Modern technologies for improving cleaning and disinfection of environmental surfaces in hospitals

Abstract

Experts agree that careful cleaning and disinfection of environmental surfaces are essential elements of effective infection prevention programs. However, traditional manual cleaning and disinfection practices in hospitals are often suboptimal. This is often due in part to a variety of personnel issues that many Environmental Services departments encounter. Failure to follow manufacturer’s recommendations for disinfectant use and lack of antimicrobial activity of some disinfectants against healthcare-associated pathogens may also affect the efficacy of disinfection practices.Improved hydrogen peroxide-based liquid surface disinfectants and a combination product containing peracetic acid and hydrogen peroxide are effective alternatives to disinfectants currently in widespread use, and electrolyzed water (hypochlorous acid) and cold atmospheric pressure plasma show potential for use in hospitals. Creating “self-disinfecting” surfaces by coating medical equipment with metals such as copper or silver, or applying liquid compounds that have persistent antimicrobial activity surfaces are additional strategies that require further investigation.Newer “no-touch” (automated) decontamination technologies include aerosol and vaporized hydrogen peroxide, mobile devices that emit continuous ultraviolet (UV-C) light, a pulsed-xenon UV light system, and use of high-intensity narrow-spectrum (405 nm) light. These “no-touch” technologies have been shown to reduce bacterial contamination of surfaces. A micro-condensation hydrogen peroxide system has been associated in multiple studies with reductions in healthcare-associated colonization or infection, while there is more limited evidence of infection reduction by the pulsed-xenon system. A recently completed prospective, randomized controlled trial of continuous UV-C light should help determine the extent to which this technology can reduce healthcare-associated colonization and infections.In conclusion, continued efforts to improve traditional manual disinfection of surfaces are needed. In addition, Environmental Services departments should consider the use of newer disinfectants and no-touch decontamination technologies to improve disinfection of surfaces in healthcare.

A Study of Bacterial Antibiotic Resistance in Four Major Waterways in a Taiwanese City

“…Besides increasing the diffusion rate of public foul sewers, some aquatic facilities may use a simple sewage filtration process to prevent partial sewage from flowing into the foul sewers, so as to reduce the sewage stream's load; and some aquatic facilities can be equipped with nano-film to block the contaminant source to some extent [23][24]. Currently, the best nano-film is capable of retaining virus particles effectively, allowing the water to flow through freely; or some aquatic facilities can conduct electrical current through a sodium chloride solution for electrolysis, so that the released chlorine can remove the bacteria in water effectively [25]. After all, the water area with safe water quality is the root of healthy and happy cities.…”

Healthcare‐acquired infections: prevention strategies

“…23,37,47 However, the completeness of physical cleaning is variable and dependent on staff performance. When measured, 50-60% of high touch surfaces that should be cleaned and disinfected are not.…”

“…While manual cleaning alone was previously viewed to be a sufficient focus of environment management, it is now clear that educational interventions and staff motivation are key determinants of cleaning efficacy and HAI prevention. 37,47 Other interventions to prevent HAI…”

“…When measured, 50-60% of high touch surfaces that should be cleaned and disinfected are not. 47,48 Initiatives including staff education, implementation of regular feedback and discussion of objective performance data, engender accountability and ownership and can result in improved standards. 38 Investment in cleaning staff as a valuable resource relies on the support of hospital executives.…”

Association Between Healthcare-Associated Infection and Exposure to Hospital Roommates and Previous Bed Occupants with the Same Organism

“…8 Numerous products are being developed and marketed to hospitals for the purpose of improving environmental disinfection, with particular attention given to routine cleaning for patients with multidrug-resistant organisms and terminal cleaning after discharge. 9 However, very few studies have actually examined whether there is a link between contamination in patient rooms and risk of infection. Given the constraints of financial and human resources for infection prevention and control, it is important to quantify the potential impact of enhanced environmental cleanliness.…”