Background: Environmental cleaning is essential for the prevention of Clostridium difficile infection. However, data on the perspective of Environmental Services Staff (ESS) on barriers and facilitators to cleaning is limited. Using a systems engineering framework, we undertook focus groups of ESS at our VA facility to examine barriers and facilitators to C. difficile prevention and environmental cleaning.
Methods: Two focus groups each consisting of 7 ESS workers were conducted. Probing questions were developed using the the Systems Engineering Initiative for Patient Safety. Data were transcribed and analyzed using inductive and deductive methods.
Results: ESS workers identified themselves as playing a critical role in prevention of nosocomial transmission of C. difficile. However, they called themselves "the invisible staff" because of perceived lack of recognition by others of this role. Major barriers identified for daily cleaning included room clutter, interruptions to the work flow and time constraints.
Conclusion: ESS workers play an essential role in prevention of healthcare-associated infection especially C. difficile. They should be included in multidisciplinary teams dedicated to reducing C. difficile infection. A systems engineering approach may be useful in identifying and removing barriers to ESS roles.
H. Moriarty, None
L. McKinley, None