Surface Selection in Health Care - Part 3

In the first and second parts of this series we discussed how materials that are selected can play a role on infection control, as well as surface assembly, microbiology, location and human behavior. Some additional considerations are:

6) Cleaning and Disinfection

This is an aspect that is obviously critical, but is often misunderstood. Everyone knows it is important to clean and disinfect everything. However, can each surface be cleaned and disinfected effectively in the timeframe set for completing that task? The typical response a manufacturer would give is “yes, you can use anything to clean all surfaces.” Clearly, this is not the case. Not all surfaces of a bed, for instance, can be effectively cleaned and disinfected the same way. Further questioning often begins to reveal a lack of understanding of infection prevention protocol and cleaning and disinfection products that are being used at different times and in different situations.

Surface manufacturers don’t know what they don’t know, particularly when it comes to infection control strategies, processes and products. The recent issue faced by manufactures of ERCP scopes has sent some back to find ways to effectively sterilize their products.

Many different cleaning products are used, some of which can cause serious damage to surfaces. Often, this damage is unseen and creates a microbial reservoir that harbors pathogens that can proliferate, untouched by disinfection products.

7) Manufacturer Warnings

Finally, it is extremely important to request and understand manufacturer warnings. Surface materials often come with warnings about using cleaning and disinfection products commonly used in healthcare facilities. Unfortunately, this information is often not documented properly and the knowledge is not passed down to those in charge of cleaning staff.  Even with this information, it is important to test surface materials as an assembly, not just the individual components. Testing individual materials will give one result but combined materials cleaned and disinfected can produce an entirely different result. Equipment may include many different surfaces that cannot be cleaned and disinfected the same way. If they are damage could occur, thereby opening areas for microbes to harbor and hide from biocides.

It is not unusual to find that a manufacturer has tested specific chemicals on their product, but has not tested disinfection products. Results can vary when an actual disinfectant product is tested, since it may be composed of multiple active and inactive chemicals. Even if your cleaning products are not called out in manufacturer warnings, make sure to confirm that they are safe to use for each product and surface.

Conclusion:

Clearly, environmental surfaces play a critical role in the transmission of HAIs. By being aware of the seven aspects presented here, my hope is to provide a clear understanding of why facilities must set surface criteria to minimize risk and prevent harm to patients, healthcare workers and the general public. By using the seven aspects to create surface selection criteria, facilities will lay the foundation for sustainable reductions in the number of HAIs.

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