Daily Disinfection of High-Touch Surfaces in Isolation Rooms to Reduce Contamination of Healthcare Workers' Hands

Research Service, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.
Infection Control and Hospital Epidemiology (Impact Factor: 4.02). 10/2012; 33(10):1039-42. DOI: 10.1086/667730
Source: PubMed

ABSTRACT In a randomized nonblinded trial, we demonstrated that daily disinfection of high-touch surfaces in rooms of patients with Clostridium difficile infection and methicillin-resistant Staphylococcus aureus colonization reduced acquisition of the pathogens on hands after contacting high-touch surfaces and reduced contamination of hands of healthcare workers caring for the patients.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The control of Clostridium difficile infection is paramount. C difficile spores are difficult to eradicate and can survive on surfaces for prolonged periods of time. Hand washing with either plain or antimicrobial soap is effective in removing C difficile spores from hands. Patients should be placed in private rooms and under contact precautions to prevent transmission to other patients. Regular hospital germicides are not sporicidal and hypochlorite solutions are required for surface disinfection. In outbreak situations, a multifaceted approach is required. Copyright © 2015 Elsevier Inc. All rights reserved.
    Infectious Disease Clinics of North America 01/2015; 29(1). DOI:10.1016/j.idc.2014.11.006 · 2.31 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Documenting effective approaches to eliminate environmental reservoirs and reduce the spread of hospital-acquired infections (HAIs) has been difficult. This was a prospective study to determine if hospital-wide implementation of a disinfectant cleaner in a disposable wipe system to replace a cleaner alone could reduce HAIs over 1 year when housekeeping compliance was ≥80%. In this interrupted time series study, a ready-to-use accelerated hydrogen peroxide disinfectant cleaner in a disposable wipe container system (DCW) was used once per day for all high-touch surfaces in patient care rooms (including isolation rooms) to replace a cleaner only. The HAI rates for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile were stratified by housekeeping cleaning compliance (assessed using ultraviolet-visible marker monitoring). When cleaning compliance was ≥80%, there was a significant reduction in cases/10,000 patient days for MRSA (P = .0071), VRE (P < .0001), and C difficile (P = .0005). For any cleaning compliance level there was still a significant reduction in the cases/10,000 patient days for VRE (P = .0358). Our study data showed that daily use of the DCW applied to patient care high-touch environmental surfaces with a minimum of 80% cleaning compliance was superior to a cleaner alone because it resulted in significantly reduced rates of HAIs caused by C difficile, MRSA, and VRE. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
    American Journal of Infection Control 12/2014; 81. DOI:10.1016/j.ajic.2014.10.016 · 2.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Title: Comparison of Hand Hygiene Monitoring using the 5 Moments for Hand Hygiene Method versus a Wash In-Wash Out Method Authors: Venkata C.K. Sunkesula MD, MS, David Meranda, BS, Trina F. Zabarsky, RN, Sirisha Kundrapu, MD, Abhishek Deshpande, MD, PhD, David R. Macinga, PhD, and Curtis J. Donskey MD. Abstract Background: One strategy to promote improved hand hygiene behavior is to monitor healthcare workers' adherence with recommended practices and give feedback. For feasibility of monitoring, many healthcare facilities assess hand hygiene practices upon room entry and exit (Wash In-Wash Out). It is not known if the Wash In-Wash Out method is comparable to a more comprehensive approach such as the World Health Organization's My 5 Moments for Hand Hygiene method. Methods: We conducted a prospective study to compare the results of hand hygiene monitoring using the Wash In-Wash Out and 5 Moments methods. A surreptitious observer rounded with physician teams and with nurses. Adherence to recommended hand hygiene practices was monitored simultaneously using both methods. Results: Of 283 healthcare worker room entries observed 175 (62%) physicians and 108 (38%) nurses, 184 (65%) involved patient contact with or without concurrent environmental contact, 25 (9%) involved environmental contact only, and 74 (26%) did not involve any contact with the patient or environment. In comparison to 5 moments monitoring, Wash In-Wash Out resulted in similar overall adherence to recommended practices (70% versus 72%, respectively) (Figure). Wash In-Wash Out required 148 hand hygiene events not required by 5 Moments (i.e., before and after room entry with no patient or environmental contact) while not provide monitoring for 89 hand hygiene opportunities involving moments 2 and 3. However, observed adherence after moments 2 and 3 was similar to overall adherence (65 of 89 opportunities; 73%). Conclusion: The Wash In-Wash Out and 5 Moments monitoring methods resulted in similar overall values for hand hygiene adherence. Use of the Wash In-Wash Out method should include ongoing education and intermittent assessments of adherence to hand hygiene before clean procedures and after body fluid exposure in patient rooms (i.e., moments 2 and 3). Figure. Comparison of Wash In-Wash Out and 5 Moments methods for hand hygiene monitoring
    IDWeek 2013 Meeting of the Infectious Diseases Society of America; 10/2013


Available from
May 26, 2014