For years, consumers have been striving to rid their
homes of odour eating bacteria. I'm sure
that if you were to check under your sink or where ever you keep your cleaning
supplies you would find a spray bottle that claims to kill odours on
contact. If you dig deep enough you may
also find something that you can use to clean and sanitize your carpets or
other fabrics - you know the one you
bought when you were house training your dog?
The concept of soft surface sanitizing has been around
for some time and widely used by us in our homes as a mean to rid ourselves of
nasty odours. However the concept of
sanitizing soft surfaces within the healthcare market is relatively new and our
focus is not to rid ourselves of offending odours but to try and kill pesky
pathogens from surfaces than may contribute to transmission of disease. First off, infection prevention within
healthcare focuses on disinfection of environmental surfaces and patient care
equipment. We need to kill significant
numbers of the germs that are the cause for hospital infections such as
bacteria, viruses and fungi. EPA
registered disinfectants allow us to do just that. BUT, EPA registered disinfectants are
intended for use on hard, non-porous surfaces (beds, tables, toilets, Infusion
pumps etc) that do not absorb disinfectants and can be "easily"
cleaned and disinfected (at least according to the EPA definition..). In designing healthcare facilities great care
is taken when choosing finishes and equipment to ensure that we can clean and
disinfect thereby effectively minimizing the transmission of germs.
Where then in the realm of infection prevention do soft
surfaces fit in? Well, until recently
when researchers started investigating if soft surfaces such as privacy
curtains contributed to infection transmission everyone's stance was
"change when visibly soiled".
I suppose the ugly truth was we ignored one of the most highly touched
surfaces in a patient room because we did not know what to do with it! The science being published today is showing
that pathogenic germs can be found on privacy curtains. There has not been a study that I am aware
that conclusively blames privacy curtains for transmitting infections or being
the root cause of an outbreak, but I suppose, if touched enough by HCWs and
said HCWs did not clean their hands after touching the environment (privacy
curtains count!) then.......it could be plausible.
Enter stage left, the new claim on the Healthcare block -
Soft Surface Sanitizing. It's important
for HCWs to understand, sanitizing DOES NOT equal disinfection. Sanitizing means you reduce the number of
Vegetative Bacteria on a surface usually by 99.9%. Sanitizing claims DO NOT allow for claims
against viruses. Further, to make such a
claim (at least according to the EPA), testing needs to be done on ALL of the
soft surfaces you wish to use it on. The
type of fabric may impact the ability of a chemical to kill so testing on 100%
cotton or 100% polyester only may not cover the plethora of fabrics we see with
in a healthcare facility.
It is important that HCWs, especially those in infection
prevention or environmental services understand the distinction between
disinfection and sanitizing claims.
Certainly such a claim has merit, but if you choose to implement a
product with a soft surface sanitizing claim as part of your infection
prevention program do not think that it is the silver bullet for stopping the
spread of germs. Sanitizing will reduce
the level of germs of the surface. But,
sanitizing soft surfaces such as privacy curtains does not negate the need for
proper hand hygiene or continued vigilance in cleaning and disinfection of
environmental surfaces and patient care equipment AND the use of a soft surface
sanitizer does not negate the need for laundering!
In the end, it will be interesting to see if researchers
can build the science to conclude that such a claim will in fact make a
difference from an infection prevention perspective, but don't get caught in
the noise and hype of marketing and advertising. I've seen data to show that wiping or
spraying a privacy curtain can reduce bioburden. In theory, reduced bioburden on curtains may
help to reduce the risk for transmission, but hand hygiene will still by far be
the most effective means to reduce transmission. This New Claim on the Block will certainly
"legally" allow chemical manufacturers to paint a pretty picture of
how their products can be used and in talking with some healthcare facilities
that have been cited for using a "disinfectant intended for use on hard,
non-porous surface" on a porous or soft surface you will now be able to
state that your product is appropriate for use on soft surfaces. But, be sure to tell that Joint Commissions
auditor that soft surface disinfectants do not exist.
The question I have is if the new claim on the block will
be like the boy band New Kids on the Block?
Will it fizzle out after its moment in the starlight or will it truly
make a difference and be an important part of a well managed infection
prevention program? For me, the jury is
still out, but I suppose that it is in part as intuitively if you spray any
disinfectant onto a soft surface ensuring it is damp and allow the appropriate
contact time common sense would dictate that you're going to kill at least some
of the germs on the surface would it not?
Bugging Off!
Nicole
