Reducing the risk of healthcare-associated infections

healthcare-associated infections
© iStock/AndreasReh

Nova Biologicals presents a systematic and proven approach to reducing Clostridium difficile and many other healthcare-associated infections.

Healthcare environmental microbiology, the study of the microbial jungle associated with healthcare-associated infections (HAIs) is one of the most important areas of scientific and medical research. The Environmental Service Optimisation Programme (EvSOP™) provides a systematic approach for the microbiological threat assessment of healthcare facilities and solutions for the effective reduction of the identified threats. Additionally, evidence-based practice guidance is offered to facilitate the training of personnel who are responsible for maintaining a clean and safe healthcare environment for patients, employees and the public.

This is the heart of EvSOP.

EvSOP has made its global debut. It is a scientifically and medically approved way to significantly reduce the causes and effects of healthcare-associated infections (HAIs). When deployed with the support of all stakeholders, EvSOP is proven to be an effective programme, reducing Clostridium difficile infections by 30-40% and HAIs by 45-55%.

Introduction: the complexity of the healthcare-associated microbial jungle

Healthcare environmental microbiology might be considered by some to be a confusing and poorly defined subject. In specific terms of healthcare settings, where does the environment begin? Where does it end; and how does the patient fit into the definition?

More than 2,000 years ago Marcus Terentius Varro observed ‘minute creatures’, then hundreds of years later Antonie van Leeuwenhoek first viewed the ‘animalcula’ beneath his hand-crafted microscope lens. There is no place on Earth where people have looked and not found microorganisms of some type, from smoke chimneys in the depths of the oceans, to the air we breathe, to the environmental surfaces we encounter each day and to the deepest recesses of the human body.

The vast world of what may be considered healthcare environmental microbiology continues to explode beyond the standard definition of ‘the study of microorganisms existing in natural, manmade and healthcare environments’. Concurrently, our knowledge and understanding of microorganisms is rapidly increasing as the result of dramatic improvements in detection and analytical methodologies, especially at the molecular and genomic levels. Healthcare environmental assessments and testing, microbiological testing, data interpretation and management, facility cleaning and disinfection and interdepartmental collaboration are essential for patient safety, reduction in HAIs, reduction in healthcare costs and improved patient care.

The challenge for healthcare professionals is to effectively employ methods, means and equipment that will protect human health and safety and be medically and scientifically accurate and reliable.

EvSOP’s success

The success of EvSOP is based on the essential element of teamwork. The objective of the programme is to support a programme design, comprising standardisation of evidence-based methods, means and equipment, for environmental cleaning and disinfection in healthcare facilities to reduce the risks and incidence of HAIs.

EvSOP evaluates 10 key elements of a successful environmental service programme and builds a process for improvement around those elements. The elements are derived from evidence-based documents provided by the US Centers for Disease Control and Prevention (CDC), the Association of the Healthcare Environment (AHE) and the European Centre for Disease Prevention and Control (ECDC).

10 key elements of success

  • The Executive Sponsor is a senior member of the EvSOP team and generally does not have a working role on the team. Rather, the Executive Sponsor is actively involved in discussions at critical moments for approval or redirection;
  • Recognition Advocates are a group of people selected to perform the work of creating, launching implementation and monitoring EvSOP. Typically, between five and nine people represent all functions within the facility. This includes an appropriate mix of gender, age, role and years of experience;
  • Data gathering is a priority. Gathering important data points related to, inter alia, current practices, organisational practices and survey data provides the opportunity for immersion and understanding from a different perspective than what is already in place. Data gathering provides guidance for goal setting and creates a mechanism to evaluate successes and needs refinement;
  • Assessments and analytics provide the opportunity to review, assess and analyse the gathered data. Important aspects of this process embrace the mapping of current practices: what is going on in the facility, alignment of current practices with the organisation’s core values, brand and voice. Evaluation of the analytical and observational data must also occur during this phase;
  • Developing a blueprint includes creation of structure. This must incorporate meaningful current practices, recognition of gaps, evaluation of new ideas, creation of a network of advocates, communication tools and evaluation of Nays and Yeas. Establishment of action items and key advocates to pursue completion of action items;
  • Implementation of a new system is difficult and requires great care – as much care as the development. Implementation of the new EvSOP should start with rolling it out with intentional fanfare and detailed planning. Momentum can be created by bringing key stakeholders into the launch planning process. It may help to present a step-by-step guide that explains how the programme works and how it benefits the team and enhances the facility’s ability to deliver exceptional quality healthcare;
  • Analysing and measuring the milestones at 90-day intervals for the first year and annually after that. Maximising the data gathered enables a more comprehensive evaluation of the programme for meaning and relevance. Compare the plan to actual results, identify successes as objectives that were actually met, identify improvements needed and refine objectives based on success and those that need improvement;
  • Refining the blueprint is the process of ongoing evaluation and refinement of training, coaching, communication and recognition delivery.
  • Implementation refinement to EvSOP requires great care. Implementing change, even when it is for the benefit of a necessary improvement, is not easy. Identifying and securing the support of key stakeholders is a key step to assuring the success of EvSOP™ and reducing healthcare-associated infections.
  • It is important to continue to analyse and measure, as people and objectives change over time. EvSOP is a dynamic process and must be regularly revisited to keep it fresh and responsive. Continued vigilance is required to enhance the programme by maintaining awareness of microorganisms, environmental cleaning and disinfection methods and supplies and the facilities dynamic operational environment.

In summary

Several clinical studies have examined or documented the role of the healthcare environment as potentially being a contributing factor to HAIs. In many parts of the world, especially those that are resource poor, it is also believed that contaminated healthcare environments contribute to a significant proportion of some diseases.

EvSOP is a programme specifically designed to mitigate the role of the environment in the transmission of infectious agents. For more information about EvSOP, Nova Biologicals Inc. or The Pearce Foundation Scientific Endeavor, please contact us at We can assist you in all phases of EvSOP as we work together to reduce the pain, suffering and costs of HAIs.

About the author

Dr Pearce has more than 40 years of medical and environmental laboratory testing and teaching experience. He is the owner and Laboratory Director of Nova Biologicals, Inc; and founder of The Pearce Foundation for Scientific Endeavor. He says: “Many of the solutions to our current problems have been hiding in plain sight. I have seen and solved so many of these problems and now I want to share solutions that are available to each of us.”


2 August 2020 pp33-35; February 2020 pp27
5 Practice Guidance for Healthcare Environmental Cleaning. Second edition. American Hospital Association.

Dr Paul Pearce
Nova Biologicals

This article is from issue 15 of Health Europa. Click here to get your free subscription today.


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