HHM Compatibility Special Edition Feb/Mar 2020 HHM Compatibility Special Edition Feb:Mar 2020 | Página 7

cover story
Surfaces & Equipment:
Chemical Compatibility
Issues Driving
New Inquiries,
Scientific Inroads
By Kelly M. Pyrek
S
urfaces and medical equipment
“We have had lots of surfaces in
¡
found in the healthcare environ-
my hospital fail,” says Christine Carr,
Exposure to the various
ment are made up of many different
MD, CPE, FACEP, a professor in the
types of metals, plastics and polymers.
Department of Emergency Medicine
chemistries used in the
The compatibility of surface materials
and Department of Public Health
hospital has led to cracking,
with chemical cleaning agents and
Sciences at the Medical University of
crazing and hazing in
disinfectants in the healthcare envi-
South Carolina. “The toxicity of the
certain plastics and other
ronment is a growing area of research
cleansing agents that we use combined
materials, which can trigger
and requires education of healthcare
with the frequency that we have to
professionals and key stakeholders
clean our surfaces exaggerates flaws in
failure and compromises in
around the associated challenges
the product quickly. Also, the variety of
performance, product life
and opportunities.
restrictions on what cleansing products
and safety of the device.
In the last two decades, emphasis
we can use them what services makes
has been placed on evidence-based
it complicated. I’m more likely we will
design to improve clinical outcomes and boost the satisfaction use the wrong product in the wrong surface. Examples
of patients and healthcare personnel, yet it is debatable if
include failed mattress covers on the stretchers, fading of
the process of basing decisions about the built environment countertops, etc.”
on credible research to achieve the best possible outcomes
The ramifications of failure are significant, according to
has encompassed the compatibility challenge. While Carr. “When mattress covers fail, body fluids get into the
evidence-based healthcare architecture is expected to create mattress, which is evident when we cut it open. Flooring is
safe and therapeutic environments while promoting efficient
another common failure, results in using duct tape and other
staff performance and to improve the organization’s clinical, stop-gap measures that are unsightly and difficult to clean.”
economic, productivity, satisfaction, and cultural measures
The challenge is that the dangers of these failures
– everything is for naught if surfaces and chemical cleaners aren’t necessarily on the radar of busy clinicians who are
and disinfectants don’t play nicely together.
preoccupied with their patient-care responsibilities, and if
Surface materials in the built environment, as well as the problems persist without being addressed properly, they
equipment and medical device housings are subject to become expensive for the healthcare institution to correct.
cracking, crazing and discoloration from some disinfectants
“I think clinicians are generally not aware of surface
that are used to reduce rates of healthcare-acquired infections
material compatibility issues. We also must contend with
(HAIs), and this can lead to equipment and device failure, equipment cleaning issues and variation around that as well.
thus threatening patient and healthcare personnel safety.
Adding various surface cleaning nuances seems unrealistic.
Higher-performing materials used in the construct of
We shouldn’t rely on clinicians to become familiar with the
patient-care equipment and the build environment are variations on how to clean different surfaces, we should
expected in the healthcare setting. But they are constantly fix the surfaces.”
under assault by disinfectants such as peracetic acids, form-
Experts agree that materials matter—designing and
aldehydes, ammonium-based chemicals, isopropyl alcohol,
sourcing devices made from disinfectant-compatible
and other chemicals. Exposure to the various chemistries polymers reduces HAIs, lowers the cost of ownership for
used in the hospital has led to cracking, crazing and hazing
healthcare providers and, most importantly, improves the
in certain plastics and other materials, which can trigger patient experience.
failure and compromises in performance, product life and
Minimizing surface damage is important in the healthcare
safety of the device.
setting because damaged equipment can hide pathogens,
Chemical compatibility, also referred to as chemical resis- be very costly to replace and affect the overall image of a
tance, is defined as the resistance to change in mechanical
hospital. The pathogen threat is continuing to evolve, and
properties after exposure to a chemical under a well-defined disinfectants must stand up to the toughest pathogens.
set of conditions.
The challenge is that more powerful disinfectants are also
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