Battling a Hidden Enemy: Reducing Infection from Environmental Contamination

In the healthcare sector, risk of infection is a major concern, not only in terms of patient well-being, but also when it comes to maintaining a steady and efficient flow in the hospital environment. The sources of contamination are varied and, in many cases, unknown, and inappropriate cleaning practices can see an accumulation of surface contamination in the environment itself. How do we expect our cleaning personnel to deal with the colonies lurking on ceiling tiles, or the undersides of bedframes and furniture? Not only does evidence show that full environmental decontamination is almost impossible to achieve by manual means, but to even attempt it would also take more labour resource than our hospitals have at their disposal.

The majority of hospitals depend solely on manual cleaning methods carried out on a regular basis by their domestic staff, in and around their other duties. Such conventional methods tend to involve the application of chemicals to surfaces, which, whilst giving the appearance of a clean environment, are unable to tackle some of the deadliest organisms prevalent in hospital settings, such as CPE, C. diff and others.

Evidence also suggests that manual cleaning is far from effective. It has been estimated that 20% of the sources of pathogens causing a healthcare-associated infection (HAI) in the intensive care unit are from other factors, including environmental contamination. The study also went on to reveal that over the past decade, substantial scientific evidence has indicated that the contamination of environmental surfaces in hospital rooms plays an important role in the transmission of several key healthcare-associated pathogens, including MRSA, VRE, C. difficile and norovirus. What’s more, all are characterised by their ability to survive for prolonged periods of time on environmental surfaces.

Attempts to Reduce Environmental Decontamination

When faced with a decontamination issue, hospitals typically have several options:

Adopt stricter cleaning practices – It has been suggested that hospital cleaning staff should simply be more effective in their cleaning processes, but are they really to blame? Several studies have indicated that after manual cleaning intervention, less than 50% of surfaces were properly cleaned. However, in a study by Blazejewski et al. (2015), the manual cleaning processes in an ICU unit were documented in great detail. They included the floor being cleaned three times a day using a wet sweep and once a day using a quartnernary ammonium compound. After patient discharge the healthcare workers cleaned and disinfected surfaces with chemical disinfectant. This process was conducted twice so as to provide a higher level of efficacy. After analysis, whilst there was a significant reduction in bacterial environmental contamination, there was also the same level of multi-drug resistant organism (MDRO) contamination as at patient discharge. It could therefore be argued that despite following strict cleaning procedures, manual cleaning has its limitations when it comes to effective decontamination.

Use an On-Call Deprox® Decontamination Service Routine terminal cleaning followed by a hydrogen peroxide vapour treatment such as Deprox® is more efficient than routine terminal cleaning alone for the disinfection of MDRO-contaminated rooms following patient discharge. With an On-Call Decontamination Service, hospitals can simply call in an engineer to decontaminate an infected room as and when the need arises, to help ensure the room is safe for the next patient to enter. Engineers usually arrive within 4 hours and can have a room ready for patient readmission in around 2.5 hours.

Use a Deprox® Managed Service In hospitals where there is a high infection rate, or where there is a specific need for an even faster service, there is a managed service which provides an on-site engineer and Deprox® system better suited to their demands.

Why Deprox®?

A portable and easy-to-use technology, Deprox® is a regulated hydrogen peroxide vapour system that delivers quick and effective environmental and surface decontamination. With average treatment times of around only 2.5 hours per room, Deprox® gives hospital staff the assurance that full decontamination has taken place and that the new patient is not at risk from cross-contamination.

Recently, a UK children’s hospital deployed the Deprox® system as a countermeasure to drug-resistant gram-negative bacterial infections in their neonatal intensive care unit. Focussed on reducing the number of avoidable infections in such vulnerable patients, the hospital was very impressed with the results achieved by the system: “Numbers of babies being colonised with ARGNB were reduced for at least five months following Deprox® HPV decontamination.”

Another hospital, in Western Australia, experienced similar success with the Deprox® system in an elderly care unit, reporting it as “efficient in ridding the hospital environment of VRE (vancomycin-resistant enterococcus) where routine cleaning has failed”.

The UK’s healthcare sector is facing many drug-resistant bacteria risks, including the worrying prevalence of the new ‘superbug’ CPE, which has become so difficult to treat that automated decontamination technologies are the only effective solution. Precaution and prevention through screening, isolation of infected patients and effective decontamination of rooms and shared patient equipment is key, and pivotal to any healthcare setting.

While there is certainly a need to remind healthcare professionals of the importance of hand hygiene in the fight against the spread of infection, in most cases automated decontamination like Deprox® is the only way to be sure that a room is clean and safe for a new patient to enter. Ultimately, Deprox® can be the difference between keeping on top of outbreaks and being dominated by them.

Sources

http://www.ruh.nhs.uk/about/policies/documents/procedures/Cleaning_Procedure_Manual.pdf

Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: Focus on clinical trials – Weber et al. (2016)

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