcontentuploadssites3201603Environmental-Cleaning-Fact-Sheetpdf Accessed July 26 2017

Centers for Disease Control and Prevention Environmental Checklist for Monitoring Terminal Cleaning Available at httpswwwcdcgovhaipdfstoolkitsEnvironmental-

Cleaning-Checklist-10-6-2010pdf Accessed July 26 2017

Agency for Healthcare Research and Quality Environmental Cleaning for the Technical Brief Number 22 Prevention of Healthcare-Associated Infections Available at

httpswwweffectivehealthcareahrqgovehcproducts5922103healthcare-infections-report-150810pdf Accessed July 26 2017

Association for Professionals in Infection Control and Epidemiology (APIC) APIC Text cleaning disinfection sterilization Available at

httptextapicorgtocbasic-principles-of-infection-prevention-practicecleaning-disinfection-and-sterilization Accessed July 26 2017

Association of periOperative Registered Nurses (AORN) Recommended practices for environmental cleaning In 2014 perioperative standards and recommended practices

Available at httpwwwaornstandardsorgcontent1SEC18body Accessed July 26 2017

THANK YOU


Consultant

DGDumigan Consulting LLC

100 York Street Suite 4C New Haven CT

06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS



1077 Bridgeport Avenue Shelton CT 06484

Office203-926-1525

GdumiganNHCGcom

SESSION ONE

CREATING EFFECTIVE AND SUSTAINABLE HOSPITAL

POLICIES THE WHO WHAT WHEN AND HOW

This session will discuss ways to facilitate policy

development educational programs and methods to

sustain success

Learning objectives

At the completion of this session participants will be able to

Describe at least two quality tools used to analyze healthcare

environmental cleaning problems

Create effective policy development teams

Adapt methods to sustain success

FOCUS-PDCA


improve


knows the process


knowledge of the

process




improvement(s)

Plan

Improvement(s)

Do

data collection

data analysis

Check

data analysis

team voiceopinions

lessons learned

Act

to hold gain

to continue

improvement(s)

QUALITY TOOL 1

SYSTEM SKILLS



Devise solutions


measure for results

Implementation

The great challenge






to make change

000

100

200

300

400




2007 Aug 3







101086589906






A Noble-Wang J




to sample surface



0

100

200

300

400

500

600

700

800


TVRemote

Grab bar ToiletSeat

Re

lati

ve

Lig

ht

Un

its

Phase I






change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

FOCUS-PDCA


improve


knows the process


knowledge of the

process




improvement(s)

Plan

Improvement(s)

Do

data collection

data analysis

Check

data analysis

team voiceopinions

lessons learned

Act

to hold gain

to continue

improvement(s)

QUALITY TOOL 1

SYSTEM SKILLS



Devise solutions


measure for results

Implementation

The great challenge






to make change

000

100

200

300

400




2007 Aug 3







101086589906






A Noble-Wang J




to sample surface



0

100

200

300

400

500

600

700

800


TVRemote

Grab bar ToiletSeat

Re

lati

ve

Lig

ht

Un

its

Phase I






change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

SYSTEM SKILLS



Devise solutions


measure for results

Implementation

The great challenge






to make change

000

100

200

300

400




2007 Aug 3







101086589906






A Noble-Wang J




to sample surface



0

100

200

300

400

500

600

700

800


TVRemote

Grab bar ToiletSeat

Re

lati

ve

Lig

ht

Un

its

Phase I






change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom






to make change

000

100

200

300

400




2007 Aug 3







101086589906






A Noble-Wang J




to sample surface



0

100

200

300

400

500

600

700

800


TVRemote

Grab bar ToiletSeat

Re

lati

ve

Lig

ht

Un

its

Phase I






change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

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tive L

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Bedrail Overbed

Table

TV

Remote

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0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

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P R

ea

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Table

Light

Moniter

Phone

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Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom




2007 Aug 3







101086589906






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to sample surface



0

100

200

300

400

500

600

700

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change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

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Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

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Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

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RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom




to sample surface



0

100

200

300

400

500

600

700

800


TVRemote

Grab bar ToiletSeat

Re

lati

ve

Lig

ht

Un

its

Phase I






change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom



0

100

200

300

400

500

600

700

800


TVRemote

Grab bar ToiletSeat

Re

lati

ve

Lig

ht

Un

its

Phase I






change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom





change






A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

A FEW WORDS ABOUT



IP as facilitator






Plan agendas

Assign speakers


HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

HOUSEKEEPING TEAM






Nurse Educators



Housekeepers

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

QUALITY TOOL 2





Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

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Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

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100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

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Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom




Easy to use



Done in silence





Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

Who cleans

what

What gets

cleaned

what product

will be used

How much time

will be allowed for

cleaning

How will everyone

be trained in

process

How will we

know if

equipment is

clean or soiled

bull Is it nursing

or EVS

bull What about

pumps and

special

equipment

bull What if pt

doesnrsquot want

us to touch

their bedside

equipment

bull What about

the OR

bull Do we make our

own solutions

bull How often are

mops changes

bull When do we use

bleach

bull Can we use

bleach wipes

bull How many

wipes or rags do

we use

bull Where in room

do we start

cleaning


enough time to

clean now


enough staff

bull Do we change

curtains When do

we change them

Will we be given

enough time


allow extra time if

needed


be trained to do

the same thing


ldquorollingrdquo

equipment be

cleaned

bull How will we

know if

equipment is

clean or soiled

bull How will our

cleaning be

rated



EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

EXPANDED TEAM





Nurse Educators



Housekeepers




OR Personnel

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

TYPE OF

CLEANING

RESPONSIBLE

SERVICE


CLEAN

COMMENTS

ROUTINE DAILY

CLEANING OF

PATIENT ROOM

Environmental

Services

1dust window ledge






shelf etc)




10remove trash


or

1 - 8 EPAICC hosp


CD and Enteric

Precautions

9 EPAICC hosp quat

8 Step daily

cleaning process

TRANSFER

DISCHARGE

CLEANING OF

PATIENT

ROOM AND

ANY PATIENT

ROOM AT

NURSErsquoS

REQUEST

(WHEN ROOM

IS EMPTY)

Environmental

Services




TV control








9dust all ledges



12wipe down walkers

13wipe down canes




apply sani-strip


17pull trash


1 - 16 EPAICC hosp

quat

or



Enteric Precautions

16 EPAICC hosp quat

para see cleaning



below


notes below

8 Step

Discharge

cleaning process


NURSING SERVICES


EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

EQUIPMENT TAG



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom



of cleanliness

Fluorescent

marker system

Inexpensive

Minimal equipment

needed


Must mark surfaces

before cleaning and

check them after

cleaning

Aerobic colony

counts

Relatively simple

Detects presence of

pathogens

More expensive


for 48 hrs later

ATP

bioluminescence

assay systems



Quick results


More expensive

Requires special

equipment






to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom




to sample surface





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom





P lt 001 lt 0001 02 002 87

0

100

200

300

400

500

600

700

800

Rela

tive L

igh

t U

nit

s

Bedrail Overbed

Table

TV

Remote

Grab bar Toilet

Seat

Phase I Phase II

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

0

50

100

150

200

250

300

350

400

450

500

0 5 10 15 20 25

AT

P R

ea

din

gs (

RL

U)


Table

Light

Moniter

Phone

Handle






Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom


Talent Magnet



Liberator



work

Challenger


people to stretch

Debate Maker


rigorous debate

Investor



Empire Builder



Tyrant



capability

Know-It-All


how much they know

Decision Maker



organization

Micro-Manager


involvement


RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

RESOURCES

























THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom

THANK YOU


Consultant



06511

Cell 203-530-2172

Dgdumiganaolcom

George G Dumigan MS




Office203-926-1525

GdumiganNHCGcom