COVER STORY
Being confident that your wipes work
At a time when the NHS is facing a changing future, we look at the increase of single-use wipes and the development of new test methods that enable simpler and more accurate purchasing decisions.
Wipes have been used to remove dirt from soiled skin and surfaces for many years. The concept of the single-use wipe is not new, however, in recent years, there has been a significant increase in the development, education and acceptance of single-use wet wipes in the healthcare market. Wipes are now the accepted and ‘normal’ method of cleaning and disinfecting high touch areas, non-invasive medical devices and surfaces in the near patient environment within healthcare settings. As a result of this market trend, the NHS is now one of the major consumers of cleaning and disinfectant wipes in the UK. Since 2011, when the Royal College of Nursing wrote ‘Wipe It Out’, their guidance paper on the selection and use of disinfectant wipes, the development in wipes technology and availability through NHS supply routes has enabled all parts of the NHS to benefit from the practicality, time saving and lower risk of contamination that wipes can offer.
Infection control and prevention is one of the major challenges within the healthcare environment. An estimated £1 billion per year is spent by the NHS in combatting healthcare acquired infections (HCAIs). If selected and
used correctly, wipes for cleaning and disinfection can be an effective means of supporting the fight against infections.
Wipes guidance
Six years ago, the Royal College of Nursing made recommendations following a review of the use and selection of wipes in health care. They put forward the recommendations having noted that at the time, there was little or no guidance available to support the decision maker when choosing wipes as an effective infection prevention intervention. “The selection of an appropriate product can be a complex process that includes the consideration of scientific information and the interpretation of laboratory test data. The need for rigour in purchasing any item for use in a health care setting is also important to ensure financial resources are used appropriately.” (Wipe It Out: 2011) Their recommendations included a collaboration between scientific and professional organisations, users, manufacturers and standards organisations in order to investigate the development of realistic standard test methods. A further recommendation was for manufacturers to
provide test data on the efficacy of active ingredients with shorter contact times. This furthers a report by Gareth Williams of Cardiff University, Wales, which was presented at the American Society for Microbiology General Meeting in Boston in 2008. It reported that bacteria were removed from surfaces when wiped, but were not necessarily killed, thus creating a potential source for recontamination. Many leading wipes providers rely on brand names for credibility. As such, efficacy claims made by such brands are used for headline sales purposes and often not referenced back to detailed reports. Wipes that are only tested in laboratory conditions with a solution test may not be advanced enough or reproducible in a healthcare working environment. Long contact times are not realistic in a hospital environment. Time constraints on staff as well as the warm conditions mean surfaces will not be wiped and remain wet for the whole contact time duration.
The microbial efficacy of disinfectant wipes has traditionally been tested by extracting the impregnated disinfectant solution from the wipes and adopting the EN standard designed to test liquid disinfectants, not wipes. Using a solution test to measure the efficacy of wipes means that there is no consideration for the amount of active solution a wipe will release to a surface when used, or the impact of the pressure, the wiping action and any cross
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WWW.CLINICALSERVICESJOURNAL.COM SEPTEMBER 2017
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