Keeping your hospital clean this winter

A norovirus outbreak can cause widespread chaos, reducing staffing to critical levels and closing hospital wards at the drop of a hat.  It is therefore imperative to prevent the spread of infection at the earliest opportunity; a lag in reactive specialist disinfection can have a major impact on overall infection rates. 

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. All services need to be adequately resourced and clearly defined through a strategic cleaning plan. It is vital that it does not affect overall service delivery or result in having beds unavailable, however that being said, swift reactive disinfection of contaminated areas is paramount to reduce the overall burden that is placed on our health services.

Specialist cleaning needs to be carried out on a regular basis to reduce the number of cross-infections occurring. Outbreaks in busy places such as hospitals, nursing homes and schools are common because the virus can survive for several days on surfaces or objects touched by an infected person. Ensuring public areas are regularly sanitised can have a big influence on the numbers of infections acquired within any unit.

Washrooms should always be considered a high risk area of potential contamination. The incubation time of norovirus is typically 24-48 hours, and when the symptoms do break, the washroom is often frequented. It is therefore wise to include the regular specialist fogging and disinfection of washrooms as part of the overall infection control strategy. Pathogenic microbes can easily be spread around and contaminate their surroundings, such as toilets, bedclothes, skin and clothing, and can be transmitted through direct contact with shared contact points, therefore high levels of hand hygiene and regular sanitisation of shared surfaces is fundamentally essential.

Reactive disinfection should be undertaken as soon as a known infection is presented by a patient or visitor, and if that person is known to have inhabited a certain area, then that area should always be sanitised prior to re-use. It is also highly beneficial to have that area fogged with a dual disinfectant and cleaner, as this will further increase the efficacy of the treatment programme by having direct contact with airborne pathogens such as those spread in aerosolised vomit and diarrhoea.

Ultra Low Volume (ULV) fogging allows the treatment medium to naturally gravitate to areas that other microbes may have drifted to. This may not always be possible due to the footfall of the area, however where it can be used, this should be carried out as best practice. Another area for consideration within the infection control programme should include hospital provided transport, which can act as a reservoir of infection for those arriving and departing the hospital environment and can have a significant impact on the spread of infection both from, and back into the wider community.

All staff in a healthcare environment and all visitors, including transient patients, should participate in the prevention and control of infection by following good hygiene practices and conforming to the infection control protocol.

Best results of infection control are achieved through a combination of high personal hygiene standards, daily cleaning and infection control by the healthcare unit, backed up with regular and responsive disinfection by specialist service providers. Once this is achieved, a reduction of both the volume and frequency of infectious outbreaks should be realised. 

Written by Luke Rutterford, technical manager, Rentokil Specialist Hygiene