HHM Compatibility Special Edition Feb/Mar 2020 HHM Compatibility Special Edition Feb:Mar 2020 | Page 16

“Manufacturers of chemical-based disinfectants file for an
EPA number based on testing of the active ingredients against
the key microorganisms in the healthcare environment,”
explains Strain. “Manufacturers of equipment/products/
surfaces that will be used in the healthcare environment
provide a list of approved cleaning/disinfecting products
in the IFU. Healthcare end users may make choices from
the list of cleaning/disinfecting product without regard
to effect to the equipment/product goods other than the
effectiveness on microorganisms. Other scenarios such as
the selection of a ‘like’ agent not on the manufacturers list
or recommendations based on personal use or organization
history may occur. ‘But I chose one from the list’ is the refrain
most often heard with the ensuing casting of blame upon
the equipment/product goods manufacturer. Uninformed,
circular conversations result in no or incorrect resolution often
creating another issue cycle without resolution.”
Strain continues, “At a more global level, it may be
prudent to use a LEAN A3, FMEA or other problem-solving
methodology to create a safe, non-judgmental discussion of
the root cause of this critical safety issue. Chemical based
disinfectant testing might join forces with makers of polymer/
metal/ceramic/composite materials used to fashion healthcare
equipment/products/goods to assure fully developed IFUs
and add language to the FDA Good Manufacturing Practices
requirements to reflect this.”
Partners in raising awareness around the compatibility
issue are hospital supply-chain and purchasing managers
and healthcare institution leadership, who are faced with
costly repairs and replacements when equipment, devices
and surfaces fail.
‘There is an overall awareness among clinicians regarding
the surface materials compatibility, but they lack the
knowledge on ways to best solve the issue,” says Graham.
“Their awareness stems not from a true understanding of
the compatibility issue but due to seeing the degradation
of equipment and surfaces. This issue has really emerged
over the past several years as result of the various types
of cleaners most infection control programs request to
be used with medical devices and surfaces. Clinicians are
frustrated because they see the results of hospital equipment,
furniture and other surfaces break down from using the
required cleaners according to their hospital policy but
feel helpless about finding the right solution. To improve
clinicians’ overall knowledge, I believe this must start with
the suppliers providing more in-depth details on which of
the commonly used cleaners within hospital will work best
with their equipment, devices, furniture or other surfaces
and how to prevent the degradation. Additionally, clinicians
need to get involved at the very beginning of the medical
device selection working with biomedical engineers, infection
control and value analysis so they have a clear understanding
of the cleaning requirements and the potential side effects.”
Graham continues, “While the use of disinfectants
is crucial in helping to reduce the rates of HAIs, it is a
contributing factor to why medical devices or other surfaces
break down. This occurs because the ingredients within the
disinfectant that breaks down the pathogen also breaks
down the components of the device. The issue related
to degradation of healthcare surfaces is definitely on the
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minds of healthcare leadership, biomedical engineering,
regulatory, infection control as well as value analysis staff
but there is a lack of best practices to help mitigate these
issues. Healthcare professionals have some understanding of
the issue but there needs to be more education around the
effects of medical device surface disinfectants. The cost for
continually replacing medical devices or surfaces put even
more of a strain on healthcare organizations who are trying
to reduce their overall costs.”
“Value analysis programs provide the structure to an
informed decision using clinical-based evidence, data
gathering, evaluation where appropriate and analysis
phases,” Strain explains. “This structure often uses a checklist
approach in which safety of patients and staff is one of
many considerations. Several questions provided by infection
prevention cover cleanability, agents recommended by the
manufacturer in their IFU-instructions for use and related
topics. A must-have item that should be added to the checklist
¡
Partners in raising awareness around the
compatibility issue are hospital supply-chain and
purchasing managers and healthcare institution
leadership, who are faced with costly repairs
and replacements when equipment, devices and
surfaces fail.
is compatibility of cleaning and disinfecting agents with
equipment/products/goods/care environment construction/
design elements. In the best-case scenario, a request of the
manufacturer should yield such testing results related to the
establishment of their IFU. The next-best scenario is to ask
the manufacturer to perform testing using a mutually agreed
upon cleaning and/or disinfecting agent and methodology
to establish this benchmark. There is still much work to do
in this rapidly growing area of compatibility and safety of
our care-environments but keeping it on your radar during
your selection or investigation processes until there is a
more extensive and well-connected testing system is key.”
“Many value analysis professionals and others in
purchasing know that equipment failures are costly and are
occurring to some extent because of incompatibility with
disinfectants,” Eastman’s Turner says. “C-suite executives
may be aware of the cost associated with equipment failures,
but they may have less knowledge of the reasons behind
those failures. One thing is for sure, when they become
aware, they want those avoidable costs to stop and they
want to ensure patient safety is not compromised. What
most don’t realize is that you don’t have to choose between
clean equipment and broken equipment.”
“Value analysis professionals play a crucial role in assisting
hospital leaders and staff to understand the impact of
disinfectants on medical devices and surfaces,” Graham
says. “The value analysis process helps to gather the data
around the disinfectant process for the particular medical
device or surface. The questions to elicit this information from
manufacturers should be embedded within the healthcare
Compatibility Special Edition February/March 2020 • www.healthcarehygienemagazine.com