What EVS for Hospitals Clean

What part of the hospital does housekeeping apply to?” is a question people who work in healthcare housekeeping services are often asked. Perhaps this question stems from a lack of clarity regarding the department’s name.

In the past, the responsibilities of custodial technicians were known as healthcare housekeeping services. Yet it became increasingly evident that their duties extend beyond those of most commercial cleaning services. Housekeeping in hospitals was always on the frontline of infection prevention, but this wasn’t fully acknowledged until the COVID-19 pandemic. As infection-prevention specialists, these workers must have extensive knowledge of specific pathogens. They also need to know how to properly dispose of biological waste and sharps and perform terminal cleaning. Studies show they contribute significantly to patient satisfaction and HCAHPS scores….and more. Their additional responsibilities extend beyond housekeeping, so healthcare housekeeping services departments were renamed environmental services (EVS) for hospitals and other healthcare facilities.

Despite the name change, the question remains, “What part of the hospital does EVS clean?” The answer is that hospital EVS providers clean just about everything, although other than transport equipment such as wheelchairs and gurneys, most do not clean medical devices or IT equipment. This is not to say they clean all areas or surfaces with the same intensity—although that, too, has changed since the COVID-19 pandemic.

EVS for Hospitals Clean

More Areas, More Often

The frequency of EVS’s cleaning and disinfecting in hospitals has been ramped up since the COVID-19 outbreak. Most EVS for hospitals now clean high-touch points several times a shift. Patient rooms and emergency departments have always been a top priority for EVS, to prevent healthcare-associated infections (HAIs) and other infections. If the room/area has been exposed to a COVID-19 or HAI-infected patient, EVS terminally cleans them.

COVID-19 – and the fear of another outbreak of it, a variant, or another infectious disease such as monkeypox has also changed how EVS cleans other hospital areas. For example, lobbies and waiting rooms are now cleaned and disinfected more thoroughly, with attention paid to surfaces that previously might have been overlooked, such as the underside of chair arms, where fingers are most likely to hit when people sit down or get up from a chair. Similarly, surfaces in these areas where patients or visitors might move items from outside the facility to one surface after another are considered potential infection carriers. Consider the purse or laptop that is placed on the lobby floor, then moved to a lap, then a chair, then a patient’s bedside table, or even the bed itself. Since COVID-19—and in preparation for the next possible pandemic—everything is suspect in the world of infection prevention. This also means that lesser-used areas that might only have been visited occasionally, such as storage areas, are being cleaned regularly.

Finding a Balance

While hospital EVS is responsible for keeping surfaces clean and disinfected, it is also up to this department to rely on their training and common sense to balance keeping hospital occupants safe and doing more harm than good by introducing disinfectants into the environment needlessly. In the United States, every disinfectant must be registered with the EPA because they are meant to kill pests (pathogens) and are therefore considered pesticides. Disinfectants often contain toxic chemicals. They can cause respiratory, skin, and eye irritation and can negatively impact indoor air quality. Most experts also agree overuse of these heavy hitters can make pathogens immune to them, creating superbugs that render both disinfectants and antibiotics ineffectual. It is up to EVS to recognize the pathogen’s threat level and use the appropriate disinfectant force.

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