12 MONTH NHS HOSPITAL REVIEW
There is little evidence to support the current national hospital cleaning regimes. Hospital-acquired infections (HAI) have been linked with contamination within the hospital environment, but the role of cleaning in this study was defined as aerobic colony counts (ACC) on hand-touch sites. Previous studies in the same environment have shown that visual assessment of cleanliness is not a good indicator and ATP bioluminescent technology is limited as a measure of a microbiologically clean environment.
In this study we specifically monitored Staphylococcus aureus(MRSA) in addition to ACC. Staphylococci, including MRSA, can survive for months in the hospital environment. They were found on floors, furniture, bedside lockers and over bed tables. These sites were usually situated beside the patient. It is possible that staphylococci are transmitted between patients via the hands of health workers after touching a contaminated surface. Sites nearest the patient pose a greater risk to the patient than the sites far distant in a clinical area, Therefore effective removals of these pathogens from the surfaces adjacent to the patient would be expected to reduce the transmission of HAI.
One purpose of this study was to measure the efficacy of the present cleaning regimes using the chlorine-releasing agent compared with DuoMax. Furthermore, the central question of can the currently used cleaning agent be replaced with agents of equivalent or superior effectiveness? Potentially these agents cause less
damage to equipment than chlorine based agents, in addition to reduce in staff hypersensitivity reactions. The study was conducted within the NHS Greater Glasgow and Clyde Health Board (GG+C and was supported by Health Facilities Scotland, a division of the Scottish NHS.
Both DuoMax and the chlorine releasing agent are equally efficacious at removing environmental contamination from the four surface sample sites. DuoMax was compared to Actichlor +, a chlorine releasing agent and the currently (and widely) used agent. Both agents have cleaning and antimicrobial capabilities in vitro. During this study, no difference in cleaning efficiency was seen between the agents on the basis of ACC, mean MRSA colony counts or percent detection of MRSA on environmental sample sites.
Summary of findings
This is an important finding, because chlorine releasing agents have been associated with hypersensitivity reactions in staff. Free chlorine, being a strong oxidising agent, is also a contributor to damage of the environment, including medical devices. This study therefore provides evidence that DuoMax, introduced during this study, can effectively replace chlorine releasing agents without a loss of cleaning efficiency.