One year ago this month, we began to understand the reach of COVID-19. This is part of a periodic series at HopkinsAllChildrens.org/Stories on various ways the pandemic has made an impact.

Thelma Jackson likes to bond with the patients.

A housekeeper at Johns Hopkins All Children’s Hospital, she works to keep patient rooms and other areas clean. Along the way, she often makes a connection with the kids. It’s part of the joy of working at a children’s hospital.

Over the past year, COVID-19 has put a spotlight on Environmental Services team members such as Jackson. Patients and families needed to be sure the hospital was clean and safe. High-touch areas needed greater attention. Staff members need to feel good about their work environment.

Jackson now wears a mask and a face shield as she works. Before COVID-19, she only occasionally needed a mask for certain rooms.

But Jackson still finds a way to bond with the patients.

“I still talk to them, but it’s not the same,” she says. “I don’t get close enough to do high-fives, but I talk with them the same.”

Partnering to Prevent Infection

Environmental Services has worked closely with Infection Prevention throughout the pandemic. The Centers for Disease Control and Prevention (CDC) recommended that only essential personnel wearing a respirator mask or an air-purifying respirator called a PAPR unit enter the rooms of patients who were or might have been positive for COVID-19. Before the pandemic, only a small, dedicated Environmental Services group had been fitted or trained on use of this personal protective equipment. 

“When the patient was discharged, we let the room stay closed until the appropriate air exchanges cleaned the air in the room for the safety of the Environmental Services personnel,” says Kay Sams, R.N., Infection Prevention director at the hospital. “Then, the team was able to safely enter the room to perform the terminal clean and ready it for the next patient.”

As the CDC, Johns Hopkins Medicine and others learned more about the virus, the Environmental Services team was trained and protocols adjusted accordingly. Sams’ team worked with Michael Dansberger, director of Environmental Services, and his team to communicate changes to a staff that largely doesn’t work at desks.

“We provided in-person education for the Environmental Services leadership and team leads,” Sams says. “This education focused on new signs as well as the additional requirement in April of all staff needing to wear masks and face shields when in patient rooms. This was a big change for the staff and required follow-up teaching and check-ins to see how the new process was working. Infection Prevention was also out on the units rounding and assisting with any real-time concerns or issues by staff.” 

Dansberger and Jackson both said the increased use of personal protective equipment (PPE) was the biggest change their team has encountered.

“The equipment and techniques are the same,” Dansberger says. “We just increased our scope of service for Environmental Services and increased the use of PPE as there were and are still many uncertainties about COVID-19.”

Keeping Patients Safe

Early in the pandemic, the Environmental Services team faced shortages in PPE and other equipment, such as the alcohol wipes they use to wipe down surfaces.

“In February 2020, we noticed suppliers out of stock with disinfectant, bleach and alcohol wipes,” Dansberger says. “We developed a process with approval from Infection Prevention and Regulatory using CDC guidelines to manufacturer disinfectant, bleach and alcohol wipes for the hospital and the Outpatient Care Centers.”

Sams recalls being impressed by how nimble the Environmental Services team was.

“I recall when we learned we had limited disinfectant supply left, just days on hand, my heart sank,” she says. “Supply chain and Environmental Services quickly found a suitable product, but it meant a complete change in process, including recycling and cleaning our used disinfectant canisters and staff having to make and mix the new product for distribution to the units. This all occurred in less than two days. It’s an amazing team!

“They work tirelessly each and every day and are true heroes as they are preventing infections for staff, patients, and visitors each day by the cleaning and disinfecting they are doing to keep us all safe.”

Dansberger is proud of his team’s performance throughout the pandemic.

“Environmental Services has truly shown a level of adaptability that has been nothing short of impressive,” he says. “There were and will continue to be changes to workflow and how we will conduct the care for our patients and families with increased level of cleaning in all our public areas to give a level of confidence to our families that they will be safe while on our campus.”