cover story
Surfaces & Equipment:
Chemical Compatibility
Issues Driving New Inquiries,
Scientific Inroads
By Kelly M. Pyrek
Editor’s note
This article
originally
appeared in a
special edition
on surface
compatibility
published in
February 2021.
Surfaces and medical equipment found
in the healthcare environment are made
up of many different types of metals, plastics
and polymers. The compatibility of surface
materials with chemical cleaning agents and
disinfectants in the healthcare environment
is a growing area of research and requires
education of healthcare professionals and
key stakeholders around the associated
challenges and opportunities.
In the last two decades, emphasis has been
placed on evidence-based design to improve clinical outcomes and
boost the satisfaction of patients and healthcare personnel, yet
it is debatable if the process of basing decisions about the built
environment on credible research to achieve the best possible
outcomes has encompassed the compatibility challenge. While
evidence-based healthcare architecture is expected to create safe
and therapeutic environments while promoting efficient staff
performance and to improve the organization’s clinical, economic,
productivity, satisfaction, and cultural measures – everything is
for naught if surfaces and chemical cleaners and disinfectants
don’t play nicely together.
Surface materials in the built environment, as well as equipment
and medical device housings are subject to cracking, crazing and
discoloration from some disinfectants that are used to reduce
rates of healthcare-acquired infections (HAIs), and this can lead
to equipment and device failure, thus threatening patient and
healthcare personnel safety.
Higher-performing materials used in the construct of
patient-care equipment and the build environment are expected
in the healthcare setting. But they are constantly under assault
by disinfectants such as peracetic acids, formaldehydes, ammonium-based
chemicals, isopropyl alcohol, and other chemicals.
Exposure to the various chemistries used in the hospital has led to
cracking, crazing and hazing in certain plastics and other materials,
which can trigger failure and compromises in performance,
product life and safety of the device.
Chemical compatibility, also referred to as chemical resistance, is
defined as the resistance to change in mechanical properties after
exposure to a chemical under a well-defined set of conditions.
“We have had lots of surfaces in my hospital fail,” says Christine
Carr, MD, CPE, FACEP, a professor in the Department of Emergency
Medicine and Department of Public Health Sciences at the Medical
University of South Carolina. “The toxicity of the cleansing agents
that we use combined with the frequency that we have to clean
our surfaces exaggerates flaws in the product quickly. Also, the
variety of restrictions on what cleansing products we can use them
what services makes it complicated. I’m more likely we will use
the wrong product in the wrong surface. Examples include failed
mattress covers on the stretchers, fading of countertops, etc.”
Biomedical Engineers: A Key Colleague to IP and EVS
We
spoke with Richard Fechter, a principal developmental
engineer at UCSF Medical Center
and UCSF Benioff Children’s Hospital, who helps manage
nearly 40,000 pieces of medical equipment, regarding
the key role biomedical engineers play in hospitals.
HHM Are biomedical engineers working in the hospital
environment the unsung heroes – if no one knows they
exist, does that mean all of the equipment/devices is
working properly?
HHM For the uninitiated: What, exactly, do biomedical
engineers in the healthcare environment, do and why
are they so critical?
Richard Fechter (RF): The biomeds (also known as clinical
engineers or healthcare technology management professionals)
manage all the equipment in the hospital. Everything from
simple thermometers to multi-million-dollar MRI scanners. This
includes capital budget planning and construction to routine
maintenance and repairs. When equipment fails, it can be a
danger to patients and staff and disrupt scheduling.
RF: I suppose you could say that, but equipment problems
are a daily occurrence so most of the clinical staff are well
acquainted with us.
HHM How do you see the role of biomedical engineers
supporting patient/healthcare worker safety?
RF: In addition to repairing broken equipment, we also
investigate incidents involving equipment and find ways to
prevent problems from happening again. Here is an example:
Some time ago we had a number of incidents involving our
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20 august 2020 • www.healthcarehygienemagazine.com