ENVIROMENTALCONTROL

Environmental Contamination

• Patients with pathogens such as methicillin-resistant S. aureus (MRSA), Clostridium difficile, vancomycin-resistant enterococci (VRE), and Acinetobacter frequently contaminate environmental surfaces .

• These organisms can remain viable in the environment for weeks or months

Survival time Infectious dose

MRSA 7 days to 7 months 4 cfu’s

Acinetobacter 3 days to 5 months 250 cfu’s

C.difficile 5 months 7 spores

VRE 5 days to 4 months <103 cfu’s

Norovirus 8 hours to 7 days 10-100 virions

Kramer, BMC Infect Dis, 2006; Dancer SJ, LID 2008; Chiang, Crit Care Med 2009;

Wilcox M, 2010; Larson, Lancet 1978; Kjerulf et al, APMIS 1998

Properties of hospital pathogens

Examples of Contaminated Environmental Surfaces

• Items frequently contaminated near patients include:• Bed rails• Bed linen• Over-bed tables• Blood pressure

cuffs• Intravenous

pumps• Nurse call buttons• Urinary collection

bags

Carling et al, JHI 2010

Frequently touched surfaces!

Environmental Control

Use EPA-registered disinfectants that have tuberculocidal

activity . It will act against the pathogens most likely to contaminate

the patient-care environment.

Use in accordance with manufacturer's instructions , for dilution and

contact time .

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Cleaning

Is the removal of adherent visible soil, blood, and other debris from surfacesGenerally accomplished with water and detergentsRemoves or eliminates the reservoirs of potential pathogenic organismsCleaning should be done on a regular basis to remove soil and dust

Disinfection and Sterilization …

Disinfection

is the destruction of harmful microorganisms, other than bacterial spores, on inanimate objects by the use of a chemical agent

Sterilization

Is the process by which all forms of microbial life, including bacteria, viruses, spores and fungi are destroyed

Cleaning Schedules

Keep housekeeping surfaces visibly clean on regular basis

Starting from non- infected area and keep infected area at last

Clean up spills promptly

Clean and disinfect high-touch surfaces, such as doorknobs, bed rails, light switches, and surfaces in and around toilets on a more frequent schedule

Use EPA -registered hospital disinfectant

Clean walls, blinds, and window curtains in patient-care areas when visibly soiled or dusty

After last procedure of day, mop the floors

Cleaning of some pathogen

For MDRO,MRSA use routine cleaning

In case of Clostridium difficile spores, use hypochlorite-based products for disinfection (Clorox 1:10).

For VRE vigorous cleaning is required

Blood and Body Fluids Spills

Promptly clean and disinfect spills of blood and other potentially infectious materials.

Use protective gloves and other personal protective equip.

Use CHLORINE RELEASING DISINFECTANT (active against HIV or HB)

Wet blood: Presept powder (GRANULES ) Dried blood: Presept tablet diluted @ 10,000 ppm

Contact time: 2 minutes

Scoop and dispose in yellow bag

Clean with hot water and disinfectant

Terminal Cleaning of Rooms

Discard all disposable items in accordance with the policy on disposal of infectious wastes.

Thoroughly clean all horizontal surfaces of furniture, mattress covers and patient care equipment with a disinfectant-detergent.

Wet-vacuum or wet-mop all floors with a disinfectant-detergent solution.

Clean walls and blinds. Change curtains.

Separate DIRTY ITEMS FROM CLEAN ITEMS

Remember…

Everything you

touch has been touched by

someone else!

KING KHALID UNIVERSITY HOSPITALINFECTION CONTROL DEPARTMENT