Lecturer: Ni Xiaoping, Professor of Hangzhou Center for Disease Control and Prevention, China
Source of content: SIFIC Healthcare Micro-hygienic Cycle Helps Prevent and Control Covid-19
Topic: Key Precautions for Practices of Hospital Environment Cleaning
The following content is the key parts extracted from Mr. Ni's courseware.
Hospitals are places where patients gather and are highly susceptible to microbial infections, and only by proper cleaning and disinfection of the environment can we provide patients with a safe and reassuring medical experience and create an efficient working environment for medical staff. Infection control in hospital wards, as one of the key links in infection and control in medical institutions, is an effective way to cut off pathogen transmission.
The three links of pathogen transmission are susceptible populations, sources of infection, and transmission routes. Surgical instruments, catheters, hand hygiene, and environmental surfaces in the entire medical environment system are transmission routes of microorganisms. Mr. Ni mentioned in the courseware that "pathogenic microorganisms can survive on inanimate surfaces and become the source of infection". If patients touch the contaminated surface, they also spread bacteria to the environment. Therefore, disinfection of environmental surfaces not only provides patients with a warm diagnosis and treatment environment but also reduces the routes for pathogenic microorganisms to transmit through the environment.
According to the Disposal Requirements for Reuse of Cleaning Tools, the relevant surface that is adjacent to a patient and that the patient frequently touches is considered a cleaning unit (nursing unit), such as the ward bed, bedside table, monitor, ventilator, and micro-pump.
The contrast experiment of "one towel cleans one item" vs. "one towel washes multiple items" was given in the courseware, and the results showed that if using one towel to clean multiple units, pathogenic microorganisms on the surface would spread and transmit, and that only unit-based cleaning could minimize cross-contamination. Professor Ni said, "The ultimate goal of cleaning units is to prevent the horizontal transmission of pathogenic microorganisms.
According to WS/T 512-2016 Regulation for Cleaning and Disinfection Management of Environmental Surface in Healthcare, cleaning tools shall be used in specific areas and color marked; microfine fiber wiping cloth or floor towels shall be used; the used or contaminated wiping cloths or floor towels shall not be repeatedly soaked in cleaning water, in-use cleaning agents, and disinfectants.
Professor Ni mentioned the need to use cloth in specific areas, which are parted by colors and numbers to reduce cross infections, and summarized two key points for effective reuse. First, the conditions for effective reuse are a clean and dry place with good ventilation and a quantitative proportion of cleaning tools. Second, the difference between manual and mechanical disinfection shall be regarded with a dialectical view to select an effective disinfection method for reuse. For manual disinfection, the concentration ratio and soaking time cannot be accurately confirmed, while setting disinfection time by the machine can clarify the disinfection process and ensure the quality of disinfection.
Professor Ni stressed that the most critical thing of mechanical disinfection is being able to keep dry to avoid secondary pollution caused by natural drying. Effective reuse is the only way to prevent the vertical transmission of pathogenic microorganisms, thus reducing or avoiding their cross infections during disinfection.