‘Super clean’ crews dispatched to four more hospitals

C. difficile infection at Burnaby prompted broader initiative

Fraser Health is sending cleaning crews who have battled high levels of antibiotic-resistant bacteria at Burnaby Hospital to four more hospitals to try to wash down infection rates there.

The so-called “super clean” crews will spend two weeks each starting April 2 at Langley Memorial, Peace Arch, Royal Columbian and finally Surrey Memorial hospitals.

Petra Welsh, Fraser Health’s director of infection prevention and control, said the decision was made based on the work at Burnaby Hospital, where high rates of C. difficile (CDI) prompted doctors to speak out and led to an independent review and a series of new recommendations.

“These four facilities are the ones that see the sickest patients, the ones that are most vulnerable to CDI,” she said. “These are also the facilities where we see the higher trend of C. difficile due to the large size of the facilities.”

Hospitals will first de-clutter floors by moving some equipment and furniture into storage so cleaners can more effectively conduct the thorough two-stage enhanced cleaning.

Crews will use a regular cleaner followed by a second disinfection using a bleach solution several hours later.

The super clean treatment could roll out to even more hospitals, but Welsh said that need will be reassessed in the weeks ahead.

C. difficile infects the intestines and can cause illnesses ranging from diarrhea, nausea, vomiting, fever and colitis, and in some cases, results in death.

A number of deaths across the health region have been linked to C. difficile infections in recent years.

Welsh said new infections are down in the wake of the Burnaby cleaning.

“People say the sites smell cleaner and look cleaner,” she added.

The work is being done by cleaning contractors Aramark and Sodexho, which have pulled in casual cleaners who normally work at Vancouver Coastal hospitals in order to meet the higher workload in Fraser.

Hospital Employees’ Union spokesman Mike Old said Vancouver General and St. Paul’s hospitals are short-staffed as a result, remaining cleaners are over-worked and patients could pay the price if cleanliness suffers.

The union has filed a grievance at the two hospitals over excessive work loads.

“The bottom line is, they don’t have enough cleaners,” Old said. “They’re taking cleaners from one health authority to deal with the problem in another health authority.”

Welsh said Fraser Health has been assured the transfer of workers from Vancouver Coastal isn’t leaving those hospitals short-staffed.

Old disputes that and said he believes cleaning staff levels will return to their old, lower levels once the super cleans are finished, calling it “a temporary Band-Aid fix” to a long-term problem.

He called the controversy over CDI infections at Fraser in recent weeks a sign the government’s move to privatize hospital cleaning a decade ago was a failure.

He suggested the health authority would be better off if it ran housekeeping services directly.

“Fraser Health wears it when something goes wrong, but they don’t control it,” Old said. “They need to fix it.”

He said regular audits of hospital cleaners that are designed to reassure the public are flawed.

“Burnaby Hospital passed their cleaning audit as the very time they were having a serious C.difficile outbreak,” Old said.

Welsh said Fraser is working with its housekeeping partners to refine its protocol of how to respond to future cases of bacterial infection.

Besides enhanced cleaning when warranted, she said the health authority’s main strategy is to focus on improved hand washing, and the appropriate use of antibiotics, which can, if overused, foster bacteria resistance.

Fraser Health’s hospitals have averaged a C. difficile infection rate of 12.6 cases per 10,000 patient days so far in 2011-12 – more than double Health Canada’s national benchmark.

Langley Memorial, Burnaby, Mission Memorial and Surrey Memorial have run an infection rate over 15 this fiscal year, while Fraser Health statistics show Royal Columbian’s is 14.4 and Peace Arch’s is 10.2.

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