|Stop the Spread of Infectious Disease|
|By Dawn Shoemaker and Robert Kravitz|
Dr. Joseph Bick has established quite a name for himself in the corrections industry. When Bick, an infectious disease specialist, became the chief medical officer at the California Medical Facility, Vacaville, CA, in 1993, he discovered a chaotic situation: years of neglect of inmates and prison facilities, a medical staff that was demoralized, and HIV-positive inmates whom he described as being in “open rebellion” due to poor medical care as well as a lack of access to treatment drugs.
Over the years, he has helped improve the facility considerably, according to most accounts, some say even making it a model prison for the treatment and prevention of various diseases. He implemented prevention strategies to help stop the transmission of illnesses common in prisons, such as Hepatitis A and C, as well as other infectious diseases, some of which, such as MRSA,* were likely not even an issue when Bick started his career.
According to Bick, prisons and jails provide an ideal environment for the transmission of contagious diseases. This is due to a variety of factors, some of which are beyond administrators' control. One such factor is the transient status of inmates in many facilities. They are often moved from one location to another, increasing the likelihood of an illness spreading and making it hard to isolate the origin of the outbreak.
Additionally, there are a number of hygiene issues that can spread disease in facilities if protocol is not followed properly. Fortunately, many of these--from the wearing and proper use of gloves to increased hand washing by staff and inmates to more thorough, hygienic cleaning--can help slow the transmission of disease and benefit and protect the health of inmates and, because most of the inmates will eventually be released, the public at large.
Proper Use of Gloves
Most corrections administrators, health care providers, and staffers are well aware of the importance of wearing gloves. Unfortunately, in prisons, just as in medical facilities, gloves are often not worn as frequently as they should be or as required.
Gloves should be worn whenever one is likely to come in contact with blood or other bodily fluids, including cuts and bruises on the skin of inmates and staff members. Gloves should also be worn when touching contaminated surfaces. These guidelines apply to both health care administrators in the prison as well as correctional staffers.
According to Bick, the proper selection of gloves is also critical, and the type chosen depends on where and how they are to be used. For instance, he suggests the following:
It cannot be overstated how important proper hand hygiene is in a prison setting. Washing with warm, soapy water for approximately 20 seconds is recommended. Additionally, rubbing fingernails against the palm of the opposite hand helps remove bacteria lodged under the nails.
Along with proper hand washing, it is vitally important to use alcohol-based hand sanitizers. However, hand washing and the use of sanitizers are not the same. Hand washing removes soils and contaminants from hands. Sanitizers kill germs and bacteria, but they do not clean hands. They should be used as an interim, temporary measure to supplement frequent hand washing.
Additionally, to stop the spread of disease in a crowded prison setting, inmates must also be educated about the importance of washing their hands frequently. Unfortunately, many correctional facilities lack adequate facilities for washing hands with soap and water—making frequent and proper hand washing by inmates and staffers difficult.
Proper housekeeping procedures and cleaning systems are paramount in a correctional facility, and this is of even greater importance today than in the past. According to Peter Sheldon, veteran of the building service contracting industry and vice president of operations for Coverall Cleaning Concepts, health-based or hygienic cleaning typically found in health care settings to control the spread of infection should now be considered in other types of settings, from schools and office buildings to correctional facilities. “Because of the growing number of pathogenic threats showing up in these facilities, it has become clear that there is a significant need for this type of microbial-focused cleaning to extend to all facilities.”
Sheldon explains that some of the most crucial elements to a health-based or hygienic cleaning system include:
As states around the country prepare their budgets for the coming fiscal year, one after another is looking for ways to cut costs related to correctional facilities. One state, California, would even like to sell one or more of its prisons, in the hopes that private industry might be able to run them more efficiently and less expensively.
However, with these cuts and proposals, questions are arising about the impact on the health of the inmates incarcerated in these facilities. And according to Bick, this is more than just a correctional-facility issue. Because most inmates will eventually be released, focusing more attention on the health of those incarcerated as well as the health and cleanliness of correctional facilities will help prevent the spread of disease to the general public as well.
Worker Productivity Issues
With budget cuts, correctional managers are not only looking to clean more hygienically, but to find ways to improve worker productivity. According to a study conducted at North Carolina State University, which has more than 32,500 students and 10 million square feet of campus facilities, using spray-and-vac cleaning systems were two-thirds faster than the conventional cleaning systems ─ mops, buckets, cleaning cloths - used previously.
This corresponds with studies conducted by ISSA, the leading trade association for the professional cleaning industry. Their studies found surfaces could be cleaned in approximately a third the time using a spray-and-vac cleaning system.
*Methicillin-resistant Staphylococcus aureus
Dawn Shoemaker and Robert Kravitz are writers for the professional cleaning industry. They can be reached at firstname.lastname@example.org
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