INF ECTION P R EVENTION
Best practice to avoid contamination transfer
Nadine Bellamy-Thomas discusses the best practice approaches to minimise the risk of contamination transfer during reprocessing of medical devices, instrumentation and PPE.
In any clinical or healthcare environment, the risk of infection is one of the most critical factors to manage in order to ensure patients are protected during their treatment and recovery throughout their time in the facility. As well as putting patients in potential danger, the neglect of thorough hygiene practices can be hazardous to the integrity and reputation of practitioners. This was highlighted in the scandal of Daybrook Dental Practice in Nottinghamshire in 2016, which sparked the “biggest NHS patient recall in history”1
after failings in
cleanliness standards led to the testing of 4,526 patients for hepatitis C. Five were found to be infected.
While this was an extreme case, there is always a risk of infection spreading in any clinical environment, and co-infection or secondary infection of patients in care can cause complications with potentially lethal consequences. This risk factor is heightened by the coronavirus pandemic. Cox et al (2020) described how 50% of patients dying of COVID-19 had secondary bacterial infections.2 The use of invasive mechanical ventilation to treat the symptoms of the virus increases likelihood of indirect infection from the hospital or medical unit and the academics recommended that an urgent characterisation of co-infection within patients could help save lives throughout the pandemic. Now more than ever, regulations and training to cover decontamination procedures are standard practice, covering routines such as anything from the sterilisation of instruments, transfer between clean and dirty zones, and the disposal of infectious
waste. However, there are small actions that can result from complacency or lack of insight that can allow the transfer of contaminants in even the cleanest of environments.
When it comes to risk of infection, there are many factors to consider. Most healthy individuals have a general resistance to infection3
thanks to the body’s natural
defences, both external and internal. But a patient in a healthcare environment is more vulnerable to infection, because of factors such as their existing health conditions, weakened immune system, open wounds or invasive devices such as ventilators or catheters. The young and old are also at increased risk. Another important risk factor is the amount of contamination that a person is exposed to and if the level of contamination is enough to cause an infection to develop. Scientists are still studying the minimum effective dose for COVID-19.4
However, it is clear that the lower the amount of 66 l
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contaminant that a person comes into contact with, the lower the potential risk to any patient. While this is a constant primary concern in any healthcare environment, the prominence of COVID-19 across the world makes decontamination an even greater priority for clinicians. Miele Professional works closely with organisations throughout the UK to help them minimise contamination in two particular areas: cleaning and disinfection of reusable items such as glassware, instruments and medical devices, and the laundering and disinfection of garments such as lab coats, scrubs and PPE. To do this, the company gains a full insight into their daily hygiene and cleanliness routines and, as a result, it has identified a number of areas which can commonly be overlooked in terms of best practice when it comes to decontamination and maintaining a sterile environment. These are outlined in this article, along with recommendations to ensure peace of mind for staff and patients alike.
MAY 2021
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