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(https://www.who.int/news-room/q-a-detail/q-a-how-is-covid-19-transmitted) (https://www.tork.co.uk/about/hygiene/dispenser-placement-healthcare)


A healthcare issue – on the surface


Frequently-touched surfaces in healthcare facilities need to be kept clean and COVID- free to ensure the safety of staff, patients and visitors, but hand hygiene is equally as important, says Essity’s Liam Mynes.


COVID-19 has spread like wildfire across the globe, and there is still much to learn about how it is communicated.


According to the World Health Organization, current evidence suggests that the virus is mainly transmitted through direct, indirect or close contact with infected people via secretions from the mouth and nose.


These include saliva, respiratory secretions and droplets released when an infected person coughs, sneezes, speaks or sings. Anyone in close contact with a sufferer could contract COVID-19 if these infectious droplets permeate their mouth, nose or eyes.


This is why we all need to practise ‘social distancing’ to avoid close contact. However, there is growing evidence that the virus can also be spread via contact with surfaces around us. This is a particular issue in the healthcare sector where there’s a higher concentration of COVID-19 sufferers, along with vulnerable people in at-risk categories.


According to a new study from South Korea, a range of hospital surfaces such as pillows, bedside rails and call buttons can harbour the virus that causes COVID-19. Researchers studied data from 13 patients in two South Korean hospitals, all of whom had tested positive for COVID-19. Environmental samples were collected from various surfaces in patient rooms including monitors, blood pressure cuffs, pillows, bedside rails and nurse call controllers.


COVID-19 was detected in 17.5% of the patient room surfaces in one hospital, and 13.6% of surfaces in the second facility. However, negative tests were recorded for all areas outside the patient rooms such as anterooms, corridors, and nursing stations. The study’s authors concluded that the results justified an ongoing need for strict cleaning, disinfection, and contact precaution protocols.


A second study carried out in the US in August had more alarming results. Scientists at the University of Nebraska Medical Centre collected air and surface samples from the environment around people in quarantine facilities who had tested positive for COVID-19.


Samples were taken from the subjects’ high-touch personal items such as phones, exercise equipment and television remotes while room surfaces tested included ventilation grates, tabletops and window ledges. A total of 75% of all room surfaces sampled were positive for COVID-19, with researchers concluding that all hospital procedures needed to account for the risk posed by objects and surfaces.


Cleaning protocols in hospitals everywhere have been stepped up in the wake of the pandemic – and in some


50 | HEALTHCARE HYGIENE


cases, new technologies have been adopted. In July, two Midlands hospitals began using human-sized robots to disinfect wards, theatres and corridors with the aid of ultraviolet light. The battery-powered machines, deployed at facilities in Derby and Burton, were claimed to be capable of killing 99.99% of germs and viruses.


In August it was announced that Manchester’s NHS Nightingale Hospital was to begin using air purifying devices supplied by Glasgow-based Purer Clean Air to keep its patients and staff COVID-safe. The University of Birmingham is also currently developing a new surface technology aimed at the healthcare sector claimed to be active against bacteria, fungi and viruses. The technology, christened ‘NitroPep’, is a coating which can be applied on to plastic and metal surfaces.


However, most hospitals are simply stepping up cleaning frequencies and using the same measures they have always adopted to keep their premises safe. Cleaners are working around the clock to scrupulously clean all high-touch surfaces after every source of contact, but contaminated surfaces are only a problem when someone touches them and transfers the virus to other objects or to their own nose, mouth or eyes. This is why scrupulous hand hygiene is just as important as keeping surfaces clean – and the two measures should be taken in tandem.


Hand hygiene was identified early on in the pandemic as an important factor in reducing contamination levels. The need to wash the hands frequently for 20-second intervals to ensure they were clean was clearly communicated to all staff members.


However, it is not healthcare staff alone who are likely to come into contact with contaminated areas surrounding hospital patients. Bed rails and chairs will be touched by hospital visitors while the lockers, bedside tables and call buttons will be frequently touched by the patients themselves.


Hand gel stations are usually installed at strategic points around hospitals and outside ward doors, and most UK trusts now make it a requirement that visitors use them on entry and exit. But no one is actually policing this practice because healthcare staff are far too busy to keep a check on visitors’ hygiene practices.


Prominent posters situated around the hospital will help to remind visitors – and patients – about the need for good hand hygiene. Efforts should also be made to enhance the signage around sanitiser dispensers, and these should be placed in strategic positions to ensure that they are used.


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