A variety of our recent posts have looked at both manual cleaning and disinfection, how effective manual efforts are, and touchless disinfection technology to complement manual cleaning regimes. We also reviewed what data is available and how to rate that data when considering investing in a touchless disinfection technology.
In this post I would like to recap some of the main points from our prior posts and introduce the latest in our series of infographic downloads (available here) that reviews the areas for cleaning, the choice of disinfectants (per CDC HICPAC guidelines) and also serves as an introduction to the complementary touchless disinfection systems that are available.
- With regard manual cleaning and disinfection there are a wide variety of guidelines around what to be cleaned and the CDC HICPAC guidelines (all 250 pages!) is one of the most widely used and adopted standard. They divide the room into three sections based around wether the areas to be cleaned penetrate or touch broken or unbroken skin. This then leads to the choice of disinfectant in order to achieve sterilization for critical items that are used to penetrate and be inserted into the body or disinfection for environmental surfaces. The full post is here.
- Unfortunately we know from a range of studies that less than 50% of surfaces are cleaned and disinfected routinely (1), and even after bleach disinfection C. difficile was able to be cultured from 44% of surfaces (2), MRSA was cultured from 66% of sanitized surfaces (3) , whilst VRE was cultured from 71% of surfaces after bleach disinfection (2). In addition it is widely known that handling contaminated linens can then lead to surface contamination via hand or glove contamination (discussed in our blogs here), or from bed changes which can re-contaminate rooms as large quantities of microorganisms are released into the air. Full post here.
- A wide range of touchless disinfection technologies are available to complement manual cleaning regimes (reviewed in our blog here). These range from episodic cleaning agents such as ultraviolet light and vaporization or aerosolization of disinfectants, to self sanitizing surfaces such as Cupron Medical Textiles or Cupron Enhanced EOS Solid Surfaces.
- The touchless disinfection technologies data can be ranked and rated based upon McDonald and Arduino (4) of the Division for Healthcare Promotion, CDC. The data fits into five tiers of evidence with tier V being the highest quality data. We suggested a range of questions to ask your technology provider here, and suggested peer reviewed, published data from Tier IV or V being the new standard to implement a touchless disinfection system in addition to your current manual regime.
As always we welcome your feedback and thoughts, and please comment below with your experiences and input. Click Here to download the helpful infographic!
References quoted in this article
- Carling PC, Parry MM, Rupp ME, Po JL, Dick B, Von Beheren S. 2008. Improving cleaning of the environment surrounding patients in 36 acute care hospitals. Infect Control Hosp Epidemiol 29:1035-1041.
- Eckstein BC, Adams DA, Eckstein EC et al. 2007. Reduction of Clostridium difficile and vancomycin-resistant Enterococcus contamination of environmental surfaces after an intervention to improve cleaning methods.BMC Infect Dis 7:61.
- French GL, Otter JA, Shannon KP, Adams NM, Watling D, Parks MJ. 2004. Tackling contamination of the hospital environment by methicillin-resistant Staphylococcus aureus (MRSA): a comparison between conventional terminal cleaning and hydrogen peroxide vapour decontamination. J Hosp Infect 57:31-37.
- McDonald LC, Arduino M. Editorial commentary: climbing the evidentiary hierarchy for environmental infection control. Clin Infect Dis. 2013 Jan;56(1):36-9.