ENVI RONMENTAL DECONTAMINAT ION
frequently hear the same phrase repeated by domestic staff: “We’ve always done it that way!” Regrettably, this makes innovation extremely difficult in such a critical discipline within any hospital. Research carried out in the last decade repeatedly demonstrates that conventional cleaning alone is not as effective as we think.
One study highlighted that “a large assessment of conventional cleaning in 36 acute hospitals using fluorescent markers revealed that <50% of high-risk objects in hospital rooms were cleaned at patient discharge”.2,3
Europe, where it was seen as a significant game changer in the battle against HCAIs. Initial reaction in the UK was dubious, as many could not understand how traditional mops and cloths with detergent could be outperformed by ‘mystical’ microfibre textiles and just water, even though there was plenty of evidence to the contrary.
The paper explains: “The key
problem associated with the cleaning and disinfection procedure is the reliance on the operator to repeatedly ensure adequate selection, formulation, distribution, and contact time of the agent”.4,5,6 Is wiping a surface with a textile cloth and chlorine the answer simply “because we’ve always done it that way?”; or can the adoption of new technologies simplify the manual cleaning process and significantly enhance levels of disinfection?
Traditional vs. microfibre
Many may not realise it, but the introduction of microfibre cleaning technology to the NHS dates back to the mid-1990s. The concept had been developed some time before in
Despite the scepticism, there were a number of hospitals who could see the benefits and became early adopters of the technology. Their belief led to a series of UK- based trials, both laboratory and in the field, which reinforced the findings of European counterparts. One such field-based trial of ultramicrofibre (UMF) in Scotland found that “Cleaning with UMF [and] water reduced TVC on the test surfaces by 30%”.7
Their findings
supported a previous laboratory trial carried out by microbiologists at University College London Hospitals (UCLH) back in 2006.8 The UCLH team confirmed that many outbreaks of HCAIs had been attributed to environmental sources, which needed to be identified and eliminated. They recognised classical cloth-based cleaning required disinfectants as well as detergents if pathogens were to be consistently and effectively removed. Expressing concerns about the safety of these chemicals, they sought a process for enhanced removal of
Cleaning audit percentage scores will be aided by a new star rating which should be displayed to give patients, visitors and staff a clear indication of the standard of cleanliness being met. This approach encourages collective responsibility as an area is now evaluated as a whole, ensuring colleagues work together to achieve high standards.
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bacteria from surfaces without having to resort to potentially toxic and destructive biocidal agents. Their goal was to help protect staff and minimise the risk of antimicrobial resistance, while preserving the structural integrity of the buildings. In order to assess the efficacy of UMF and a typical disposable cloth widely used in hospitals, four microorganisms were selected: MRSA, Klebsiella oxytoca, Acinetobacter calcoaceticus var. baumannii (ACCB) and Clostridium difficile spores. UCLH used several different surfaces for these studies: rough and smooth tile, laminate worktop (new and old) and stainless steel. Each surface was sterilised and then contaminated with bacterial suspensions made in phosphate-buffered saline (PBS) with or without 7% BSA. Both types of cloths were moistened with deionised water immediately prior to use. ATP swab tests were taken to quantify the performance of each of the cloths. Concluding the trials, the researchers stated: “UMF cloths are considerably more effective than ‘J cloths’ at removing MRSA, Acinetobacter, K. oxytoca and spores of C. difficile (applied in PBS and allowed to dry) from all three of the work surfaces tested. In most cases, cleaning with UMF cloths, but not J cloths, resulted in complete, or almost complete, removal of culturable bacteria or C. difficile spores.”9
They added: “The data
presented here clearly demonstrate that when compared with J cloths, UMF cloths consistently remove a larger proportion of organisms responsible for HCAI from several intentionally contaminated surfaces relevant to healthcare, irrespective of organism type.”10 Microbiologist and global hygiene specialist for Vikan A/S, Debra Smith, has long been an advocate of microfibre cleaning technology. In her previous role as researcher at Campden BRI, she worked with the NHS and Department for Health to undertake a study that compared the efficacy of a single- use, disposable microfibre cloth to that of a
JUNE 2022
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