2: Beyond Hand Hygiene: The Five Critical Moments for Environmental Disinfection in Health Care

Infection prevention has long focused on hand hygiene, but what about the surfaces patients and healthcare workers touch throughout the day? Jim Gauthier, MLT, CIC, alongside coauthors Carol Calabrese, RN, BS, CIC, and Peter Teska, MBA, introduced the concept of Targeted Moments of Environmental Disinfection (TMED)—a structured approach identifying 5 critical moments for cleaning high-touch surfaces in patient care areas, published in The Joint Commission Journal on Quality and Patient Safety. In this interview, Gauthier discusses the importance of real-time disinfection, the hidden dangers of overlooked surfaces, and practical strategies to integrate TMED into daily health care practices, ultimately aiming to reduce health care-associated infections and enhance patient safety. “TMED is a heuristic, risk-based model proposing additional cleaning and disinfecting within the patient zone modeled on a similar concept developed by [World Health Organization] for hand hygiene,” The authors wrote. “TMED identifies and suggests when disinfection should be conducted by [health care workers], either after or before certain procedures or events that may leave organisms on high-touch surfaces, or to remove organisms that may have been deposited during other care procedures.”