Sunday, March 8, 2015

Environmental Cleaning, Revisited with New Technologies

Lately I have been thinking a lot about terminal room disinfection as one of the aspects of our infection prevention program. 

For those of you who labor over similar concerns, here is an informative review on new technologies for room disinfection, published in Current Treatment Options in Infectious Diseases

There is no single best method for cleaning patient rooms. Traditional manual cleaning is still the norm however this is labor intensive and subject to issues with compliance and quality. In my opinion, there is simply too much variability in practice and too great a risk for optionalism and human error to make this a truly effective approach.

New technologies, such as UV-light robots and hydrogen peroxide robots allow for "whole room'' disinfection, following a manual wipe down of bioburden and debris. This is promising yet not salvation.These technologies are costly, add additional time to cleaning, decrease patient throughput, require a vacant room (cannot be used while patient remains in the hospital room) and may be damaging to some materials.

Last, we know that the inanimate environment is teeming with pathogens and spores. A precise estimate of the proportionate impact of environmental cleaning on decreasing hospital acquired infections, even with the employment of new technologies, is lacking.

We are still searching for the optimal strategy for cleaning our hospital environment.   

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