Sanitization and disinfection of hospital patient care equipment
When it comes to the sanitation and disinfection of medical equipment, it is essential for medical staff in hospitals and clinics to adopt appropriate precautionary measures. This is because simple cleaning will not be sufficient to eliminate all potentially dangerous microorganisms, especially regarding medical accessories and equipment.
In addition to cleaning, it is important for medical devices, medical equipment, and surgical instruments to be properly disinfected and sterilized to the highest standards, using products approved by the Ministry of Health.
Surfaces are generally classified as either hard surfaces (e.g., window sills, workstations, floors, walls, ceilings) or soft surfaces (e.g., bed linens, upholstery, privacy curtains, clothing). Hand hygiene has been the primary focus of infection prevention efforts; however, the design and selection of surfaces in the built environment (especially those identified as “high-touch surfaces”) are also important considerations for breaking the chain of transmission.
Many healthcare facilities (including medical and dental offices) use disinfectant wipes to clean equipment. If a piece of equipment is cleaned quickly, is this sufficient to ensure that all organic material has been removed and that the disinfectant is killing microorganisms in accordance with the label claims? To be effective, all organic material must be removed for the disinfectant to act as stated on the label.
The first thing to check is whether the disinfectant wipe is a combination of detergent and disinfectant or just a disinfectant. This information should be found on the label or in the product documentation, which is why it is essential to use only products approved by the Ministry of Health. KLINOMED WIPES® Surface disinfectant wipe, 85% alcohol
The importance of disinfecting medical equipment
Could patient care equipment pose a risk to patients? Is there a real risk or is it just a theoretical one? Is the disinfection of patient care equipment an unjustified burden for staff in clinics and hospitals? Has patient care equipment been associated with an outbreak of infection or, at the very least, with the transmission of organisms?
To answer these questions, we will analyze the role of equipment in the transmission of microorganisms and in infection outbreaks within specialized literature. Numerous studies have examined the spread of methicillin-resistant Staphylococcus aureus (MRSA) from colonized patients during medical procedures. It was found that 32% of surfaces touched by staff and 25% of portable equipment (e.g., vital signs equipment, bladder scanners) were contaminated with harmful organisms. From this perspective, in addition to surface disinfection, it is also necessary to perform disinfection of medical instruments.
Which equipment carries a high risk of spreading potentially dangerous microorganisms?
In studies conducted over time, common medical equipment has been implicated in several outbreaks as a source of pathogen transmission. Specialists[1] have conducted a review of the literature that compared outbreaks related to patient care equipment between 1987 and 2016. The authors found that the types of equipment responsible for outbreaks have not changed over time, and other medical equipment was involved in almost all situations analyzed.
Based on the literature review, researchers classified various equipment according to the risk of outbreaks and healthcare-associated infections. They classified humidifiers, nebulizers, suction machines, ultrasound probes, and thermometers as high-risk, as these items were responsible for multiple outbreaks. Pressure transducers and stethoscopes were considered to have a moderate risk of being a source of infection outbreaks.
Blood pressure cuffs, computer keyboards, mobile phones and tablets, electrocardiography (ECG)/lead wires, enteral feeding sets, medical charts, tourniquets, wheelchairs, and toys were categorized by the authors as having a low risk, as these items were involved in fewer outbreaks. Interestingly, an Acinetobacter baumannii outbreak was identified on a humidifier temperature probe, even though the probe had been disinfected with 70% ethanol according to the manufacturer’s recommendations.
This observation underscores the importance of interdisciplinary collaboration and including an infection prevention specialist when reviewing cleaning and disinfection instructions in medical facilities. Another recent study, which quantified interactions between hospitalized patients and equipment, found that a high percentage of portable equipment was contaminated with MRSA, vancomycin-resistant Enterococcus (VRE), and/or Clostridioides difficile. Approximately 42% of equipment came into direct contact with patients in medical-surgical or intensive care units. The rest of the equipment was touched only by medical staff.
Procedures for disinfecting medical equipment in hospitals
What is the best way to ensure proper hygiene and disinfection of patient care equipment?
An important step in answering this question is the use of professional disinfectants specifically designed for healthcare facilities. Furthermore, it is important for those in charge of hygiene at medical institutions to determine exactly the right type of product for each surface, in accordance with current recommendations.
Another extremely important step is the development of equipment cleaning policies based on the recommendations of equipment and disinfectant manufacturers and indicating the party responsible for each piece of equipment. Responsible staff will carry out a sanitation and disinfection protocol and ensure its implementation.
Some additional ideas for determining if equipment is being cleaned properly, according to the literature, include the use of a fluorescent marking gel that can be seen only with the help of a black light or an adenosine triphosphate (ATP) monitoring system. The marking gel is the least expensive and requires little training to use. When used, the areas most likely to be contaminated on the equipment intended for monitoring will be determined beforehand, and the marked area will be changed periodically to prevent focusing only on marked areas.
Spraying disinfectants (e.g., chlorine, phenols, hypochlorites, quaternary ammonium compounds, accelerated hydrogen peroxide) and wiping surfaces with microfiber or cotton cloths are the first stages of the cleaning process. The concentration of the disinfectant, choice of applicator, application process, volume-to-surface ratio, and total contact time can enhance or undermine surface decontamination. In some cases, pathogens can accumulate on surfaces following cumulative cycles of soiling and cleaning.
[1] https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/abs/selection-of-the-ideal-disinfectant/B234721A16E7FD0A3960FD5DA3E95790
