As human resistance to antibiotics increases in the UK it is even more vital that hospital-acquired infections are eradicated before they can spread. Luke Rutterford looks at recent techniques to keep hospitals safer.
5 June 2014
Healthcare environments in the UK are subject to strict legislation about the standards of hygiene that must be maintained.
But upholding these standards can be challenging for many hospitals; the National Institute for Health and Care Excellence (NICE) recently warned that infection rates still need to be cut. The watchdog reported that nearly 300,000 patients develop an infection each year while being treated by the NHS.
The challenge of specialist cleaning
Providing a clean and safe environment ensures that the risk to patients from hospital acquired infections (HAI) is reduced to a minimum. But the vast areas that have to be kept clean and the huge numbers of people passing through (many of whom are unwell), makes keeping hospitals hygienic a very difficult task.
Specialist cleaning in hospitals can be challenging, not only because of the complex nature of the task at hand, but also because of the need to keep disruption to a minimum. This was evident in January, when members of the public were asked not to attend University Hospital Llandough in Cardiff for several weeks because of a Norovirus outbreak.
In addition to the health risks to patients, failure to maintain hygiene standards can have severe business and administrative repercussions for a hospital. Outbreaks can cause hospital wards to close to new admissions, limiting the income for private hospitals and, more importantly, restricting the number of people a hospital can serve.
Deep cleaning is critical to hospitals
To effectively combat infectious outbreaks in hospitals it is imperative that all services are adequately resourced and clearly defined by a strategic cleaning plan. Forming a strategic cleaning plan with a deep-cleaning specialist is a sensible approach. To identify the best solution, a consultation should be undertaken that factors in the specific dynamics of the site, weighs risk against cost and efficiency, and also considers environmental factors such as the fabric of the building, the footfall, isolatable areas and any specific target pathogens.
How frequent the in-house cleaning regimes should be must then be determined, as well as how to implement specialist disinfection to enhance everyday infection control measures. It should be considered that although cleaning schedules and routines need to be put in place, it is vital that this does not affect service delivery.
Specialist cleaning needs to be carried out on both a proactive and reactive basis (neither work alone) to reduce the number of cross-infections occurring. Proactive routine cleaning of shared contact points and communal areas is essential, as is reactive disinfection as soon as a known infection is introduced by a patient or visitor. If that person is known to have inhabited a certain area, then that area should also always be disinfected before it is used again.
Innovations in deep cleaning
To combat outbreaks of infectious diseases, hospitals and healthcare practices need to partner up with a specialist cleaning provider who can sanitise areas quickly and efficiently. Technicians need to be highly trained, well equipped, and very experienced in providing specialist disinfection services.
Innovations in specialist cleaning technology aim to provide the highest possible levels of hygiene, while also ensuring that downtime and disruption are kept to a minimum. In an ideal situation, where you have an empty ward for 24 hours, HPV (Hydrogen Peroxide Vapour) fogging would be an option. But in the greater scheme of things an expedient and less time-consuming option is preferred.
For example, the use of ULV disinfectant fogging technology enables treatment of large areas very quickly. Foggers generate a fog or mist formed of Ultra Low Volume (ULV) droplets, measuring 5-50 microns (µm) in diameter. This means they are small enough to hang in the air long enough to tackle pathogens, and are also attracted to land underneath, on top and on the sides of surfaces where they can come into contact with pathogenic microbes that might otherwise be missed by manual cleaning.
Fogging is seen as a key weapon in the fight against Norovirus, also known as "winter vomiting bug". There are more than 25 different strains of the virus, which affects between 600,000 and one million people each year. The virus is usually transmitted through contact with a contaminated surface, and can survive on a surface for a number of days after being touched by an infected person. For this reason it can spread like wildfire in areas that are densely populated and where there is much coming and going, such as a hospital. Potential outbreaks need to be identified and dealt with quickly. Fogging technology can disinfect over 100 square metres in just a few minutes, helping to limit the spread of infectious disease almost instantly.
Another response in the fight against the transmission of infectious organisms is a post-pest disinfection service. Pests such as flies, cockroaches and rodents can carry bacteria and viruses that can be spread throughout the hospital environment, and so a reactive response to the health risk can significantly minimise any impact.
In addition to using specialist cleaners and the latest cleaning technologies, it is essential that all staff and visitors in a hospital take personal responsibility by following any infection control procedures that are implemented. This, combined with using the safest, most effective and advanced products delivered by a highly trained professional, is essential to the overall success of the operation.
Luke Rutterford, technical manager, Rentokil Specialist Hygiene