CM/Spotlight: Sustainability First, the organization can be restruc-tured so cleaning staff can report directly to trained infection prevention; at the least, environmental services staffs can begin a direct dialog with infection prevention spe-cialists to determine how to achieve a more cooperative, interdependent relationship. Second, the cleaning staff can learn about the strengths and weaknesses of the different products they use, especially with respect to disinfection. Cleaning staffs should know enough to avoid common pitfalls of surface disinfec-tion like the overuse of properly prepared disinfectant solutions. Research shows that the resulting deple-tion of the active ingredient leads to cross-contamination of adjacent surfaces. The final, and probably easiest, way to increase compliance is to provide the cleaning staff with a tool that makes fool-proof surface disinfection easy. The optimal surface disinfectant for the hospital environment would have these qualities: Easy to use, quick disinfection, broad kill range, reduces potential of cross-contamination, non-toxic and will not dam-age surfaces. A commercial steam vapor system outfit-ted specifically for surface disinfection pro-vides all of these qualities and more. Commercial steam vapor systems pro-vide many advantages, but they must be individually validated for surface disinfec-tion because a steam vapor system’s germ-killing power depends on many factors: The moisture content of the steam, its tempera-ture at the tool-surface interface and tool surface area. A leading manufacturer of commercial steam vapor systems recently completed extensive surface disinfection efficacy test-ing at three established, independent labo-ratories. A realistic test system was designed for all studies — many of which were done entirely in duplicate. High initial microbial concentrations that were dried onto a mix of porous and non-porous surfaces were used. Study results show that the system rapid-ly kills viruses, fungi and antibiotic-resistant bacteria, providing a sanitizing benefit with-in two seconds of surface contact and dis-infecting surfaces within five seconds. In the hands of trained cleaning staff, commercial steam vapor systems have many advantages. Most systems are chemical-free, safe to use around patients, quiet and portable. Since targeted heat, not chemicals, is the “active ingredient,” disinfection is exceed-ingly fast and broad-spectrum. There is no specter of chemical cross-resistance to antibiotics, surfaces do not become sticky, stain or discolor over time and staff can disinfect as frequently as nec-essary without long-term chemical expo-sure concerns. Since pre-cleaning is not required and the contact times necessary for disinfection are on the order of seconds rather than minutes, staff compliance is naturally less of an issue for the commercial steam vapor system. Additionally, commercial steam vapor systems afford a key advantage: The steam cleaning tool remains very hot, so the potential for cross-contamination from sur-face to surface or room to room is greatly reduced. This is in sharp contrast to the traditional “spray and wipe” approach, which recent studies suggest can actually spread pathogens from one surface to the next if the disinfectant becomes overused or is inadvertently inactivated. This person would focus on disinfecting surfaces such as doorknobs, light switches, bedrails in patient rooms and other high-touch surfaces. Meanwhile, the second staff member would focus on deep cleaning and disinfec-tion of a broader group of surfaces between room changeovers. There would be many advantages to such an approach. Foremost, the repetitive disinfection of the high-touch surfaces would dramatically decrease transmission of pathogens throughout the hospital. Traditionally, such surfaces are cleaned once a day or once a week and, considering the rate at which these surfaces are touched, once a day or week is wholly inadequate. By using a steam vapor system, high-touch surfaces can be disinfected on an hourly basis without damage to the surface, chemical irritation to sensitive populations or long-term risks to staff. Time To Take Action It is time to take action, to be open with respect to how we think about preventing pathogen transmission by hospital surfaces. Hospital surfaces are cleaned to enhance appearance and preserve functionality; they’re disinfected to prevent infections. Chemical disinfectants have surely pre-vented many infections, but they can be irri-tating to patients and dangerous to staff. In addition, they are not used in hospitals as intended. As such, chemical disinfectants may not provide the kind of disinfection that is needed in this era of increasing antibiotic resistance. Commercial steam vapor systems repre-sent a new approach to infection control that is environmentally friendly, chemical-free, broadly active and rapidly efficacious. If you are interested in infection control, you doubtless enjoy opportunities to evalu-ate new technologies as they become available. Consider steam vapor from an objective, scientific perspective: It is a new technolo-gy with the potential to reduce pathogen transmission within your facility. The impact to human health may well be worth the time and contemplation invested. CM Visualizing The Change Just as there is no breakthrough cure for multi-drug resistant infections in sight, there is no disinfectant likely to be developed soon that will provide the unique benefits of a steam vapor system. The optimal plan will be determined through careful scientific research, but it will certainly capitalize on the ability of commer-cial steam vapor systems to be used seam-lessly around patients and frequently on high-touch, often vertical surfaces. In one scenario, a member of the hospi-tal cleaning staff would be tasked with ongoing “hot spot” disinfection while anoth-er would be responsible for terminal clean-ing and disinfection with a commercial steam vapor system. The first staff member would move in a cyclical fashion from wing to wing or floor to floor on an ongoing basis. 20 CM/Cleaning & Maintenance Management ® • June 2010
CMM – Archives Jun 2010: 20
