Issue link: https://beckershealthcare.uberflip.com/i/246400
Executive Briefing: Mobile Equipment Disinfection rooms, at no longer than 60-minute intervals), the…procedure actually can spread heavy microbial contamination throughout the healthcare facility." As a result, hospital infection prevention staff must ensure nondisposable items are laundered daily, as recommended by the CDC, or encourage the use of single-use, disposable towels impregnated with a disinfectant to achieve the low-level disinfection required for non-critical items. Additionally, healthcare organizations should continue to encourage frequent hand washing among staff. Successful efforts to improve hand hygiene (e.g., asking providers to wash hands before entering and leaving a patient room) further reduce the risk of bacteria transfer to and from mobile equipment, since potential pathogens are eliminated before they are spread to hard surfaces. Roadblocks on the way to better infection prevention While these seem like fairly straightforward recommendations, hospitals often unwittingly fail to adhere to them. Adherence challenges are even greater for mobile equipment that, by its nature, doesn't stay in one place. Accessibility of the disinfectant product is especially important to improve adherence. The easier it is for staff to easily locate the disinfectant product, the more likely they will be to use it, the more likely the hospital will be to achieve better disinfection rates and the more likely patient outcomes won't be damaged because of an HAI. Studies have shown that compliance increases with increased accessibility to disinfectants. A proactive environmental and hand hygiene initiative at a 137-bed long-term care facility identified a lack of convenient and accessible solutions for disinfection. In response, a greater number of products were installed and strategically placed on medication, treatment and housekeeping carts as well as in all nursing stations, dining, therapy and activity rooms and public lounge areas. Staff input was solicited to determine optimal placement. This, coupled with intensive staff education for all shifts, resulted in a dramatic reduction of hospital transfers due to HAIs, reduced employee absenteeism and reduction in cost association with antibiotic use.8 Disinfection solutions should be placed in multiple areas where equipment may be used, stored or moved to. Ideally, products should be placed on, or connected directly to, the equipment so the ease of access and use is continuous. Product placement on equipment also serves as a constant reminder to disinfect, thereby improving compliance. Ongoing education and monitoring As with most healthcare improvement efforts, though, the problem doesn't lie with identifying best practices; rather, the challenge comes with ensuring adherence to best practices becomes an ongoing and ubiquitous part of organizational life. To ensure this occurs, healthcare organizations must put a formal, written protocol into place that clearly defines who is responsible 19 for disinfection, when it is to take place, and what standards, processes or procedures should be followed. After identifying the responsible staff members and training them on best practices, organizations should also offer regular education, reminding the staff of disinfection processes and its importance. Furthermore, organizations should put in place some mechanism to regularly monitor that the standardized processes are being appropriately followed. A 2011 study in the American Journal of Infection Control suggests that monitoring is critical to ensuring compliance. In the study, a multi-disciplinary committee spanning many departments identified and assigned certain areas and equipment to be disinfected by either nursing staff or housekeeping staff. However, the subsequent analysis of rolling blood pressure units and compliance by nursing staff found that the equipment was not being sufficiently disinfected, despite the development of written procedures. The researchers recommended periodic education and monitoring to ensure compliance.9 Conclusion Given the prevalence, cost and negative impact, both on patients' lives and the reputation of American healthcare delivery, HAIs continue to be a major concern for healthcare organizations. To combat them, healthcare organizations must implement standardized best practices that are maintained through education and monitoring. Proper disinfection techniques are imperative, even for less high-profile elements of a hospital, such as its mobile equipment, which have been shown to harbor potentially dangerous pathogens. To achieve true optimization of infection control efforts, mobile equipment can't be ignored. n Scott, D. (2009, March). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. CDC report. 1 2 Sehulster, L. M., et al. (2003). Guidelines for environmental infection control in health-care facilities. Recommendations from CDC and the Healthcare Infection Control Practices Advisory Committee. 3 Kramer, A., Scwebke, I., Kampf, G. (2006). How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infectious Diseases, 6,130. 4 CDC (2008). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. 5 Munoz-Price, et al. (2012, September). Decreasing operating room environmental pathogen contamination through improved cleaning practice. Infect Control Hops Epidemiology, 33(9), 897-904 6 Po, et al. (2009, November) Dangerous cows: an analysis of disinfection cleaning of computer keyboards. Am J Infect Control, 37(9), 778-780. 7 Peretz, et al. (2013, August 11). Do Wheelchairs Spread Bacteria within hospital walls? World J Microbiol Biotechnol. 8 Schandel, J. M., et al. (n.d.) Project: Clean Sweep Reducing Healthcare-associated Infections, Employee Absenteeism, Healthcare Cost and Hospital Readmissions in a Long Term Care Facility. 9 Havill et. al. (2011, September). Cleanliness of portable medical equipment disinfected by nursing staff. Am J Infect Control, 39(7), 602-604. PDI helps reduce preventable infections, control healthcare costs, and ultimately help save lives by delivering a broad range of evidence-based, market leading environmental hygiene and patient care solutions. 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