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drainage systems may not be feasible for some sink designs and could be costly and labor intensive. Thus, we are currently inves- tigating several simpler approaches to achieve the same effect.
Acknowledgments. We would like to thank the staff of the Cleveland VA Medical Center’s Engineering Service for assistance in designing and installing sink valves.
Financial support. This work was supported by the Department of Veterans Affairs.
Conflicts of interest. C.J.D. has received research funding from Clorox, GOJO, Pfizer, Avery Dennison, PDI, and Boehringer Laboratories. All other authors report no potential conflicts.
References
1. Kizny Gordon AE, Mathers AJ, Cheong EYL, et al. The hospital water environment as a reservoir for carbapenem-resistant organisms causing hospital-acquired infections—a systematic review of the literature. Clin Infect Dis 2017 May 15;64:1435–1444.
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2. Jencson AL, Cadnum JL, Piedrahita C, Donskey CJ. Hospital sinks are a potential nosocomial source of Candida infections. Clin Infect Dis 2017;65:1954–1955.
3. Livingston SH, Cadnum JL, Gestrich S, Jencson AL, Donskey CJ. A novel sink drain cover prevents dispersal of microorganisms from contaminated sink drains. Infect Control Hosp Epidemiol 2018;39: 1254–1256.
4. Parkes LO, Hota SS. Sink-related outbreaks and mitigation strategies in healthcare facilities. Curr Infect Dis Rep 2018;20:42.
5. Kotay S,ChaiW,GuilfordW,Barry K, MathersAJ. Spread from thesink to the patient: in situ study using green fluorescent protein (GFP)– expressing Escherichia coli to model bacterial dispersion from hand washing sink trap reservoirs. Appl Environ Microbiol 2017;83(8):pii: e03327-16.
6. Klick JM, du Moulin GC, Hedley-Whyte J, Teres D, Bushnell LS, Feingold DS. Prevention of gram-negative bacillary pneumonia using polymyxin aerosol as prophylaxis. II. Effect on the incidence of pneumonia in seriously ill patients. J Clin Invest 1975;55:514–519.
7. Gbaguidi-Haore H, Varin A, Cholley P, Thouverez M, Hocquet D, Bertrand X. A bundle of measures to control an outbreak of Pseudomonas aeruginosa associated with P-trap contamination. Infect Control Hosp Epidemiol 2018;39:164–169.
A novel color additive for bleach wipes indicates surface coverage and contact time to improve thoroughness of cleaning
Kevin Tyan BA, Katherine Jin BA and Jason Kang BSc Kinnos, Brooklyn, New York
To the Editor—Healthcare-associated infections (HAIs) exact a heavy toll on the US healthcare system, affecting ~1.7 million patients and resulting in direct costs of up to $45 billion each year.1 Institutions are heavily emphasizing frequent disinfection of high- touch surfaces to prevent transmission to patients because con- taminated surfaces are known to be reservoirs for nosocomial pathogens.2 In particular, hospitals have increasingly adopted the approach of daily cleaning with ready-to-use bleach wipes to combat C. difficile infections (CDIs). Daily cleaning with a sporicidal agent was demonstrated to be the most effective single intervention against CDI and asymptomatic colonization,3 while one hospital reported a reduction of 85% in CDI following the implementation of daily bleach wipe cleaning in all patient rooms.4 However, effective disinfection requires proper technique, adequate
feedback. This assertion is evidenced by a report in which environ- mental services (EVS) staff improved their cleaning performance from 52% to 83% after implementing fluorescent marker monitoring but regressed toward the baseline (57%) after monthly feedback ceased.6 Current methods for quality control monitoring are retrospective and often are only intermittently performed; thus, it may be challenging to translate to timely feedback for EVS staff. To sustain a high level of cleaning compliance, a unique approach is needed, one that provides direct and immediate feedback to workers. A novel attachment to bleach wipe containers, the Highlight
training, and constant monitoring.5 Significant human error in disinfectant wiping practices has been well documented, with personnel missing high-touch surfaces, overusing single wipes, and inadvertently transferring pathogens between surfaces, or drying off the applied disinfectant before the necessary wet-contact time.5 Periodic assessments of cleaning compliance through adenosine triphosphate (ATP) bioluminescence assays and fluorescent marker systems may help mitigate human error, but improvements cannot be sustained without permanent systematic changes and constant
Author for correspondence: Kevin Tyan, 760 Parkside Avenue, Suite 215, Brooklyn, NY 11226. E-mail:
kevin@kinnos.us
Cite this article: Tyan K, et al. (2019). A novel color additive for bleach wipes
indicates surface coverage and contact time to improve thoroughness of cleaning. Infection Control & Hospital Epidemiology 2019, 40, 256–258. doi: 10.1017/ice.2018.323
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved.
Wipes Lid (Kinnos, Brooklyn, NY) administers a blue indicator onto dispensed bleach wipes to provide real-time visual feedback of the thoroughness of surface coverage and the passage of contact time.7 As shown in Fig. 1A, the device consists of (1) a reusable lid that attaches onto standard containers of commercially available bleach wipes, and (2) a disposable cartridge containing the Highlight blue liquid additive and pre-installed batteries. A user presses the button to dispense individual wipes imbued with the blue indicator through the front face of the battery-powered lid. This dispensing mechanism was designed for ease of use and prevention of bleach splash-back that typically occurs when manually pulling wipes through standard lid orifices. Furthermore, the lid automatically retracts hanging wipes back into the canister after a period of inactivity to prevent drying of the bleach wipe, loss of efficacy, and wastage of the product— problems common in currently used bleach wipes. Figure 1B compares the visibility of surface coverage using
bleach wipes alone and bleach wipes dispensed through the Highlight Wipes Lid. When wiped on a standard bedside rail
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