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INF ECTION P R EVENTION


shortages.1


It was considered by UHS


managers that an immediate contingent stockpile was required in the event of supply- line failure (i.e. if all supplies and stocks of PPE became exhausted, and essential clinical services are at risk as a result). This contingent stockpile would be developed and evaluated, then held in readiness should supply circumstances deteriorate. To be suitable for use, reprocessing must achieve both physical cleaning and microbial decontamination, must not deteriorate the functional effectiveness of the garment, must not introduce further risk to the processor or wearer, and must be able to be defined and controlled for reproducibility. After initial in-house work to develop cool-temperature laundering of PPE garments to achieve reprocessing, the UHS sterile services and microbiology departments engaged Inivos to develop a process of vaporised hydrogen peroxide (VHP) sanitisation of the laundered garments, in order to assure an effective and reproducible level of sanitisation. VHP was selected since it is known to be effective against coronavirus and leaves no toxic residues. Under the advice of the UHS director of infection control, bacterial cultures were selected for testing decontamination efficacy which in his opinion would be more challenging to destroy than coronavirus SARS-CoV-2.


UHS concluded that the process was suitable to be developed into operating procedures within the sterile services department to reprocess PPE garments in the event of a supply-line failure.2


It was


considered that the method could achieve sufficient decontamination of PPE garments to be used in clinical areas, but that these should not be used for sterile processes, e.g. theatres. In addition, the garment integrity was not affected by the process. Ultimately, it is vital to have a plan of action should there be an outbreak of SARS-CoV-2 or any other hospital-acquired infection. Hospitals requiring urgent decontamination can call Inivos’ 24-Hour Rapid Response service for on-demand decontamination services which can be deployed within eight hours of first contact.


Manual cleaning is not enough on its own Manual cleaning is a necessary step to ensure clinical environments are safe for patients and staff alike; however, it is essential that manual cleaning is not solely relied upon as unavoidable but unintentional human error can leave pathogens behind. The micro-organism that causes the COVID-19 virus, SARS-CoV-2, can survive on surfaces for up to 28 days.3


Therefore, even if a space is thoroughly cleaned, 58 l WWW.CLINICALSERVICESJOURNAL.COM


manual cleaning can ultimately leave these deadly micro-organisms behind, due to unavoidable human error.


In order to combat this dangerous


micro-organism effectively, vigorous methods of decontamination are necessary. However, healthcare professionals must ensure that the methods used to effectively decontaminate a space are established and evidence-based to avoid staff or patients being exposed to potentially harmful chemicals, or chemicals that are ineffective against SARS-CoV-2. To ensure decontamination, hydrogen peroxide vapour (HPV) and ultraviolet-C (UV-C) light are effective, reliable methods that are demonstrated to reduce micro- organisms much more resistant than SARS-CoV-2 pathogen to safe levels. Both methods break down the fat and protein outer layer of the virus, before destroying the genetic material within. Their efficacy means they are often used by NHS Trusts to combat infection concerns like COVID-19, MRSA and C.difficile – more than a third of NHS Trusts (41%) currently use Inivos’ HPV and UV-C decontamination technology and services.


Therefore, it is vital that following a manual clean, cleaning professionals use these technological innovations to ensure that there is no trace of harmful pathogens. This can be achieved by ensuring that cleaning professionals feel educated and comfortable using these machines which can help aid the infection control process.


We will need to start taking a more proactive approach Research suggests that somewhere between 40% and 80%4


of COVID-19 cases are


asymptomatic, therefore seemingly healthy people can be silently and unknowingly transmitting the virus. Further to this, it can take some people up to 14 days to develop symptoms of the COVID-19 virus. The combination of these two factors means there is a large window of time for people to carry the virus unknowingly and pass it on to others.5 Recent research has also indicated that SARS-CoV-2 viral RNA can remain on ICU surfaces for up to 28 days after patient discharge.6


Even when there are


no known cases of the virus and visitors pass temperature checks, they can still be carrying the pathogen without symptoms. Therefore, there is a critical need for hospitals to proactively and regularly decontaminate all areas – even if they are a ‘green’ COVID-free site.


Infection prevention professionals need a seat at the table Moving forward, the critical role of hospital infection control experts, such as infection


SEPTEMBER 2020


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