Reynolds Kelly A, Sexton Jonathan D, Garavito Fernanda, Anderson Brandie, Ivaska Joan M
Environment, Exposure Science and Risk Assessment Center, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ.
Banner University Medical Center, Tucson, AZ.
Crit Care Explor. 2021 Feb 17;3(2):e0340. doi: 10.1097/CCE.0000000000000340. eCollection 2021 Feb.
Healthcare surfaces contribute to nosocomial disease transmission. Studies show that despite standard guidelines and practices for cleaning and disinfection, secondary infection spread among healthcare workers and patients is common in ICUs. Manual terminal cleaning practices in healthcare are subject to highly variable results due to differences in training, compliance, and other inherent complexities. Standard cleaning practices combined with no-touch disinfecting technologies, however, may significantly lower nosocomial infection rates. The objective of this study was to evaluate the efficacy of a whole-room, no-touch disinfection intervention to reduce the concentration and cross-contamination of surface bacteria when used in tandem with manual cleaning protocols.
Bacterial tracers were seeded onto hospital room surfaces to quantitatively evaluate the efficacy of manual terminal cleaning practices alone and in tandem with a no-touch, whole-room atomization system. Cross-contamination potentials and labor efficiency were also evaluated.
Environmental service personnel cleaning efficacy was evaluated pre and post application of manual terminal cleaning protocols alone and in tandem with a whole-room atomization system with an United States Environmental Protection Agency-registered hospital-grade hypochlorous acid disinfectant.
The study was conducted in an unoccupied patient room at Banner University Medical Center in Tucson, AZ. The room was located in a newly constructed ICU suite.
Manual terminal cleaning averaged a 2.4 log reduction in seeded bacterial counts compared with a 4.9 average and up to a 6 log reduction with tandem cleaning. Cross-contamination among surfaces following terminal cleaning alone was documented in 50% of the samples compared with 0% with tandem cleaning, with the latter achieving a 64% improvement in manual labor efficiency.
The use of whole-room atomized disinfection with terminal cleaning protocols lowered manual labor times, improved disinfection outcomes, and eliminated the transfer of bacterial pathogens in healthcare environments.
医疗保健环境中的表面会导致医院感染传播。研究表明,尽管有清洁和消毒的标准指南及做法,但重症监护病房(ICU)中医护人员和患者之间的二次感染传播很常见。由于培训、依从性和其他内在复杂性的差异,医疗保健中的手动终端清洁做法结果差异很大。然而,标准清洁做法与非接触式消毒技术相结合,可能会显著降低医院感染率。本研究的目的是评估一种全室非接触式消毒干预措施与手动清洁方案一起使用时,对降低表面细菌浓度和交叉污染的效果。
将细菌示踪剂接种到医院病房表面,以定量评估单独的手动终端清洁做法以及与非接触式全室雾化系统一起使用时的效果。还评估了交叉污染可能性和劳动效率。
在单独应用手动终端清洁方案以及与全室雾化系统一起使用美国环境保护局注册的医院级次氯酸消毒剂后,对环境服务人员的清洁效果进行了前后评估。
该研究在亚利桑那州图森市班纳大学医学中心一间无人占用的病房进行。该病房位于新建的ICU套房内。
手动终端清洁使接种细菌计数平均减少2.4个对数级,而联合清洁平均减少4.9个对数级,最高可达6个对数级。单独终端清洁后,50%的样本记录到表面存在交叉污染,联合清洁则为0%,后者的体力劳动效率提高了64%。
全室雾化消毒与终端清洁方案一起使用,可减少体力劳动时间,改善消毒效果,并消除医疗环境中细菌病原体的传播。