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Green Cleaning in Hospitals: Cleaning To Protect Health Without Harming The Environment
Green Cleaning in Hospitals: Cleaning To Protect Health Without Harming The Environment
Mission: Green the cleaning industry We do NOT see ourselves at advocates. Rather, we aspire to be transformers. Clients include building owners, contract cleaning services, product manufacturers, policy makers, environmental organizations, and others.
Never doubt that a small group of thoughtful committed citizens can change the world. In fact, its the only thing that ever has.
Margaret Mead
Overview
Essential to have top management support for implementing green cleaning Recommend having a team to come together to make changes in cleaning products and practice
Administrator, president, marketing, community relations Environmental services, purchasing, infection control, GPO, others
Who What products are being used What do products cost When Where are they being used (are the same products used everywhere?) How Frequency Training and communications how often, issues Are there other opportunities for improvement
H2E Green Cleaning Presentation
In-house Services
Out-sourced Services
Green Products: Products that reduce impacts on health and the environment when compared to similar products used for the same purpose. E.O. 13101 Green Cleaning: Cleaning to protect health (patients/occupants, staff, administrators, and visitors) without harming the environment. AG
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20% are eye and skin burns (chemical exposures) Muscular/skeletal injuries (ergonomics)
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3,350,000 residents 2,000,000 staff (full and part time) 660,000 patients (per day) 4,535,000 staff (full time equivalents) 100,000 hospital trainees Visitors???
Hospitals
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Nosocomial Infections
2,000,000 (About 5.7%) of all Patients Admitted to U.S. Hospitals Acquire These Infections. 3.8% of Nosocomial Infections are Fatal 70,000+ People Die Every Year From Nosocomial Infections Approximately one-third are preventable $$$$$
This is NOT an indictment of the cleaning industry. We know how to clean. We just need the budget, time and tools to do the job right.
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Evaluate how facility is defined for cleaning purposes All one level?
(ASTM E1971-89 Standard Guide for Stewardship for Cleaning Commercial and Institutional Buildings)
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Typically in a hospital..
An important first step is to evaluate how the risk areas are defined and identified. You can probably reclassify many areas as low risk areas, which in turn can reduce resources, impacts and costs.
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Exterior maintenance Administration Areas, accounting, records, HR, etc. Patient registration and waiting areas Shops, carpentry, mail, printing, materials management Hallways
Restrooms (public) Nursery Clinics, outpatients, diabetes, respiratory Rehabilitation, physical therapy, cardiac rehab
Emergency Labor and Delivery Morgue Surgery
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Monitor pests and weeds Use local plants adopted for the site Use mulches and replenish as necessary Train weed-eater operators not to damage trees Use ice melters before precipitation begins and use to break bonds to remove by shoveling and plowing (not intended to melt the ice or snow) Consider closing redundant entrances Switch from sodium and calcium chloride to potassium and magnesium chloride and dont over apply Use environmentally preferable exterior cleaning chemicals and dispose properly
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Provide adequate and secure storage areas with appropriate plumbing and chemical dispensing equipment
Have a plan to maintain the dispensers Provide training on appropriate chemical storage
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www.greenseal.org
Use low VOC products for other categories MSDS full disclosure Use concentrates with dispensing equipment Increase the life of finishes Use metal-free floor finishes Maintain a log of all cleaning activities Train cleaning personnel
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All microorganisms are not bad and we do not want to sterilize the world! Some antimicrobial products may increase resistance Good physical cleaning of environmental surfaces often is enough All antimicrobials are not bad and they are an important tool in the toolbox
Use disinfectants only where they are necessary and select the appropriate product. One size does NOT fit all needs. Cleaning personnel are smart enough to use multiple products.
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Risk Continuum
Very effective antimicrobial Corrosive to eyes and skin Damage floor finishes, carpets, clothing, etc. Respiratory irritant Environmental concerns from production, contaminants, byproducts Mixing can create poisonous gas
Phenols
Effective against TB HBV assumed Corrosive to eyes and skin Damage floor finishes and other surfaces Strong pungent odor respiratory irritant Environmental concerns. Possible estrogen mimic. Typically not effective against TB or HBV Less toxic then Phenols eye, skin and surface corrosivity Toxic to aquatic life
EPA Sanitizer. Not a disinfectant. Superior health & environmental profile compared to phenols and quats
H2E Green Cleaning Presentation
Quats
Peroxide
Low
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Purpose of product is to kill hepatitis B, but there was no EPA approved testing methodology, so Surrogate test is killing of M. tuberculosis - if solution can kill M. TB, it will kill hepatitis B
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Janitorial Equipment
www.carpet-rug.com
Extraction equipment remove sufficient moisture to dry carpet in 24 hours Buffers & burnishers with vacuum attachments Propane equipment have high-efficiency, low emission engines Auto scrubbers equipped with variable-speed pumps Battery-powered equipment environmentally preferable batteries (gel batteries) Ergonomic equipment Maintain an equipment log
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www.epa.gov/cpg/products.htm Toilet tissue: 20% minimum PC content Paper hand towels: 40% minimum PC content Industrial wipes: 40% minimum PC content Facial tissues: 10% minimum PC content Plastic trash liners: 10% minimum PC content
Processed chlorine free Large rolls Hands-free dispensers that limit paper Micro-fiber cloths, mops and bonnets Recycled containers, buckets, carts, mats, etc.
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Landscape to eliminate safe havens Prevent pests from entering the building Eliminate food and moisture Monitor for pests before they become a problem Eliminate clutter
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-excerpt from Integrated Pest Management, by Wayne Warren American Society for Healthcare Environmental Services Professional Development Series
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Occupant Recycling
Establish a waste reduction and recycling program that addresses the separation, collection and storage of materials for recycling including (at a minimum) paper, glass, plastics, and metals Encourage a high level of recycling by building occupants
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Insanity has been defined as doing the same thing over and over and expecting a different outcome. Negligence is defined as doing the same thing over and over even though you know it is dangerous, stupid or wrong. Now that we know, its time for a change. Negligence starts tomorrow. William McDonough Cradle to Cradle
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