Cleanliness of the clinical environment has a direct impact on healthcare-associated infection (HCAI) incidence and there is increasing evidence of its importance with regard to infection prevention and control. While traditional high-level disinfectants have excellent antimicrobial properties, these are typically offset against issues such as corrosiveness, toxicity, cost and user acceptance. Recent years have seen several user-friendly sporicidal disinfectants emerge onto the market. Antimicrobial profile and user acceptance determine the clinical success of any disinfectant. Therefore, product adoption is often a two-stage process with a tabletop evaluation of the appropriate technical data, including efficacy claims, followed by an in-use product evaluation. The first part of this article demonstrates the importance of the clinical environment with respect to HCAI and examines some of the issues around disinfectants used in health care and considerations when selecting a new disinfectant for use. The second part reports the experiences of the Infection Prevention and Control team at Alder Hey Children's Hospital in their assessment and subsequent adoption of a new user-friendly sporicidal disinfectant into clinical practice.

Background: Single rooms are in short supply in many hospitals. Aim:To evaluate the impact of introducing semi-permanent pods to convert multi-occupancy bays into single occupancy pods. Methods:We performed a 24-month pre-post observational study in a 15-bed paediatric high dependency unit. Three semi-permanent pods were installed in February 2013, in the middle of the 24-month period. The percentage of missed isolation days and the proportion of days for which >4 patients required isolation (which would exceed existing isolation facilities) were compared for the year prior to the pods with the first year of pod use using a Fisher's exact tests. Results:Missed isolation days fell from 58.2% (662/1138; 95% confidence interval [CI], 55.3-61.0) pre-pod to 14.8% (205/1382; 95% CI, 13.0-16.8) during the first year of pod use (P <0.001). The percentage of days for which >4 patients required isolation was 74.5% overall (95% CI, 70.5-78.8), and increased from 63% (95% CI, 56.2-69.4) pre-Pod to 86% (95% CI, 80.9-90.3) during pod use (P <0.001). Discussion:The introduction of three semi-permanent pods was feasible in our paediatric HDU setting and reduced the number of missed isolation days, and hence transmission risk, for important hospital pathogens.