title: Working relationships of infection prevention and control programs and environmental services and associations with antibiotic-resistant organisms in Canadian acute care hospitals.
abstract: BACKGROUND
  Environmental contamination in hospitals with antibiotic-resistant organisms (AROs) is associated with patient contraction of AROs. This study examined the working relationship of Infection Prevention and Control (IPAC) and Environmental Services and the impact of that relationship on ARO rates.
  
  
  METHODS
  Lead infection control professionals completed an online survey that assessed the IPAC and Environmental Services working relationship in their acute care hospital in 2011. The survey assessed cleaning collaborations, staff training, hospital cleanliness, and nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infection, vancomycin-resistant Enterococcus (VRE) infection, and Clostridium difficile infection (CDI).
  
  
  RESULTS
  The survey was completed by 58.3% of hospitals (119 of 204). Two-thirds (65.8%; 77 of 117) of the respondents reported that their cleaners were adequately trained, and 62.4% (73 of 117) reported that their hospital was sufficiently clean. Greater cooperation between IPAC and Environmental Services was associated with lower rates of MRSA infection (r = -0.22; P = .02), and frequent collaboration regarding cleaning protocols was associated with lower rates of VRE infection (r = -0.20; P = .03) and CDI (r = -0.31; P < .001).
  
  
  CONCLUSIONS
  Canadian IPAC programs generally had collaborative working relationships with Environmental Services, and this was associated with lower rates of ARO. Deficits in the adequacy of cleaning staff training and hospital cleanliness were identified. The promotion of collaborative working relationships and additional training for Environmental Services workers would be expected to lower ARO rates.
authors.affiliation: Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada; Quinte Health Care, Belleville, ON, Canada. Electronic address: zoutmand@queensu.ca.
authors.forename: Dick E
authors.initials: DE
authors.lastname: Zoutman
authors.affiliation: Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada.
authors.forename: B Douglas
authors.initials: BD
authors.lastname: Ford
authors.affiliation: Homewood Health Centre, Guelph, ON, Canada.
authors.forename: Keith
authors.initials: K
authors.lastname: Sopha
mesh_terms: D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control*; D002170:Canada; D003299:Cooperative Behavior; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D003625:Data Collection; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004783:Environmental Microbiology; D006302:Health Services Research; D006797:Housekeeping, Hospital / Q000458:organization & administration*; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000458:organization & administration*
keywords: Clostridium difficile infection; Methicillin-resistant Staphylococcus aureus; Vancomycin-resistant Enterococcus