Edward Dudek, assistant vice president, facilities engineering and maintenance with the University of Pittsburgh Medical Center (UPMC), and Dan Hounsell, editor of Maintenance Solutions magazine, discuss the swine flu (H1N1) outbreak and its impact on UPMC’s maintenance and operations.
Q: Can you describe the general steps your organization has taken in response to the outbreak of swine flu?
A: Our hand-washing program is system-wide, and hand-washing compliance is measured and reported monthly by the hospital infection control (IC) department to both our infection control liaison’s meeting and the safety committee quarterly. Generally, hand washing is one of the more effective precautions to infection rates as a whole and the swine flu specifically.
I have to give a tremendous amount of credit to our IC group, as they have been relentless in chasing this initiative and enforcing the process for some time now. They have managed to get a remarkable compliance level with all of the hospital staff, from the physicians and nurses to the housekeeping and maintenance staff.
Q: What specific steps did you take to control the spread of infection?
A: We have located throughout the campus Purell dispensers for the staff and for the public to use routinely, and our housekeeping staff refills them routinely to assure they are available and reliably effective. In our most recent Joint Commission survey, they commented on the program as being very progressive and one of the more effective approaches to reducing infections.
It took some effort to assure the dispensers were appropriate for installation in common areas and corridors, so as not to violate code and be installed in a safe location. But collaboratively, Facilities Engineering, Infection Control and our Environmental Health and Safety departments were able to come up with a very successful implementation. I think that my guys felt (they were) a part of a solution to hospital infections and did a great job.
Our IC department also asked if we could install dispensers for disinfecting wipes on every unit and in every patient room. We recently finished that process and installed several hundred in our Oakland Campus hospitals. Again, we pulled the same team together, and this allows for any hospital staff to wipe down anything they feel needs to be sanitized immediately, instead of waiting for someone else to do it. It also keeps them available for my staff and for housekeeping, if needed.
Q: What steps did the engineering and operations department take as part of the infection-control efforts?
A: We have many negative-pressure isolation rooms throughout the hospitals. We are extremely vigilant that these are always available and tested weekly to verify operation. So if clinical operations feels there is a precautionary need to have isolation processes in place, they have them. I would assume that a suspected swine flu case would be handled with the same routine practices we follow every day.
A few years ago, primarily in concern with the avian flu, we built a clinical bio-safety level 3 (BSL3) lab – BSL3 is a lab that has HEPA filtration on the exhaust and negative pressure control with 100 percent redundancy on both supply and exhaust – for our microbiology and virology departments. It’s a fully operational BSL3 facility, and any testing related to these sorts of viruses is handled there. It was a substantial investment and the commissioning process was involved, but we felt it was needed to prepare for issues like this proactively.
Of course, we always rely on our front-line staff to understand the concerns, and through a detailed training program, (they) help to control hospital infections where we interact within the facility. We have an Infection Control component to our new employee orientation and also have an annual update program, presented by one of the hospital Infection Control practitioners, to consistently reinforce that we’re in the health care business and not simply in the maintenance business. It’s important that we follow the appropriate processes and practices to ensure we do our part to help reduce hospital infections and to protect our patients and our staff every day, not just in response to single concerns as with the swine flu. I am pretty proud of this program and the way our staffs has stepped up and have done everything necessary for both our patients' safety and their own protection in the process. It always seems to boil down to our front-line tradesmen, and they have consistently made the biggest difference in our successes.
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