Healthcare Hygiene magazine November 2019 | Page 15

Defining “Clean” in Sterile Processing
Lichtenstein and Alfa (2019) remind us of the parameters
that define the steps of cleaning, disinfection and sterilization:
• “Cleaning refers to removal of visible soiling, blood,
protein substances, and other adherent foreign debris
from surfaces, crevices, and lumens of instruments. It is
usually accomplished with mechanical action using water,
detergents, and enzymatic products. Meticulous physical
cleaning must always precede disinfection and sterilization
procedures, because inorganic and organic materials that
remain on the surfaces of instruments interfere with the
effectiveness of these processes. Mechanical cleaning alone
reduces microbial counts by approximately 103 to 106 (three
to six logs), equivalent to a 99.9 percent to 99.9999 percent
reduction in microbial burden.”
• “Disinfection is defined broadly as the destruction
of microorganisms, except bacterial spores, on inanimate
objects (e.g., medical devices such as endoscopes).”
According to the researchers, three levels of disinfection
are achievable depending on the amount and kind of
microbial killing involved:
➊ High-level disinfection (HLD): the destruction of all
viruses, vegetative bacteria, fungi, mycobacterium, and some,
but not all, bacterial spores. For liquid chemical germicides
(LCGs), HLD is operationally defined as the ability to kill 106
mycobacteria (a six-log reduction). The efficacy of HLD is
dependent on several factors and includes the type and
Q
& A
With Wava Truscott,
PhD, MBA
We spoke with infection prevention and biofilm
expert Wava Truscott, PhD, MBA, of Truscott MedSci
Associates, LLC, about the problem of still-contaminated,
patient-ready endoscopes.
HHM: To what do you attribute this critical issue?
WT: The still-contaminated endoscopes continue to
occur at an extremely high rate due to a multitude of
reasons. These include:
• Non-compliance with required point-of-use
pre-cleaning of endoscopes immediately after use, allow-
ing organic debris to dry onto surfaces that significantly
increase the difficulty of their removal
• Failure to perform leak-testing, which can result in
undetected seal breaches allowing contaminant seep
into impossible-to-clean areas
• IFUs that are poorly written, have too many steps,
were inappropriately validated, or are not easily accessible
in decontamination
• Devices are too complex
• Poor cleaning brushes that fail to access all internal
surfaces or possess too sparsely spaced or flimsy bristles.
Continued on page 16
h ealthcarehygienemagazine
Don’t Miss
the Webinar
Novel, Persistent Antimicrobial Surface Coatings:
Impact on Healthcare-Associated Infections and
Environmental Bioburden
Healthcare-associated infections (HAIs) remain prevalent in the United States, and environmental contamination and transmission of key
pathogens is a critical target for improving the safety of care delivered. However, current cleaning practices are still sub-optimal. Additional
tools are needed to support infection prevention and environmental services’ end goal of a clean, healthy, healing environment. This webinar
will explore a study wherein the use of persistent antimicrobial coatings was associated with a persistent reduction in total live bacteria of up
to 75 percent and, most importantly, a 36 percent decline in pooled HAIs rates across two hospitals. Drs. Sean Elliott and Charles Gerba will
discuss these results and their pending publication in the journal Clinical Infectious Diseases.
Dr. Charles Gerba, Ph.D.
University of Arizona
Soil, Water and Environmental Science
PhD, Microbiology – University of Miami
Authored over 500 journal articles, books &
featured on numerous television programs
and magazines
This webinar was produced by Healthcare Hygiene magazine and underwritten by Allied BioScience.
Dr. Sean Elliot, MD
University of Arizona
Pediatric Infectious Diseases
Dean – Curricular Affairs, College of Medicine
Published over 40 peer-reviewed manuscripts and chapters
Featured on PBS Frontline‚ “Hunting the Nightmare Bacteria”
Board Certified in Pediatrics and Pediatric Infectious Diseases
h ealthcarehygienemagazine
To access this webinar, visit: https://www.healthcarehygienemagazine.com/webinars/