Role of Environmental Cleaning in Infection Prevention and Control

Transcription

1 Role of Environmental Cleaning in Infection Prevention and Control September 28, 2012 Marilyn Weinmaster RN BScN, CIC Regina Qu Appelle Health Region

2 Health Care Setting Any location where healthcare is provided Complex environment Generally contains a large variety of microorganisms which may present a risk to patients, staff and visitors

3 Health Care Setting (cont d) Transmission of microorganisms within health care settings: Complex, very different than community Consequences may be more severe

4 Survival of Organisms on Environmental Surfaces Survival of methicillin resistant Staphylococcus aureus, vancomycin-resistant enterococcus, and C. Difficile on dry inanimate objects Bacterium Methicillin resistant Staphylococcus aureus Vancomycin-resistant enterococcus Clostridium difficile spores Duration of Survival 7 days to 7 months 5 days to 4 months 5 months Kramer A. Schwebke I. Kampf G. How long do nosocomial pathogens persist on inanimate objects? A systematic review. BMC Infectious Diseases 2006; 6:130

5 Viruses on Reservoirs Virus Hard Surfaces Cloth Skin RSV 8 hours 1-2 hours 25 minutes Flu A/B hours 8-12 hours 5 minutes Rotavirus 8 days-weeks Days HIV Hepatitis A Hepatitis B Norovirus Adenovirus 2 hours 2 weeks >1 week 3 weeks 3 months Matlow, Anne, MD, Partnering to Improve Hospital Environmental Cleaning and Reduce Microbial Contaminiation. May, 2010 PowerPoint Presentation: Slide 17

6 Items Found to Harbour Microorganisms in the Health Care Environment Examples of environmental items that have been shown to harbour microorganisms such as MRSA, VRE, C. difficile, A. baumannii, RSV, influenza virus and others Bed 63 Door handle 27, 42, 52, 65, 76, 77 80, 81 Phlebotomy tourniquet Bed frame 64 Electronic thermometer 51, 78 30, 63, 82 Pillow/mattress Bed linen 42 Faucet handle 27 Sink 68 Bedpan/bedpan cleaner 65 Floor around bed 64 Stethoscope Bed rail 42, Hemodialysis machine 27 Suctioning and resuscitation equipment 68 Bedside table 67, 68 Hydrotherapy equipment 54 Table, staff work table 87 /charting area Blood pressure cuff 27, 42 Infusion equipment 42, 68 65, 67, 88 Telephone, mobile phones Call bell 65, 67 Light switch 52, 65 Television 52 Chair 27, 69 Overbed table 42 Therapeutic and fluidized bed Clean gloves that have touched room surfaces only 70 Patient bathroom 64 52, 65, 67 Toilet/commode Computer keyboard 32, Patient hoist/lift and sling 64 Tourniquet 90 Couch 27 Pen 79 Ventilator 68 29, 50, 89 Provincial Infections Disease Advisory Committee. (May 2012) Best Practices for Environmental Cleaning for Prevention and Control of Infections. Ontario Agency for Health Protection and Promotion.

7 Environmental Contamination Plays a Role in Health Care Associated Infection Evidence: is evolving Studies: 1. Microorganisms can survive on surfaces/items» Cultured from environment» Proliferate in or on surface 2. Direct means for transfer of organisms from contaminated surfaces/items in environment to hands

8 Environmental Contamination Plays a Role in Health Care Associated Infection (Cont d) 3. Exposure to contaminated surfaces/items in the environment is associated with acquisition of colonization or infection 4. Attention to environmental cleaning and disinfection of surfaces/items can significantly decrease transmission of microorganisms within healthcare settings

9 HCW Hands C. Difficile On/In Patients Susceptible Patients Environmental Surfaces Philip C. Carling, MD Role of Environmental Surfaces in Health Care Infections, January 2010 PowerPoi8nt Presentation: Slide 19

10 Conclusion The environment in health care settings is a reservoir for microorganisms Environmental cleaning and disinfection is a key strategy in reducing health care associated infection Improving cleaning practices in healthcare settings contributes towards controlling health care associated infection and costs.

11 References Community and Hospital Infection Control Association-Canada. (2011, December). Routine Practices E-Learning Modules Working Group. Provincial Infectious Disease Advisory Committee. (2012, May). Best Practices for Environmental Cleaning for Prevention and Control of Infections. Ontario Agency for Health Protection and Promotion. Health Canada (1998). Handwashing, Cleaning, Disinfection and Sterilization in Healthcare. Health Canada. Carling, Philip C. MD, The Role of Environmental Surfaces in Health Care (January 2010) Webber Teleclass. Matlow, Anne, MD, Partnering to Improve Hospital Environmental Cleaning and Reduce Microbial Contamination (May 31, 2010) Community and Hospital Infection Control Association-Canada,National Education Conference, Vancouver, BC.