HHM Compatibility Special Edition Feb/Mar 2020 HHM Compatibility Special Edition Feb:Mar 2020 | Page 18

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Some believe environmental or “high-
touch” surfaces like sinks, counters,
bedrails, door handles, light switches
and patient equipment are the main
contributing factor for the acquisition and
spread of pathogens, but these surfaces
only make up about
25% of surfaces
in patient and procedure rooms.
“Healthcare surfaces have long been established as
fomites — objects or materials to carry microorganisms that
can cause infection and illness,” say Lybert and Mitchell
(2019). “Research has shown that microbes can live on
“clean and disinfected” surfaces for days, weeks, and even
months. How is this possible when surfaces in healthcare
settings are regularly cleaned and disinfected? Surfaces
are complicated. Discussion around the impact surfaces
have in infection prevention and control creates confusion
and misunderstanding. Some believe environmental or
“high-touch” surfaces like sinks, counters, bedrails, door
handles, light switches and patient equipment are the
main contributing factor for the acquisition and spread of
pathogens, but these surfaces only make up about 25 percent
of surfaces in patient and procedure rooms.”
They continue, “Limiting focus on these surfaces and/or
these thought process leaves about 75 percent of the sur-
faces that exist in the healthcare environment unaddressed.
These include upholstery on furniture, walls, floors, linen,
fixtures, and more. They also include surfaces made up of
multiple surface materials that interact with patient and
personnel, including medical devices, surgical equipment,
and instruments. In addition, soft surfaces such as scrubs,
hospital gowns, and bedding always move between various
areas of the hospital and can serve as fomites.”
To reduce the role that healthcare surfaces play in the
acquisition and transmission of pathogens, the Seven
Aspects of Surfaces Selection must be evaluated to address
this issue proactively.
Considerations include:
Surface Materials and Textiles: There are many different
surface materials and textiles used within healthcare
facilities both in the built environment and products used
during patient care.
Assemblies: Multiple surface materials on any one product
must be evaluated individually and as an assembly for
use and cleanability. Examples; beds and other medical
devices, furniture.
Location of the Surfaces: High contamination and
high-turnover areas require durable surfaces that can
withstand frequent disinfection. Example; OR, ED.
Cleaning, Disinfection/Sterilization: Infection prevention
protocol, process and products that will be used must be
considered and an evaluation completed before products
and surfaces are purchased and put into service.
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Human Behavior: Humans continually interact with
surfaces and move throughout the healthcare facility.
While hand hygiene is critical, clothing and other products
also move throughout the facility. Many questions exist
around human behavior and transmission of microbes that
cause deadly infections.
Microbiology: There are surface materials that support
the proliferation of microbes despite routine cleaning.
Manufacturers lack standardized testing for microbes that
allow purchasers to compare products equitably.
Manufacturer Warnings and Instructions for Use (IFUs):
Disinfectant compatibility testing for surfaces is rarely,
if ever, conducted. It is concerning when manufacturers
list all disinfectants as compatible without testing data
and validation that they are in fact compatible, creating
risk of damage and the potential for a voided warranty
for healthcare facilities. It is also important that healthcare
professionals request manufacturing warnings. In this
document, you will find warnings that include chemicals
used in disinfectants and detergents.
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Certification is the Future
The Healthcare Surfaces Institute announces the develop-
ment of its Healthcare Surfaces Certification program to help
manufacturers develop products and healthcare professionals
identify products that can be effectively cleaned, disinfected,
and sterilized. This program will include the development
of surface testing standards, educational programs, and
resources as well as a certification process that will provide
manufacturers with a certificate of validation from the
Healthcare Surfaces Institute.
Goals and objectives for this program include:
• Development of consistent test methods that
includes compatibility testing of all categories of EPA
registered disinfectants as well as no touch disinfection
such a UV and hydrogen peroxide vapor
• The identification of the top four microbes for all
testing with option for addition microbial testing. The goal
is to have consistent measurable data and information
• Testing of products as assemblies – Many products
are made using multiple types of surface materials and
or textiles. When combined on one product the ability
to efficiently and effectively disinfect all materials can be
compromised causing degradation of surface materials.
• Evaluation of surfaces at a micro level. Damage is
often unseen, creating microbial reservoirs that support
the growth and proliferation of microbes
• Evaluation of IFUs to ensure they provide guidance
and recommendations pertinent to active healthcare
environments and that support infection prevention
processes and protocols.
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4 Product manufacturers can expect support with product
development that includes clarity about testing requirements
and recommendations, as well as healthcare professional
support for the creation of IFUs that support infection
prevention process and protocol.
“Most don’t know what to do to address the problem,
and that is exactly why there is a need for a cleanability
certification like the one Healthcare Surfaces Institute is
embarking on in 2020,” Turner says. “This will remove
18 Compatibility Special Edition February/March 2020 • www.healthcarehygienemagazine.com