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Environmental hygiene


Driving improvements in environmental hygiene


Associate Professor, Dr. Yew-Fong (Pamela) Lee and Dr. Thomas Oh examine the clinical evidence for the prevention of cross-contamination and spread of healthcare-associated infections, within the context of material compatibility between disinfectant wipes, surfaces and equipment.


Healthcare-associated infections (HCAIs) continue to pose a significant threat to patient safety, and the importance of hospital surroundings, together with healthcare environmental hygiene (HEH), should not be underestimated. A recent study concluded that ‘optimal HEH practices are an integral part of patient safety and a key component in improving infection prevention and control. Healthcare institutions may be able to lower their HCAI rates by improving HEH practices.’ 1 Any environmental surfaces or equipment


may be contaminated by microorganisms and pose a risk of cross infection. Effective decontamination is essential and the use of clinical wipes is one of the most efficient and prevalent methods used in hospitals. While there is evidence to support the role of wipes in preventing cross-contamination and spread of HCAIs,2


material compatibility between wipes, surfaces and equipment is becoming of real concern. Detergent and disinfectant wipes can damage plastic surfaces of medical devices if they are not compatible with the surface material. The Medicines and Healthcare products


Regulatory Agency (MHRA) issued an alert (MDA/2013/019) to this effect, warning of the potential damage caused to medical devices, if disinfectants are not compatible with the surface material.3


This followed a series of


incident reports relating to clinical wipes that degraded surfaces of medical devices (MD).


The performance and integrity of the MDs; and therefore safety in use were adversely impacted. This article examines the clinical evidence for the prevention of cross-contamination and spread of HCAIs, within the context of material compatibility between disinfectant wipes, surfaces and equipment.


Healthcare-associated infections (HCAIs) HCAIs have been described as ‘one of the gravest threats to patient safety worldwide’.1


They are


defined as infections which develop ‘as a direct result of healthcare interventions for example,


When selecting a disinfectant wipe for use in a healthcare setting, it should have a wide antimicrobial spectrum, be fast acting, keep surfaces wet for the minimum time to achieve efficacy and be compatible with common healthcare surfaces and equipment.


medical or surgical treatment, or as a result of direct contact with a healthcare setting’.4 HCAIs are caused by a wide range of


microorganisms, which have gained entry into the body by an invasive device or procedure, including Meticillin-resistant Staphylococcus aureus (MRSA), Meticillin-sensitive Staphylococcus aureus (MSSA), Clostridium difficile (C. difficile) and Escherichia coli (E. coli). Around 300,000 people a year in England


acquire an HCAI as a result of NHS care. These infections are transmitted via blood, body fluids or excretions, and can result from contact with any equipment or items in the care environment that could have become contaminated. Their impact can be devastating and HCAIs can exacerbate existing or underlying conditions, delay recovery and adversely affect quality of life.4


Maintaining


environmental cleanliness is recognised as integral to infection control precautions.4


HCAIs and healthcare environmental hygiene (HEH) Given the threat posed by HCAIs, the importance of the hospital environment for both patient


December 2023 I www.clinicalservicesjournal.com 37


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