Infection Control Today

DEC 2018

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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Proven, Quantifi ed Hygienically Clean Linens, Gowns and Scrubs Infection prevention to minimize HAIs requires your laundry service to be Hygienically Clean certifi ed to ensure healthcare textiles (HCTs) are safe from microbes, molds and fungus: • Proven best laundry practices detailed in quality assurance (QA) manuals • Multiple third-party inspections that follow consistent, proven protocols • Quarterly testing of clean laundry to internationally recognized standards Managed by an advisory board of laundry, epidemiology, infection control, nursing and other healthcare professionals, Hygienically Clean is the right certifi cation to include in your RFP for linen and uniform service. YOUR LAUNDRY VISIT PLAN—Know what to look for when you observe a healthcare laundry's washing, fi nishing (drying, folding, ironing), staging and storage. Download this guide to visible indications of a laundry's thoroughness, based on Hygienically Clean certifi cation inspection protocols: www.hygienicallyclean.org/laundryvisit study to assess the trajectory of microbial contamination on curtains over time, with control curtains used for comparison. Patient curtains became increasingly contaminated despite starting at the same level as controls. Therefore, regular curtain contact that occurs in proximity to an occupied patient bed results in increasing colonization over time. Given that we sampled areas where people hold curtains, it is likely that the increasing contamination was because of direct contact. To our knowledge, no set of standards exists for assessing hospital surface hygiene. However, it has been proposed that hospitals should be at least as clean as food preparation environments. For example, the United Kingdom has specifed that food processing equipment should be <2.5 CFU/ cm2; by day 21, 75 percent of remaining curtains exceeded this safety threshold. The food industry also tests for the mere presence of certain high-risk organisms. Indeed, certain pathogens such as MRSA are associated with signifcant morbidity and mortality. By day 14, 87.5 percent of test curtains grew MRSA. Therefore, the 14-day mark may represent an important opportunity to intervene. Fourteen days were proposed in another study to be the minimum amount of time that curtains should hang before requiring intervention." In an earlier study looking at privacy curtain contamination on a burns/plastic surgery ward for two separate occasions six months apart (23 curtains in August 2015 and 26 curtains in January 2016), Shek, et al. (2017) found curtain contamination in August 2015 was 0.7–4.7 cfu/cm2 with 22 percent testing positive for MRSA, whereas contamination on January 2016 was 0.6–13.3 cfu/cm2 with 31 percent of curtains testing positive for MRSA. As Shek, et al. (2017) explain, "Potential for cross-contamination to and from the curtains is increased in the presence of open wounds. Burns/plastic surgery units are especially at risk due to the number and complexity of patients with open wounds." They add, "Despite a hand hygiene compliance rate of more than 80 percent on this ward, the results of this study suggest that more work needs to be done to better understand the colonization on these curtains …The current method of cleaning privacy curtains at our institution is to remove them in exchange for a cleaned curtain and send the old curtain to hospital laundry. This is a labor-intensive and time-consuming process that may also decrease how readily available a bed is for the next patient. Therefore, curtains are changed at our institution only if the patient has a known antibiotic-resistant organism or if the curtains are visibly contaminated. Since we found a high rate of bacterial curtain contam- ination, the pattern of contamination needs to be further evaluated to understand optimal curtain changing or cleaning schedules. This study should be interpreted in the context of its limitations. In this cross-sectional study we showed that the curtains were contaminated with large quantities of microbes. However, as the length of time that curtains were hung is not accurately recorded, we could not correlate the length of time during which curtains were hung to the degree of microbial contamination. We were also unable to comment on the directionality of contamination from curtains to patients or vice versa. Due the small numbers it is not possible to comment on whether this contamination resulted in any infections. Finally, due to the cross-sectional nature of this study, we cannot comment on the level of contamination of the curtains when they were installed, or the rate at which microbes were acquired on the curtains." Bushey, et al. (2015) suggest increased contamination rates with higher room occupancy and that curtains should be removed, cleaned and sanitized after approx- imately fve weeks of use. The researchers sought to determine the relationship among time to contamination, total bio-burden levels, location, and occupancy over a

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