Common Culprits in Cross Contamination

Patient safety and reducing HAI's is the number one goal in healthcare for 2010.

One misconstrued problem in healthcare has been the use and protection of wearing gloves. Just as we're aware that hand-t0-surface transmission can account for a significant amount of cross contamination, so can gloves.

In a study by Boyce JM in 1997, found when healthcare works, doctors and nurses particularly, touched surfaces such as bed rails, blood pressure cuffs, computer keyboards, door knobs, bed tables, patient gowns and linens, their glove became contaminated 42 percent of the time.

In order to reduce HAI's (Healthcare Associated Infections) we need to stop the transmission of these bugs. Clostridium difficile (C. diff) is a known pathogen that has been implicated in the transmission when using gloves. According to Wave Truscott, PhD., the C. diff in our hospitals has two common hosts, an infected patient and contaminated surfaces, such as, bed rails, linen and patient gowns, computer keyboards, telephones, door knobs, and medical equipment. Cross contamination now has a passage way. If a healthcare worker, with gloves on, touches a patient who has C. diff and then proceeds to type on the keyboard to input notes, or the sink faucet, door knob, etc. before discarding his gloves, has now transferred the pathogen from host A to host B.

Host B now is a common surface where other hands with or without gloves continue to touch and transfer the pathogen throughout the facility. A facility where these pathogens can remain for weeks, months, even years depends on the host environment. The most effective way to stop the cross contamination of these bugs to is engage in thorough and proper surface cleaning constantly.

Healthcare facilities need to focus on the frequently touched ("high touched") surfaces in their practices. These areas should be cleaned daily and nightly, if they have a cleaning service. The CDC recommends a 5,000 ppm free chlorine solution for disinfecting, however, there are now EPA (Environmental Protection Agency) approved sporicidal disinfectants. These disinfectants should be handled with proper care regarding any dilution and dwelling times. If your facility has a cleaning service and you aren't sure whether a proper disinfecting solution is being used, here are some helpful questions you can ask.

1. Has it been tested against C. diff?

2. What are the kill claims?

3. Is it effective against blood borne pathogens?

4. Is pre-cleaning usually required or is it an all-in-one process?

5. Are there dilution controls?

6. Is it compatible with surfaces it must disinfect?

7. Is it a spray aerosols, which should not be used in surgery suites and can damage electronics.

8. How much wet contact time is required to kill spores?

9. Is it easy to use? Do they have handy wipes?

All these questions will help you identify the best disinfectant for your facility while continuing to help eliminate HAI's and cross contamination. However, consistent hand washing before and after using gloves as well as discarding gloves after each patient is a vital key.

Article written by: Chanel Schonert, MediClean

Reference:

Boyce JM Infect Control Hospital Epidemiol 1997; 18: 622-627

Virgo Publishing, Glove Hands, Surfaces are Common Culrits in Cross-Contamination, http://www.vpico.com/articlemnager/printerfriendly.aspx?article=289073