Improving environmental hygiene in healthcare

The World Health Organization reports that at any given time, of every 100 hospitalised patients, seven in developed countries and ten in developing countries will acquire at least one healthcare-associated infection (HAI). To prevent infections and provide patients with a better hospital stay, healthcare organisations should focus on maintaining a clean environment.

One tactic for improving environmental hygiene, or the cleanliness of surfaces, is to use the right disinfectants. However, not all disinfectants are created equally. Healthcare cleaning professionals should consider the following before selecting disinfectant products for their healthcare premises.

Efficacy

It is important to select disinfectants that are capable of killing pathogens of concern. Problem pathogens, such as norovirus and rhinovirus, might not be killed by quat disinfectants. Contact times must be realistically short so that any pathogens present are killed before the surface dries. Disinfectants with long contact times may require reapplication to ensure pathogens are killed.

A recent study published in the American Journal of Infection Control showed that the introduction of an environmental hygiene bundle that included a disposable wiping system pre-wetted with an Accelerated Hydrogen Peroxide (AHP) disinfectant cleaner and a cleaning validation system using a fluorescent marker significantly reduced the rate of HAIs including C. difficile, MRSA, and VRE over a one year period.

The Cleaning Task

The variety of available disinfectants has grown in recent years, as manufacturers have developed solutions for specific daily and problem-solving tasks. It follows that it is now more important to match the product to the specific application. Doing so maximises cleaning performance and in turn reduces inefficiencies, poor results, and the need for repeat cleaning.

Manufacturers can provide advice on the most suitable products from their product lines to use in every situation. They should be able to supply the requisite documentation and evidence to support product claims.

Patient Needs

There is a trend towards more cleaning taking place while patients are present. This means that cleaning processes must be completed safely and efficiently, so as not to create an unpleasant environment or put patients at risk. This is one of the reasons why disinfectants whose formulations include chlorine and/or quat-based ingredients are being replaced by products that incorporate alternative, but equally effective, formulations with ingredients such as AHP.

Budget

When correctly specified and used, multipurpose formulations can lower overall cleaning costs by reducing the number of separate products needed. Further savings can be achieved because multipurpose formulations simplify procurement and purchasing processes, minimise storage, and reduce implementation, deployment, and training costs.

Organisations can further reduce costs when using formulations as super-concentrates in conjunction with dispensing or dilution control systems. These ensure that solutions for spray bottles, buckets, and cleaning machines are prepared accurately and without waste to the ideal concentration for high performance. These closed loop systems are also safer because they prevent users from coming into contact with the product.

Staff Training

The easier a product is to use, the greater the chance of cleaning compliance. Products should be accompanied by training aids in multiple languages to support members of diverse cleaning teams in their first language. Meanwhile, consistent color-coded and easy to read alphanumeric labels simplify training and deployment. Despite proper training, there are still cleaning and disinfection challenges that may arise. It is therefore important to measure performance to determine if additional training is necessary.

Environmental Impact

To determine a product’s level of sustainability, healthcare cleaning professionals can evaluate several aspects and characteristics, including ingredients, format, and efficiency:

Consider the ingredients of the formulation and how they are sourced or manufactured. Many "natural” ingredients are in fact made from basic chemicals in factories. Also, products that use crop materials may result in deforestation or other intensive farming practices. Look for products that carry reputable sustainability certifications.

Consider product format (eg concentration and packaging). Smaller packaging minimises transport, storage, and handling requirements. Super-concentrates also require less packaging. Users can also evaluate if the packaging is made from recycled and/or recyclable materials.

Weigh the efficiency of the product. It is vital to ensure the product is correctly specified and used to the manufacturer’s recommendations (including correct dilution rate) to ensure maximum efficiency and performance and reduce waste.

Take into account consequential benefits. This includes reduced energy and packaging consumption and adopting innovative formulations. For example, switching to formulations designed to work at lower temperatures can save energy. Another option is to adopt alternative products that may be just as effective but less damaging to the surfaces being cleaned.

Carefully considering the application, patient needs, budget, staff training, and environmental impact can help narrow the list of potential disinfectants. With qualified recommendations, effective product in place, and an auditing programme, cleaning and disinfection programmes can be maximised.