INFECTION PREVENTION AND CONTROL
increased in the UK since 1980s. This resulted in the production of national guidance, and in 2007 a countrywide ‘deep clean’ of healthcare facilities in response to a national issue with this organism. In recent years there has been an upsurge in C. difficile, and this again is driving national policy. While only responsible for a subset of antibiotic-associated diarrhoea, unlike the illness caused by disruption of the normal flora, which is self-limiting, in this instance the disruption of the normal flora allows Clostridium difficile to proliferate. This results in a disease, pseudomembranous colitis, although there is a wide spectrum, but with a significant morbidity and mortality in those more severely affected. Meiko’s Clostridium difficile whitepaper, ‘Clostridium difficile: Hygiene management for care utensils,3
provides
information about typical transmission routes, and insights into effective hygiene management for cases of C. difficile, focusing on effective cleaning using cleaning and disinfection machines as a significant factor in hygiene management. Just how significant an issue for hospitals C. difficile
One of the latest features to be introduced is hands-free opening of the washer-disinfectors.
regulators’. The paper went on to say, however: “Substantial changes have occurred over the past 65 years that challenge interpretation and application of this system that includes inter alia emergence of new pathogens (viruses, mycobacteria, protozoa, fungi), a greater understanding of innate and adaptive microbial tolerance to disinfection, toxicity risks, increased number of vulnerable patients and associated patient procedures, and greater complexity in design and use of medical devices.” “Opportunistic pathogens (such as viruses, mycobacteria, protozoa, fungi), and infectious agents (prions), has challenged current definitions and expectations of high, intermediate, and low-level disinfection... the basis of the Spaulding Classification is challenged.”
A ‘modern alternative- ‘flush-mounted slimline bedpan washer.
The C. difficile issue Clostridium difficile has – as most will know – become a significant issue in hospitalised patients over the past 3-4 decades, with awareness of its impact having
has become – especially for clinical and nursing staff, cleaners, and Infection Prevention and Control personnel, is underlined by data showing that in the 2020-2021 financial year in the UK, there were 12,273 cases of C. difficile infection (CDI) reported. In the same period, there were 1825 all-cause fatalities in patients with a CDI diagnosis. This demonstrates the high level of mortality associated with CDI. CDI also represents a substantial economic burden on healthcare, due to the high level of recurrence associated with it. There is a high cost of hospitalisation for CDI. In the UK, this is estimated to be £8173 per patient, with the possibility of numerous recurrences.4
Benefits of ‘new generation’ bedpan-washer-disinfectors Spaulding may not have considered how bedpans are transported from the patient to the disposal point, and what happens there, but Meiko’s engineers do. Every point of contamination is considered, and especially human intervention, when they set out to design bedpan washer-disinfectors. The goal is ‘process efficiency’, characterised by an emphasis on planning, standardisation, and adherence to rules and procedures, aiming for optimal outcomes through well-defined and executed processes. Meiko bedpan washer-disinfectors (as documented) can now provide automated and documented wash processes, including temperature curves and A0 values. Disinfection is by steam for absolute hygiene. Time, temperature, and water usage are preset, ensuring consistency, and eliminating the need for human intervention, thereby establishing process efficiency. This process is also independently verified. HygCen Germany GmbH carried out a study adapted to the relevant applications based on EN 17111 and EN ISO 15883-3, confirming that Meiko TopLine appliances satisfy the requirements for ‘Virucidal activity’ classification. Chemical security is automated, with alarms that indicate when chemicals are low. The machines will not run without chemicals, while for temperature security, multiple sensors validate each other to ensure hygiene. The washer-disinfector cannot run without achieving the correct temperature parameters. The risk of incorrect loading is also eliminated; standardising utensils and retainers removes this risk. Another key advance is that load detection selects the correct wash
60 Health Estate Journal September 2025
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