DECONTAMINATION
published by a Healthcare Infection Society Working Party.11
The document states that
“good practice” includes: l Manual cleaning should be completed to the same high standard regardless of the subsequent use of automated cleaning devices.
l On first use of a fumigant or ultraviolet light in a specific room design, efficacy of sealing should be monitored to ensure safety.
l Prioritise different cleaning systems to the type of infection of the most recent room occupant by use of a red/ amber/green rating based on local nosocomial infection rates.
l Remove foam materials from the room if fumigant is used unless sealed under an impervious cover.
l Before purchasing or renting a system, run a mock decontamination cycle in a hospital room to determine turn-around times.
l After purchasing an ultraviolet-light decontamination system, consider the impact on surface finishes such as whitened polyvinyl chloride (PVC) before purchasing other equipment, and ask the equipment supplier to confirm compatibility.
l Monitor levels of fumigant or ultraviolet light at regular intervals during the contract to ensure efficacy.
l When adopting a new automated system or disinfecting a new room design, conduct microbiological culture tests (if permitted in the hospital) or take in-use environmental swab tests before and after disinfection to confirm efficacy.
Ultimately, he argued that cleaning is a science, and it is time to recognise it as such. We need to change the language – instead of saying “has that been cleaned?”, we should say “is that room/piece of equipment safe?” Garvey stated that nursing staff need to be educated in the importance of cleaning, while solutions need to be simple – such as changing over to more practical wipes. New technologies, such as UV, can help, as the latter is quick and can help hospital flow, but we also need to consider human factors. “You need to ask yourself, would you have your mum or loved one go into that room? This is how I broach my outbreak meetings,” he concluded. At the end of his presentation, Garvey announced that a new PhD has been launched in Christina Bradley’s memory, sponsored by Gamma. Tina was a committee member of the CSC in various positions culminating in being Chair between 2014-17 and was awarded Honorary Life Membership for her significant contributions to the organisation. Her work was well known to the healthcare community, and she provided an enormous contribution to improving overall standards in all areas of decontamination practice.
CSJ
For CSC membership please contact:
membership@centralsterilisingclub.org
References 1. Gilbert, J, The microbiome revolution: why microbes control your life, Ted Talks, Accessed at: https://
www.youtube.com/watch?v=aksMWePT6XQ
2. ancer SJ. Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clin Microbiol Rev. 2014 Oct;27(4):665-90. doi: 10.1128/ CMR.00020-14. PMID: 25278571; PMCID: PMC4187643.
3. Oelberg DG, Joyner SE, Jiang X, Laborde D, Islam MP, Pickering LK. Detection of pathogen transmission in neonatal nurseries using DNA markers as surrogate indicators. Pediatrics. 2000 Feb;105(2):311-5. doi: 10.1542/peds.105.2.311. PMID: 10654947.
4. Otter JA, Yezli S, Salkeld JA, French GL. Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces in hospital settings. Am J Infect Control. 2013 May;41(5 Suppl):S6-11. doi: 10.1016/j. ajic.2012.12.004. PMID: 23622751.
5. Nseir S, Blazejewski C, Lubret R, Wallet F, Courcol R, Durocher A. Risk of acquiring multidrug-resistant Gram-negative bacilli from prior room occupants in the intensive care unit. Clin Microbiol Infect. 2011 Aug;17(8):1201-8. doi: 10.1111/j.1469- 0691.2010.03420.x. Epub 2010 Dec 13. PMID: 21054665.
6. Garvey MI, Wilkinson MAC, Bradley CW, Holden KL, Holden E. Wiping out MRSA: effect of introducing a universal disinfection wipe in a large UK teaching hospital. Antimicrob Resist Infect Control. 2018 Dec 19;7:155. doi: 10.1186/s13756-018-0445-7. PMID: 30574298; PMCID: PMC6299988.
7. Anderson DJ, Chen LF, Weber DJ, Moehring RW, Lewis SS, Triplett PF, Blocker M, Becherer P, Schwab JC, Knelson LP, Lokhnygina Y, Rutala WA, Kanamori H, Gergen MF, Sexton DJ; CDC Prevention Epicenters Program. Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium
30 l
WWW.CLINICALSERVICESJOURNAL.COM
difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study. Lancet. 2017 Feb 25;389(10071):805-814. doi: 10.1016/S0140- 6736(16)31588-4. Epub 2017 Jan 17. PMID: 28104287; PMCID: PMC5935446.
8. Halstead FD, Quick J, Niebel M, Garvey M, Cumley N, Smith R, Neal T, Roberts P, Hardy K, Shabir S, Walker JT, Hawkey P, Loman NJ. Pseudomonas aeruginosa infection in augmented care: the molecular ecology and transmission dynamics in four large UK hospitals. J Hosp Infect. 2021 May;111:162-168. doi: 10.1016/j. jhin.2021.01.020. Epub 2021 Feb 1. PMID: 33539934.
9. Garvey MI, Bradley CW, Wilkinson MAC, Bradley C, Holden E. Engineering waterborne Pseudomonas aeruginosa out of a critical care unit. Int J Hyg Environ Health. 2017 Aug;220(6):1014-1019. doi: 10.1016/j.ijheh.2017.05.011. Epub 2017 May 31. PMID: 28592358.
10. Garvey MI, Bradley CW, Holden E. Waterborne Pseudomonas aeruginosa transmission in a hematology unit? Am J Infect Control. 2018 Apr;46(4):383-386. doi: 10.1016/j. ajic.2017.10.013. Epub 2017 Nov 28. PMID: 29195780.
11. Beswick AJ, Fry C, Bradley CR, Pottage T, Sharpe S, Haill CF, Mugglestone MA, Bak A, Marsden GL, Bennett A, Garvey M, Wilson APR. Automated room decontamination: report of a Healthcare Infection Society Working Party. J Hosp Infect. 2022 Jan 24:S0195-6701(22)00011-1. doi: 10.1016/j. jhin.2022.01.006. Epub ahead of print. PMID: 35085677.
Dr. Mark Garvey
Mark Garvey is a consultant clinical scientist in microbiology and the deputy director of infection prevention and control for the Infection Prevention and Control Service at University Hospitals Birmingham NHS Foundation Trust. Mark is also the director of the Hospital Infection Research Laboratory that investigates hospital infection and provides practical. Mark’s interests include water microbiology focusing on Pseudomonas aeruginosa and Mycobacterium chimaera.
JUNE 2022
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