The A-Z of Patient Care - S is for Surface Cleaning

It is estimated that of every 100 hospitalised patients, up to 10 will acquire at least one healthcare-associated infection (HCAI) as a result of receiving care (WHO). Environmental cleaning and disinfection is one of the first lines of defence against reducing the risk of HCAI’s.

Healthcare-associated infections are caused when harmful pathogens such as bacteria, fungi and viruses enter the body. These pathogens usually follow a common series of events, known as the ‘chain of infection’3.

 

The Chain of Infection

1. Infectious agent – The pathogen that can cause infection by spreading directly or indirectly from person to person.

2. Reservoir – The places in the environment where the pathogen lives and can grow (this includes people and medical equipment).

3. Portal of exit – The exit portal through which the infectious agent leaves the reservoir (examples of this include open wounds, coughing and sneezing).

4. Mode of transmission - The way the infectious agent can be passed on (through direct or indirect contact, ingestion or inhalation).

5. Portal of entry - The way the infectious agent can enter a new host (through broken skin, the respiratory tract, mucus membranes, catheters and tubes).

6. Susceptible host – The person at risk (the most vulnerable of whom are receiving healthcare, are immunocompromised or have invasive medical devices)6.

 

Breaking the Chain

We can prevent infection from arising by breaking any one of these six links in the chain1. Environmental cleaning and disinfection can do so by inhibiting the build-up of infectious agents and reducing the risk of transmission.

However traditional environmental cleaning methods such as using a bowl of water and cloth can hinder the cleaning and disinfection process. Reusable cloths can act as a vehicle to transmit microorganisms in situations where the cleaning procedure fails to eliminate contamination from the surface and the cloth is then used to wipe other surfaces7. Additionally, this method of cleaning is reliant on the concentration of disinfectant being accurately mixed; incorrect dosages of disinfectant could impact the effectiveness of the formulation to kill microorganisms4. Some bacteria such as Clostridium Difficile (C. diff) and Vancomycin Resistant Enterococcus (VRE) can persist and grow on surfaces for up to five months9, posing a threat to patients who often have a weakened immune system; it is therefore crucial that cleaning efforts are effective and thorough to reduce the risk of cross infection.

Effective Environmental Cleaning

Effective environmental cleaning follows a two-step process.

        1. Clean the surface area, to limit the ability of infectious agents thriving and increase the effectiveness of disinfection.

        2. Disinfect the surface area to kill or inhibit the growth of infectious agents.

Whilst healthcare environments are one of the most common places for infectious agents to spread, bacterial infections are widespread and can occur in any environment. As infection spreads through direct and indirect contact, ingestion and inhalation6, there is a greater chance of infection spreading in crowded areas. Public transport, gymnasiums and schools are all places where contact with pathogens is significantly increased due to the number of people in a relatively small area. It is therefore important that proper disinfection and high standards of personal hygiene are maintained, to limit the spread to infection8.

Azo Solution

The Azo range of cleaning and disinfection solutions offers products for general cleaning, rapid disinfection and two in one cleaning and disinfection. Azo offer this full selection in a pre-dosed wipe format, which has been proven to be a more effective method of cleaning and disinfection for two reasons5:

1. The use of one wipe per surface limits the spread of microorganisms from one surface to another.

2. Pre dosed wipes reduce the risk of disinfectant mixing errors.

When selecting an Azo wipe, it is important to consider what the wipe will be used for -  

  • General cleaning – Choose a detergent wipe such as Azo Detergent for routine cleaning, damp dusting or as part of a two-step cleaning and disinfection process. Containing no active ‘disinfectant’, Azo Detergent flushable and macerator friendly wipes have been proven to ‘remove’ 99.9%* of bacteria purely through the quality of the wipe material.
  • Disinfection – To disinfect, choose a product such as AzoWipe, designed to disinfect clean surfaces. AzoWipe contains 70% IPA which has a very quick microorganism kill time, leaves no residue and dries quickly, meaning surfaces can be used shortly after disinfecting.
  • Cleaning and disinfection – For time saving convenient cleaning and disinfecting with one wipe, products such as AzoMax have proved popular. They are effective at cleaning the surface, as well as killing key infection causing microorganisms.

Available Products:

AZODETVernacare’s range of detergent wipes

Designed as the first part of a two-step cleaning and disinfection process. Available as a flushable/ maceratable wipe.

 

Azo™ Detergent Wipes flushable and macerator friendly

Product Code AZD050WF

Azo™ Detergent Wipes

Product Code AZD050W

 

Azo™ Detergent Wipes

Product Code AZD050W

AZOWIPEVernacare’s  range of disinfectant wipes.

Designed as the second stage of the cleaning and disinfection process. There are options for both hard surface disinfection and non-invasive medical equipment disinfection. 

Azowipe® 70% IPA Disinfectant Wipes

Product Code 81103

Azowipe® Sterile 70% IPA Disinfectant Wipes

Product Code 81160

Azowipe® Equipment 70% IPA Disinfectant Wipes

Product Code AZ100WNCE

AZOMAX Vernacares range of 2-in-1 wipes.

Designed to save time and money by cleaning and disinfecting surfaces or non-invasive medical devices with one step.

Azomax® Cleaning and Disinfectant Wipes

Product Code AM050WCE

Azomax® Cleaning and Disinfectant Wipes

Product Code AM100WCE

Azomax® Cleaning and Disinfectant Wipes

Product Code AM200NWCE

At Vernacare, we are experts when it comes to infection prevention and offer a whole range of products designed to reduce infection risk in healthcare settings. For more information about Vernacare products and how they can help you minimise the occurrence of HCAI’s, visit our product section here.

 

References  -    

1https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf?ua=1

2Roy F. Chemaly  et al (2014) The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment 2014.

3Breaking the Chain of Infection - NHS Education for Scotland Available at https://nes.scot.nhs.uk/education-and-training/by-theme-initiative/healthcare-associated-infections/training-resources/breaking-the-chain-of-infection.aspx. [accessed 22nd Jul 2019]

 4Healthcare Infection Control Practices Advisory Committee, 2003 Guidelines for Environmental Infection Control in Health-Care Facilities

5Wiemken T et al. (2014) The value of ready-to-use disinfectant wipes: Compliance, employee time, and costs

6https://elearning.nsahealth.org.uk/local/oracle_scorm/courses/principles_of_infection_control/data/ci/fr/lo_7042/data/lang_en_f/assets/pdf/nhs059_200108.pdf

7http://hospital-medical-management.imedpub.com/hospital-surface-disinfection-need-gapschallenges-and-management-for-basin-andmop-method.pdf

8https://pdfs.semanticscholar.org/e785/ad7e395f70b25264dc04c998ca865e98104a.pdf

9https://journals.sagepub.com/doi/pdf/10.1177/2049936114543287

*valuation of bactericidal activity on non-porous surfaces, Vernacare (2018)