HHM Compatibility Special Edition Feb/Mar 2020 HHM Compatibility Special Edition Feb:Mar 2020 | Page 17

organizations new product request process. Partnering with
subject matter experts such as Infection Preventionists to help
identify the key requirements and or questions to ask, is key
to helping healthcare organizations balance disinfectants
and medical devices and surfaces.”
“The cause-and-effect related to the emergence of new
resistant microorganisms has brought about the need to
use an array of cleaning and/or disinfecting agents creating
an increase in equipment and label degradation as well as
surface blemishes, disfigurements and replacement,” says
Strain. “These and other trends must be followed closely
through institutional safety groups which are aligned to
The Joint Commission, OSHA and other guidance and
regulatory agencies. Logs of equipment, supply and goods
issues should be kept as they occur and closely reviewed for
trends, commonality, root cause and remediation in a timely
manner to assure patient and staff safety.”
The challenge is encouraging clinicians to speak up when
they get frustrated by surface and equipment degradation.
“Clinicians like biomedical engineers, nurses, technicians
and infection preventionists are well aware that disinfectants
are damaging devices and equipment,” Turner says. “They
typically don’t understand why because most of them don’t
have material science backgrounds. Other clinicians like
doctors may not always see the damage because it is handled
during room turn-over or set-up, so they may not be as
aware that compatibility with disinfectants is such an issue.”
“Product durability is critical,” confirms Carr at the
Medical University of South Carolina. “When we must replace
flooring every several years because of failure it causes delays,
unfavorable work environments and stress, particularly in a
chaotic environment like the emergency department. This
makes patients feel uneasy and healthcare workers feel
unhappy. There is science around surfaces and antimicrobial
activity, it should always be employed. We also must consider
favorable ergonomic design for healthcare workers and
anything we can do to reduce work in cleaning/changing
over a room. Examples include reduced corners on tabletops,
reducing nooks and crannies, decreasing touch. We should
use more voice commands to turn switches on and off, to
pull up imaging in a patient’s room, etc. like Alexa or Siri.
Stretchers need to be redesigned to include variable types
of patients– Not one structure for all patients. We should
use Apple watch-type charging for the stretchers and have
plugs and chargers built into the structures to reduce chords
and things. Cords are often not cleaned between patients
and tends to fail and add a trip hazard, etc.”
“Healthcare organizations will need to use their voice to
raise the bar on the standards for the types of materials used
to manufacturer medical devices and surfaces,” Graham
says. “For the designers, it is necessary for them to partner
with healthcare organizations before anything is even put on
paper. Gaining an understanding of healthcare organizations
operate can dramatically improve the design so it truly takes
the patient needs and staff use into account from the very
beginning. All too often when evaluating medical devices,
the sentiment with clinicians is frustration especially when
the design lacks the completeness necessary to improve
patient outcomes or prevents work around because it doesn’t
fit or operate for their patient population. For example,
working within the pediatric environment we consistently
struggle with manufacturers on how they design a product
because the mentality is ‘one size fits all,’ which doesn’t
work for pediatrics.”
Healthcare stakeholders play a vital role in advancing
the agenda toward better compatibility between materials
and chemistries.
“Healthcare institutions should make it clear in all RFPs
that what they are purchasing needs to be cleanable with a
wide variety of effective disinfectants and cleaning protocols
without risk of premature failure or harboring pathogens,”
Turner says. “Material selection and design are crucial to
the long-term reduction of HAIs, and if healthcare demands
improvement, it will happen. Also, they need to help fund
the successful emergence of the HSI certification process
until manufacturers are buying the certification to ensure
their long-term viability. It is an investment that will keep
paying dividends to healthcare.”
“Healthcare organizations should include testing of
currently used cleaning and disinfecting agents on potential
equipment/products/goods before final decisions are made,”
advises Strain. “If current agents yield detrimental effects
different agents may have to be tried before one or more are
found acceptable. This can lead to disruptive consequences to
routine cleaning and disinfecting of the myriad of equipment/
products/goods already established in the care environment.
If you have ever walked onto a care unit, you might already
find an array of tubs of wipes, packets of cloths, pump bottles
and other containers. Adding even one more may raise the
risk that the wrong agent might be used.”
Experts envision a path forward toward better standards
and testing methodologies and agree that what it will take
to get all stakeholders at the table is greater accountability
and better guidance.
“A well-executed independent certification for cleanability
is a great way to ensure better science makes it to market,”
Turner says. “Trade organizations should team up with the
Healthcare Surfaces Institute to leverage their expertise in
reduction of pathogens and material improvements. They
should help them make it through the early startup stage
and pull through the certification. The science of cleanability
should be a topic covered at AAMI, AVHAP, ASHE and many
other clinical trade organizations — it’s important. This is a
problem we all need to address together. It personally affects
each one of us and our organizations. If it isn’t addressed at
your next trade organization meeting, do your part to ask for
it. Innovation occurs when scientists across entire value chains
talk and solve problems together. Be willing to include this
topic next time you have the chance. We have one example
of a device manufacturer that told us biomedical engineers
were asking them in the RFP process to be sure their device
could be cleaned with a wide range of disinfectants and not
break down. This tells me that they and other clinicians have
a voice. My advice is to keep speaking up!”
Seven Aspects of Surface Selection
The Healthcare Surfaces Institute has recently adopted
a combination of the Hierarchy of Controls and the Seven
Aspects of Surface Selection ™ as a quick guide for patient
and healthcare worker safety as it relates to surface selection.
www.healthcarehygienemagazine.com • Compatibility Special Edition February/March 2020
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