Lecturer: Gao Xiaodong, Director of Zhongshan Hospital, Fudan University, China
Source of content: New Technology Helps Hospital Infection Control: A New Normal
Topic: “Equipment Protection” for Healthcare Infection during the Pandemic on an Ongoing Basis
The following content is the key parts extracted from Mr. Gao's courseware.
Currently, the pandemic in China is showing a trend of sporadic resurgences and frequent outbreaks in many places, and the infection control personnel in hospitals are under great mental stress. It is necessary to cultivate high-level logistics management capabilities, implement nosocomial infection prevention and control in logistic work, and do a good job in "equipment protection" in assisting nosocomial infection control to ensure effective implementation of various infection control in the ward and timely identification of weak links in pandemic and nosocomial infection prevention and control.
With the longer working hours during the pandemic, the protective effect of personal protective equipment (PPE), such as protective clothing, masks, and gloves, will be reduced, leading to a greater risk of medical staff being infected. PPE is the first barrier to prevent infection, and therefore strict control is required for the type, airtightness, and suitability of masks. Mr. Gao stated that "Masks, goggles, protective clothing, and other PPEs for medical staff shall be properly and reasonably selected according to the degree of appropriateness to individuals and the diagnosis and treatment environment with the risk of exposure, and shall be worn and taken off strictly following the normative and standard process." Therefore, medical staff shall properly protect themselves to reduce the risk of occupational exposure.
Cleaning and disinfection of the environment is an essential part of infection control, and the surfaces that patients and doctors touch frequently shall be emphasized in environmental monitoring. (These surfaces refer to the surfaces of items that patients and medical staff frequently touch with hands, including bed guardrails, beddings, bedside tables, bedpans, urine collection bags, toilets, faucets, and door handles.) Hospitals should strengthen surface disinfection, properly select cleaning tools to clean bedpans and other items, and adopt heating disinfection equipment to conduct high-level disinfection (A0 value ≥ 600), to avoid the risk of cross infections.
Mr. Gao mentioned that the result of the previous experiment sampling from the hospital mops showed that, in the presence of water, bacteria multiplied by eight to ten times per hour, and the number kept growing as time passed, indicating the obvious drawbacks of natural air drying of mops. Therefore, it is necessary to use the mops in specific areas, mechanically clean all the mops after use, perform heating disinfection and then dry them for later use. New technology and equipment shall be adopted to ensure the standardization and rationality of the disinfection process.
Hospitals shall promptly dispose of medical waste, conduct standardized disinfection of surfaces of sharp tools for medical fabric management, properly place sharp tool boxes, and avoid injuries caused by sharp tools due to collisions with others during operation; In addition, as the risk of transmission of pathogenic bacteria, such as aspergillus in the hospital, more attention shall be paid to patients infected with multidrug-resistant bacteria, and the medical fabrics used by infected patients must undergo high-temperature cleaning and disinfection; reduce material waste and prevent the transmission of infections.
It is necessary to build compliant and standard negative pressure wards to prevent the risk of air transmission. Building layout and heating, ventilating and air conditioning (HVAC) design shall be considered according to the settings of different scenarios. The function of air conditioners shall be maximized to ensure air circulation. Mr. Gao stated that relevant technical equipment, such as dynamic air-disinfectant equipment, shall be adopted to ensure regular circulation of air in the room; nucleic acid test booths shall adopt a positive pressure design and the principle of air conditioning to avoid the transmission of aerosols and properly control the risk of air transmission.