INTERNSHIP PROJECT

Internship Project

Isabel King

KINS 4306 Public Health Internship

Georgia College & State University

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Need for Project

My internship for the summer of 2021 was with the Infection Prevention Department of

Emory Johns Creek Hospital. I mainly worked with the Environmental Services (EVS)

Department to improve their workflow and support best cleaning practices. The outbreak of

COVID-19 in 2020 brought to light the importance of having adequately trained and qualified

hospital cleaning personnel. Across the country, hospitals were putting more pressure on their

environmental staff than they ever had before. EVS work is crucial to saving lives every day in

hospitals, whether during a pandemic or just everyday operations. The actions of EVS in

effectively cleaning and sanitizing hospital environments are fundamental to preventing many

hospital-acquired infections.

Emory Johns Creek Hospital has been struggling to reach patient satisfaction goals

regarding the hospital's environment; their EVS department had been operating for years without

a standard of work in place or proper training. Departments cannot function at their best or

produce quality work without standards of work to adhere to. Therefore, it was pertinent that

someone addresses the barriers causing the EVS department not to be up-to-par with Emory

standards. I was brought on to help identify and propose means to mitigate issues to improve

patient satisfaction with hospital cleanliness.

Project Description

I initially came in with an overall project goal set by my supervisor, and as it went on, the

nature of the project changed and shifted. The initial project was to help support best cleaning

practices, develop training materials, and establish standards of work for the EVS department.

That remained the project's goal, but over time, more gaps and missing needed educational

materials were uncovered that extended beyond Environmental Services. I shadowed EVS staff

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from all the different units within the hospital to get the perspective of what it was like to be in

their shoes. In that time, I learned of their training gaps and barriers, their general system of daily

and discharge cleaning, and I gained their trust and confidence.

Auditing EVS personnel when they performed discharge cleaning was a crucial step in

my project. First, I would pick a floor or unit to audit for the day. I then would connect with and

build rapport with the secretary of the floor, the nurses, and the technicians who would aid me in

knowing which patients were to be discharged. I would enter the room before the EVS personnel

came to the room, as they were supposed to be unaware that they were being audited. I then

sprayed down all high-touch surfaces that were indicated on the audit sheet with invisible

fluorescent material and checked them off as I went. After I sprayed the surfaces, I would then

wait for EVS to perform a full discharge cleaning. Once completed, I would enter the room and

use a black light to evaluate each surface I had marked previously to evaluate the removal or

non-removal of the fluorescent material. At the end of the day, I would enter the audits into a

computer program that would store the data and create graphics. The fluorescent material, called

Vericlean, serves as a surrogate for potentially infectious materials, and its removal suggests that

the EVS personnel cleaned the surface effectively.

While performing audits, I noticed that specific processes were not being done at

discharge by technicians and nurses, as was their responsibility. They left bodily fluids,

medication, wound care supplies, food trays, and excess linen in rooms after discharge, requiring

EVS staff to clean it up when it was not their job. There seemed to be a lack of respect or

understanding of EVS duties, and I occasionally heard the phrases "I'm not housekeeping" and

"That's a job for housekeeping" being said. These kinds of actions affect the morale of EVS staff.

It was discovered that there was no standard of work for room readiness at discharge for nursing

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and technical staff. Due to these occurrences, my supervisor assigned me to develop their

standard of work for room readiness following patient discharge.

Another aspect of my project was to ensure that expensive and fragile hospital equipment

was properly cared for when cleaned. I was tasked with developing a reference tool to identify

the appropriate cleaning solutions for various equipment and what cleaning products within the

hospital are appropriate.

Materials Created/Produced

During my time at Emory Johns Creek Hospital, I developed training materials,

educational materials, standards of work, and multiple PowerPoint presentations. I created the

EVS Training Checklist for Discharge and Daily Cleaning, which is considered their standard of

work. I also developed a spreadsheet of hospital equipment and their proper cleaning solutions. I

created PowerPoint presentations for the Nursing Excellence Coordinating Council, the monthly

PEP Rally meeting, and the Clinical Excellence Executive Oversight Committee meeting.

Finally, I developed a standard of work for room readiness at discharge for nursing and technical

staff and a 'Who Cleans What' checklist.

Project Evaluation

During my time at Emory Johns Creek Hospital, my project's goal was to implement new

training and support best cleaning practices, which I successfully completed. I effectively created

quality work products, such as standards of work and checklists, for them to use in the future to

better the hospital, which proves the sustainability of my work. I uncovered issues that were

being overlooked and aided in fixing them so that the hospital staff can work more cohesively. I

brought awareness to the need for mutual respect between medical staff and EVS employees. I

developed great friendships with many of the staff members, who came to respect my ideas. I

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would not change anything about my time at Emory Johns Creek Hospital, and I am proud of the

work I have produced. Through my internship project, I developed my professional knowledge

and abilities and feel more confident with my place in the professional world.

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