Environmental hygiene


hundred non-invasive patient monitoring devices. Each device was cleaned several times a day, and used for more than 100 days a year. Within two years, there was visible damage to the devices, including cracks and degradation to the casing. The hospital had not requested any disinfection compatibility data from the device manufacturer. The manufacturer’s recommended product was a QAC (quaternary ammonium-based cleaner), but hospital guidelines prevented the use of QAC in patient care areas. Instead the hospital chose a different chemistry without communicating with the manufacturer to ensure material compatibility. An investigation found the disinfection


protocol implemented by the hospital was the cause of the damaged monitor devices. In addition, the wipes used by the hospital were considered to be oversaturated and, after disinfection, monitors were stored in a position that meant liquid pooled around screw holes, leading to further damage. Another disinfection issue involved a decision


by the hospital to use the monitoring system’s reusable sensors as a single-patient-use component, due to concerns about being able to effectively disinfect the cables between patients. This decision had a negative impact on both cost and sustainability goals. The estimated financial costs to the hospital,


due to device damage and cable disposal, was estimated at $4,853, 679. The study authors concluded that a focus on effective cleaning and disinfection strategies can only be successful if surfaces and products are not damaged by the disinfectants that must be used to destroy


specific microbes. An expensive lesson to learn! A study investigating the effects of disinfectant wipes on sensitive healthcare surfaces’12


tested different disinfectant wipes


on various surfaces, including point-of-care touch screens, bedding material and keyboards. The aim was to examine antimicrobial efficacy as well as any damaging effects. Prior to disinfection, all of the surfaces sampled showed marked contamination with bacterial and fungal organisms including Staphylococcus aureus and Escherichia coli. In terms of the antimicrobial efficacy of


various clinical wipes, the results showed considerable variation. Some wipes achieved complete removal of organisms and others showed some to no reduction at all. Wipes containing bleach significantly damaged the bedding material and left the most residue on the touch screen compared to other products. The quat-based and accelerated hydrogen peroxide wipes produced some damage to the mattress cover material and produced filming, spotting and discoloration on the touch screens.12


Damage to surfaces creates microbial


reservoirs for pathogens to proliferate, increasing the threat of infection. Breakdown of surface materials may affect the functionality of medical devices, presenting further additional risks to patients.13


Sensitive radiology equipment Effective cleaning and disinfection of medical equipment and surfaces in radiology departments (RD) is essential. A study found that 41.7% of X- ray tubes and 91.7% of control


40 www.clinicalservicesjournal.com I December 2023


panels and imaging plates in RD imaging rooms were contaminated.14,15


It has been documented


that X-ray machines may carry Gram-negative organisms, especially Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii.16 Many common potentially pathogenic


bacteria including Escherichia coli, Enterococcus faecalis and Staphylococcus aureus strongly adhere to radiographic imaging components and can survive for more than two weeks.17 Therefore, effective cleaning regimens are of fundamental importance in controlling and preventing potential nosocomial transmission in the radiology departments. As radiology equipment is likely to be sensitive


to disinfectants, cleaning products should be selected which can be used without damaging susceptible surfaces. Incorrect cleaning could void or limit insurance, warranties, and service contracts.18


HCAIs are a cogent issue for the


RDs, and knowledge of how to prevent them is essential for health professionals.


Conclusions This article has examined the need for effective healthcare environmental hygiene practices, which have been shown to help prevent HCAIs. Using a disinfectant which is incompatible with the surface being cleaned not only leads to potentially costly financial damage, but may also affect patient safety. Sensitive surfaces like those found on medical devices may become gradually damaged and disinfection becomes less effective. Eventually, performance, safety and integrity will be compromised. Although, sensitive clinical surfaces present a


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