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GINA SLOAN – DIRECTOR OF INNOVATIONS, MICROBAN INTERNATIONAL, UK INFECTION PREVENTION AND CONTROL


A systematic approach tohygiene inhealthcare


Gina Sloan discusses hygiene considerations for healthcare environments, and how the inclusion of antimicrobial surfaces can enhance existing protocols and practices.


Healthcare-associated Infections (HCAIs) are an increasingly prevalent issue for hospitals, care homes and other healthcare facilities worldwide. Despite the efforts of global public health organisations to raise awareness of the importance of hand hygiene, compliance remains low, indicating the need for additional preventative measures. A system approach to hygiene in the patient environment of care needs to be considered to provide a comprehensive solution to HCAIs. This solution will continue to improve on hand hygiene, increase monitoring of environmental surfaces, introduce novel disinfection techniques, and utilise embedded antimicrobials. To date, preventative measures for


HCAIs have been limited to hand hygiene. While these measures have resulted in a 2% to 11% reduction in infections1


and a similar decline in HCAIs within the UK, general compliance remains low in most healthcare settings. Observational studies focused on


compliance with hand washing guidance have shown an approximate 40% compliance rate with hand hygiene measures. This means that there are six out of 10 missed opportunities for hand hygiene within the healthcare environment.2,3 In recognition of the imperfect human, healthcare facilities must search for complimentary measures to reduce HCAIs.


The patient environment The patient environment has been highlighted as a potential source of pathogen contamination and


in the US


Once present on dry, inanimate objects, microorganisms can survive for days and even months


transmittance. The patient environment can be defined as all inanimate surfaces that surround the patient. This can encompass bed railing, flooring, bathroom facilities, and even door handles. A patient is constantly shedding


bacteria, skin cells, and mucus into their surroundings presenting a risk of infection. Rutala et al established that areas within the patient environment can be classified as low, medium, and high touch surfaces. The highest touch point areas receive up to 96 touches every day by patients,


Gina Sloan Dr Gina Sloan is director of Innovations at Microban


International, a provider of antimicrobial technologies and odour control solutions.


Gina recently received the 2019 AATCC Technical Committee on Research (TCR) Service Award for her leadership of AATCC’s RA31 Antimicrobial Activity Test Methods research committee. She holds a BS in Biology from Western Carolina University, and a PhD in Molecular Genetics from Wake Forest University.


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visitors, and healthcare providers.4 Interestingly, the highest touch items do not necessarily have a higher bioburden. Instead, the high touchpoint surfaces are a place for increased interaction and potential cross contamination and transmittance. The evolving contribution of the patient


environment to HCAI development is evident in prior room occupancy statistics. Once present on dry inanimate objects, microorganisms have a remarkable ability to survive for days and even months. After a patient has been discharged, the hospital room must undergo a thorough cleaning, typically referred to as terminal cleaning. Terminal cleaning measures are meant to remove all microbes from the prior patient, presenting a microbial clean room to the next patient. However, despite best efforts, terminal cleaning continues to be inadequate. This results in an increased risk of HCAI to the new patient, representing 1.4x the risk for a Methicillin Resistant Staphylococcus aureus (MRSA)


IFHE DIGEST 2020


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