Use of a daily disinfectant cleaner instead of a daily cleaner reduced hospital-acquired infection rates.

BACKGROUND: Documenting effective approaches to eliminate environmental reservoirs and reduce the spread of hospital-acquired infections (HAIs) has been difficult. This was a prospective study to determine if hospital-wide implementation of a disinfectant cleaner in a disposable wipe system to replace a cleaner alone could reduce HAIs over 1 year when housekeeping compliance was ≥80%. METHODS: In this interrupted time series study, a ready-to-use accelerated hydrogen peroxide disinfectant cleaner in a disposable wipe container system (DCW) was used once per day for all high-touch surfaces in patient care rooms (including isolation rooms) to replace a cleaner only. The HAI rates for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile were stratified by housekeeping cleaning compliance (assessed using ultraviolet-visible marker monitoring). RESULTS: When cleaning compliance was ≥80%, there was a significant reduction in cases/10,000 patient days for MRSA (P = .0071), VRE (P < .0001), and C difficile (P = .0005). For any cleaning compliance level there was still a significant reduction in the cases/10,000 patient days for VRE (P = .0358). CONCLUSION: Our study data showed that daily use of the DCW applied to patient care high-touch environmental surfaces with a minimum of 80% cleaning compliance was superior to a cleaner alone because it resulted in significantly reduced rates of HAIs caused by C difficile, MRSA, and VRE.

Alkaline detergent combined with a routine ward bedpan washer disinfector cycle eradicates Clostridium difficile spores from the surface of plastic bedpans.

The cleaning efficiency of a ward bedpan washer disinfector was evaluated using various cycle parameters and detergent to determine which conditions could effectively eliminate Clostridium difficile spores from the surface of bedpans. Results revealed that the regular intensive cycle with thermal conditions of 85°C for 60 seconds plus the addition of an alkaline detergent was sufficient to eradicate C difficile spores. However, these thermal conditions alone, without detergent, were not adequate.

Simulated-use testing of bedpan and urinal washer disinfectors: evaluation of Clostridium difficile spore survival and cleaning efficacy.

BACKGROUND: Reusable bedpans and urinals are frequently cleaned and decontaminated using washer-disinfectors (WDs) that may be located in the central processing department (CPD) or on the ward. The objective of this study was to determine how efficiently the WDs provided cleaning and to evaluate the ability of such WDs to kill Clostridium difficile spores. METHODS: The cleaning efficacy of 2 bedpan/urinal WDs (1 in the ward [ward-WD] and 1 in the CPD [CPD-WD]) were evaluated using simulated-use testing that included an ultraviolet-visible marker (UVM) that is readily removed when exposed to liquid. In addition, a proprietary test object surgical instrument (TOSI) device was used to assess the efficacy of the WDs. Artificial test soil (ATS) and C. difficile spore removal and killing also were evaluated. The removal of approximately 10(6) C. difficile spores and subsequent killing of these spores was assessed using autoclaved stool and/or urine as the soil challenge. RESULTS: Reusable stainless steel bedpans, plastic bedpans, and plastic urinals were assessed. Triplicate testing done on 3 separate days using TOSI devices, UVM, ATS, and stool and urine soils indicated that the ward-WD did not demonstrate adequate cleaning. It was determined that installation errors accounted for the inadequate cleaning. But the ward-WD did not adequately inactivate C. difficile spores even when the installation problems were corrected and the manufacturer-adjusted maximal thermal conditions were used. The CPD-WD was able not only to adequately clean the test devices of organic soil, but also to completely inactivate the 6 logs of C. difficile spores placed in sealed ampules inside the WD. CONCLUSION: The results of this study indicate that user testing of the efficacy of WDs is critical to ensure appropriate functionality. The currently accepted thermal decontamination parameters for all bedpan WDs (ie, 80 degrees C for 1 minute) are not adequate to eliminate C. difficile spores from bedpans.