Environmental Services Update: Healthcare-Associated Infections, Antimicrobial Resistance, and New Tech

What were some of the top focuses of the live summit in April?

Rohde: The Healthcare Surfaces Summit 2025, held on April 7–8 at ISSA’s global headquarters in Rosemont, Illinois, brought together professionals from healthcare, infection prevention, design, and manufacturing to address the critical role of surfaces in preventing healthcare-associated infections (HAIs). The summit emphasized actionable strategies and collaborative efforts to enhance patient safety through improved surface hygiene. Key focus areas included:

1. Surface Hygiene and HAI Prevention

The summit underscored the importance of surface hygiene in preventing HAIs. Participants engaged in discussions and breakout sessions aimed at developing strategies to mitigate the spread of deadly microbes through contaminated surfaces. These sessions facilitated the formation of task forces dedicated to ongoing research and the development of practical tools for healthcare settings.

2. Collaborative and Action-Oriented Approach

Unlike traditional conferences, the summit adopted an interactive format featuring lightning talks, group discussions, and task force breakout sessions. This approach fostered collaboration among attendees, leading to the establishment of clear goals and new partnerships focused on improving surface hygiene and patient safety.

3. Keynote on the Ongoing HAI Epidemic

Jeanine Thomas, founder of the MRSA Survivors Network, delivered a compelling keynote titled "The Forgotten Ongoing Epidemic: Healthcare-Associated Infections (HAIs)." Drawing from her personal experience as an HAI survivor, she highlighted the persistent challenges posed by HAIs and the need for continued vigilance and innovation in infection prevention.

4. Formation of Ongoing Task Forces

A significant outcome of the summit was the establishment of task forces committed to year-round efforts in improving surface safety. These groups aim to develop research projects, tools, and resources that address the complexities of surface cleanability and disinfection in healthcare environments.

5. Emphasis on Surface Material Standards

The summit highlighted the need for standardized guidelines in surface material selection, testing, and maintenance. By focusing on the entire lifecycle of surfaces—from design and manufacturing to installation and upkeep—the summit aimed to reduce the risk of HAIs associated with contaminated surfaces.

Overall, the Healthcare Surfaces Summit 2025 served as a catalyst for actionable change, emphasizing the critical role of surface hygiene in patient safety and fostering ongoing collaboration among stakeholders to combat HAIs.

What are some advancements currently being made in HAI prevention?

Rohde: Advancements in the prevention of healthcare-associated infections (HAIs) are increasingly driven by innovations in technology, infection control protocols, and data analytics. As of 2025, here are some key developments:

1. Artificial Intelligence and Predictive Analytics

AI-powered surveillance tools analyze electronic health records (EHRs), lab results, and patient vitals in real-time to identify infection risks early. Predictive modeling helps hospitals identify patients at high risk for HAIs like catheter-associated urinary tract infections (CAUTIs) or central line-associated bloodstream infections (CLABSIs) and intervene proactively.

2. Antimicrobial Stewardship Programs (ASPs)

Enhanced use of AI-driven decision support tools to guide appropriate antibiotic prescribing is growing. Rapid diagnostic tests using molecular techniques enable targeted treatment, reducing unnecessary broad-spectrum antibiotic use and combating resistance.

3. UV-C and Hydrogen Peroxide Disinfection

Automated disinfection robots using UV-C light or hydrogen peroxide vapor are being used more widely to disinfect patient rooms and operating theaters, reducing pathogens like C. difficile and MRSA. Smart sensors ensure proper coverage and dosage during disinfection cycles.

4. Antimicrobial and Self-Disinfecting Surfaces

New materials embedded with copper, silver, or zinc oxide nanoparticles are being used on high-touch surfaces (e.g., bed rails, doorknobs) to continuously kill pathogens. Photocatalytic coatings that activate under visible light to degrade microbes are gaining traction in clinical settings.

5. Hand Hygiene Monitoring Technologies

Use of RFID and Bluetooth systems to track staff hand hygiene compliance in real-time is becoming more common. AI-enabled video analytics can detect hand hygiene adherence without intrusive supervision.

6. Smart Catheters and Sensors

Catheters with embedded sensors monitor pH, temperature, and biofilm formation to provide early warning of infection. Closed-system catheter drainage systems reduce the risk of bacterial entry.

7. Vaccination and Immunotherapy

New vaccines are under development or in use for nosocomial pathogens like Klebsiella pneumoniae, Pseudomonas aeruginosa, and C. difficile. Monoclonal antibodies are being tested as prophylactics for patients at high risk of specific HAIs.

8. Real-time Location Systems (RTLS)

This is used for contact tracing and monitoring equipment movement to identify contamination pathways. Staff can be alerted if a potentially contaminated device is reused without sterilization.

9. Enhanced Training and Simulation

Virtual reality (VR) and augmented reality (AR) are being used to simulate infection control scenarios and train healthcare workers in best practices for preventing HAIs.

10. Genomic Surveillance

Whole-genome sequencing of pathogens allows hospitals to track outbreaks more precisely and identify sources of transmission (e.g., a contaminated sink or instrument).

How has the incorporation of HSI into ISSA aided its research and work?

Rohde: The integration of the HSI into ISSA in July 2024 has significantly enhanced HSI's capacity to advance research and initiatives aimed at preventing HAIs through improved surface hygiene. This strategic merger has yielded several key benefits:

1. Expanded Educational and Certification Programs

By joining forces with ISSA, HSI has broadened its educational outreach, offering webinars, training sessions, and certification programs focused on surface hygiene and infection prevention. These programs provide healthcare professionals with the knowledge and tools necessary to implement effective surface cleaning and disinfection protocols.

2. Enhanced Research and Development Opportunities

The merger has facilitated collaborative research efforts, enabling HSI to work closely with industry experts, manufacturers, and healthcare professionals to develop and validate surface materials and cleaning methods. This collaboration aims to establish standardized guidelines and best practices for surface selection and maintenance in healthcare settings.

3. Increased Global Reach and Influence

As a division of ISSA, HSI benefits from ISSA's extensive global network, allowing for greater dissemination of research findings and best practices. This expanded reach supports the adoption of improved surface hygiene standards worldwide, contributing to the reduction of HAIs on a global scale.

HSI's Executive Director, Linda Lybert, has assumed a full-time role within ISSA, bringing her extensive experience in infection control and surface hygiene to the organization. Her leadership ensures that HSI's mission remains focused on developing sustainable solutions to prevent the transmission of pathogens via surfaces.

Overall, the incorporation of HSI into ISSA has strengthened efforts to combat HAIs by promoting research, education, and the implementation of effective surface hygiene practices across the healthcare industry.

What should healthcare leaders be focusing on when it comes to EVS right now?

Wilkerson: They should be ensuring that they have strong training programs that include competency validation, and they should also be following CDC’s best practice guidelines for environmental cleaning healthcare facilities.

What would be the consequences of EVS staff disappearing all together? 

Wilkerson: Increased HAIs! Without them none of the other HAI prevention efforts would be worthwhile.

What specific challenges need to be addressed within EVS right now?

Wilkerson: Improving manufacturers’ development and instructions for use of equipment (IFU) and surfaces used in the healthcare setting is a big challenge. Often the IFU only lists one cleaning/disinfection solution that can be used by brand, which makes it challenging if the healthcare facility does not have access to this solution and confusing for the care team if they need to use multiple different products. We have IFUs for products used in healthcare settings that require the use of solutions that are not appropriate for the healthcare setting like mild detergents or Pine-Sol that may clean but do not disinfect. Then we have surfaces/equipment that cannot be cleaned/disinfected appropriately due to their complex design like some endoscopes or porous surfaces like grout in bathrooms.