ENVI RONMENTAL T RANSMI S S ION
The UK did not adopt a Search-and- Destroy policy as it was thought that this would cause considerable clinical disruption. Instead, the UK tended to emphasise single- measure strategies such as hand hygiene – such as the ‘Cleanyourhands’ campaign.4 Unfortunately, a steady year-on-year increase in HCAI-related deaths followed.5 It was not until 2007 that cases of HCAIs fell when a more holistic approach towards cleaning in the UK, including widespread deep cleaning of wards, cohorting staff and patients, as well as improved testing of patients, was introduced.
Aerial dissemination The Dutch were also quick to identify that HCAIs can disseminate through the airborne route, whereas the British were not. Whereas isolation rooms in the Netherlands were required to have an antechamber and be negatively pressurised, in the UK, positive patients were simply placed in ward side rooms. This action failed to acknowledge that contaminated clothing and bedding of colo- nised patients released S. aureus into the air when disturbed. Infection rates continued to rise in the UK. The level of recognition given to airborne dissemination in the UK com- pared to the Netherlands indicates why the UK may not have received the same level of success in controlling the spread of HCAIs.
Ventilation air conditioning units There has also been a debate surrounding whether ventilation air conditioning units prevent or encourage HCAI breakouts. These types of units contain large areas of ductwork where particulate matter can deposit or accumulate, which has caused ventilation units to have stirred increased concern over their risk.
There is little evidence available to prove that heavily contaminated ductwork results in adverse health risks. Ventilation systems, in theory, should act as a huge filter, effec- tively removing microbial particles from the air. Therefore, one would assume that if they are deposited in the ventilation system then they are effectively removed from the air flow within the ward space.
However, if recirculated this could pose a
risk. Unfortunately, there has been a lack of studies to date and, therefore, an absence of data to support either argument. This increased concern, which has been highlighted by the recent events of COVID-19, has encouraged contractors to introduce specialist ductwork cleaning services. As we begin to understand more about how the COVID-19 virus transmits, it has become more apparent that air hygiene and quality plays a vital role in the current circumstances. Even beyond the pandemic, air quality should be considered critical in all buildings. Alongside that, modern ventilation systems need to be maintained and thoroughly cleaned. For the healthcare sector in particular, air circulation is paramount for the safety and well-being of staff and patients. However, this can be challenging as different estates will require specific needs i.e. facilities range from a small community GP surgery in a converted dwelling, through to major purpose-built hospitals. The most important factor is that, whatever the size or infrastructure, air needs to keep moving safely.
Infection Control Technologies Specialist infection control technologies, such as ultraviolet (UV-C) light and hydrogen peroxide vapour (HPV), play a critical role in efficient cleaning processes to control the spread of infection.
Ultraviolet light UV-C has been around for over 100 years and plays a part in a disinfection method known as Ultraviolet Germicidal Irradiation (UVGI), which uses a short-wavelength light that can destroy inactive microorganisms by disrupting their DNA. This ensures they are unable to perform vital cellular functions. It is a chemical and residue-free disinfection method which is why it is a popular choice of sterilisation. The UV-C lights are beneficial when conducting deep cleaning processes in small and enclosed areas. UV-C has been proven to create a safer patient environment, which avoids any clinical disruption and improves the overall experience for patients and staff. However, like many products on the market, UV-C has not been clinically tested against the virus which causes COVID-19 (due to the very recent emergence of SARS-CoV-2), although it has successfully destroyed related coronaviruses.
Hydrogen Peroxide Vapour Hydrogen Peroxide is a powerful oxidising agent consisting of hydrogen and oxygen atoms, which naturally decompose into water and oxygen. The liquid chemical compound kills bacteria easily and is a successful and effective method for
66 l
WWW.CLINICALSERVICESJOURNAL.COM
sterilising and disinfecting surfaces contaminated with HCAIs.
HPV releases tiny droplets of hydrogen peroxide which then disperse in an enclosed area. Hydrogen peroxide uses a unique methodology of vapour dispersal technology coupled with powerful circulation.
How safe are they and which is best? Both methods are residue-free and safe to use. UV-C decontamination can be controlled remotely outside of the treatment area which eradicates the risk of operator exposure to UV-C light.
While hydrogen peroxide is a
hazardous liquid, the HPV system used for decontamination ensures complete safety. For example, an HPV decontamination system uses Proxin, which contains a low concentration of hydrogen peroxide. Therefore, this would be suitable and safe for use in hospital settings. In addition, the system automatically understands its environment and adjusts the decontamination process without an operator and is automatically and safely deactivated once complete. UV-C is the most popular
decontamination process because, compared to HPV, it is relatively cheap, quick and easy to conduct. It is also a trusted method of decontamination, used since the mid-20th century and is what most hospitals tend to use for ease of not changing the process. If you have a particularly busy Trust,
then UV-C is probably the best method of decontamination as it can usually only take 15-30 minutes to reduce pathogens, making it very efficient for wards that have a high turnaround. However, UV-C is not as effective at combating more robust bacterial spores. While UV-C is efficient, it is arguably not as effective as HPV as a form of decontamination as it does take a considerably shorter amount of time than UV-C to complete. If you have a ward with high rates of HCAIs, then it will ultimately create a safer environment for patients.
JANUARY 2022
©rost9 -
stock.adobe.com
@Hasselblad H5D
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84
