The Need for Additional Investigation of Room Decontamination Processes

Po, John Leander; Carling, Philip

doi:10.1086/653819

Cited by 11 publications

(11 citation statements)

References 10 publications

(4 reference statements)

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“…Although some studies are well done, these reports should be considered carefully because there are often concurrent interventions that confound the findings. Furthermore, few offer robust cost-benefit analyses, even though the devices are expensive and none obviate the continued requirement for basic cleaning [83]. There are also technical constraints which make routine use of robots problematic for busy hospitals [84].…”

Section: Automated Decontamination Methodsmentioning

confidence: 99%

“…Concerns have already been raised over efficacy and cost-benefits of automated devices because laboratory testing does not necessarily predict what happens on hospital surfaces [79,80,82,83,91,98,99]. Furthermore, the situation during outbreaks is rather different and managers quickly find resources for new technologies.…”

Section: Ultraviolet C Light Devicesmentioning

confidence: 99%

“…It would be wise to consider the use of no-touch systems for routine disinfection and outbreak control separately rather than assume that published outcome covers both situations. These systems obviously offer an alternative strategy for disinfecting hospitals, but their logistical complexities, requirements and costs, make it imperative that objective, controlled and independent studies should be performed to establish overall cost-benefits [83,100].…”

Section: Ultraviolet C Light Devicesmentioning

confidence: 99%

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Dos and don’ts for hospital cleaning

Dancer

2016

Current Opinion in Infectious Diseases

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Purpose of review More evidence is emerging on the role of cleaning and decontamination for reducing hospital-acquired infection. Timely and adequate removal of environmental pathogens leads to measurable clinical benefits for patients. This article considers studies published from 2013 examining hospital decontamination technologies and evidence for cost-effectiveness. Recent findings Novel biocides and cleaning products, antimicrobial coatings, monitoring practices and automated equipment are widely accessible. They do not necessarily remove all environmental pathogens, however, and most have yet to be comprehensively assessed against patient outcome. Some studies are confounded by concurrent infection control and/or antimicrobial stewardship initiatives. Few contain data on costs. Summary As automated dirt removal is assumed to be superior to human effort, there is a danger that traditional cleaning methods are devalued or ignored. Fear of infection encourages use of powerful disinfectants for eliminating real or imagined pathogens in hospitals without appreciating toxicity or cost benefit. Furthermore, efficacy of these agents is compromised without prior removal of organic soil. Microbiocidal activity should be compared and contrasted against physical removal of soil in standardized and controlled studies to understand how best to manage contaminated healthcare environments.

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Section: Automated Decontamination Methodsmentioning

confidence: 99%

Section: Ultraviolet C Light Devicesmentioning

confidence: 99%

Section: Ultraviolet C Light Devicesmentioning

confidence: 99%

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Dos and don’ts for hospital cleaning

Dancer

2016

Current Opinion in Infectious Diseases

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“…The latter paper also reported an overall decrease in the number of patients acquiring multidrug-resistant organisms despite missing a quarter of opportunities to apply the device after patient discharge (202). Innovative technologies offer an alternative strategy for environmental hygiene purposes, but their logistical complexities, aside from costs of equipment, training, management, and personnel, make it imperative that objective, controlled, and independent studies be performed in order to establish overall costs versus benefits (203). Furthermore, studies have hitherto concentrated on efficiency of surface disinfection without specifically examining the effects on airborne pathogens.…”

Section: Comparison Between Uv Light and Hydrogen Peroxide Systemsmentioning

confidence: 99%

“…Rapid disinfection cycles may well sterilize hard surfaces without eliminating viable organisms surviving in the air (41). Concern has been expressed by several authors over the premature incorporation of these systems into routine decontamination schedules (171,173,197,203,204). Cost-effectiveness studies would help health care managers choose the most appropriate system for their facilities based on evidence rather than advertising (197).…”

Section: Comparison Between Uv Light and Hydrogen Peroxide Systemsmentioning

confidence: 99%

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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SUMMARY There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens.

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The need for clinically relevant studies of non-touch disinfecting systems

Carling

2013

Journal of Hospital Infection

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The Need for Additional Investigation of Room Decontamination Processes

Cited by 11 publications

References 10 publications

Dos and don’ts for hospital cleaning

Dos and don’ts for hospital cleaning

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

The need for clinically relevant studies of non-touch disinfecting systems

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