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Hi Kristie
A/Prof Mitchell raises some good points in relation to the CDC study and which should be considered in future studies. I have always been concerned that ICPs who read the CDC study results will assume that the system used in that study is in some way superior to other brands and types of non-liquid surface disinfection. Please note that there is a plethora of research using other systems and brands and the evidence is increasing very quickly.
I have close relationships with a large group of US ICPs who manage large corporate IC programs across the country. They report using various systems with various results. When talking to them they discuss the importance still of routine cleaning and terminal cleaning before disinfection. They also discussed issues regarding implementation (storage, designated users, capital outlay/ return on investment, cycle time, impact on operating time/ access to patient rooms etc).
Personally, I expect and hope that non-liquid surface disinfection will become the routine standard in Australian in and out patient settings. My early work with Dr Macbethh from 2011 was the first Australian publication to show the inadequacy of routine cleaning and I would suspect that the typical healthcare setting would yield similar results even now unless there has been serious campaigning to raise awareness of the envionrmental burden.
I have a database of many published papers on non-liquid disinfection and am happy to share with you offline if needed.
Good luck with your decisions and I hope members support Brett’s important research around this issue.
Regards
Cath
Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus.
Cath@infectioncontrolplus.com.au
Hi Kristie
Here is a link to a CDC funding study on this point. https://idsa.confex.com/idsa/2015/webprogram/Paper53062.html
There are a few questions that in my mind remain unanswered and or request some further discussion:
* Was this intervention cost effective?
* There were reductions in arms B, C and D, in comparison to A (reference group), just because something isn’t statistically significant, it doesn’t mean it isn’t clinically relevant. For example, arm C (bleach only) showed a reduction
* Is a quaternary ammonium a suitable reference group, especially in Australia?
* It is a shame one of the arms was not just detergent
I am certainly not wanting to be critical of this study. This was a large complex study and the first of its kind in many instances. Those involved are to be congratulated. We need more of these types of studies conducted, not only in the cleaning area, but also IP&C more generally. I raise these questions in the interest of sparking some debate and ensuring we take a considered approach before jumping wholeheartedly into UV. These are questions you are likely to face. There are also a number of implementation issues that remain central to any cleaning intervention. This is one thing the REACH study (randomised stepped wedge cluster control study in 11 Australian hospitals) is seeking to explore, in addition to effectiveness and cost effectiveness of a cleaning bundle. http://reach.cre-rhai.org.au/
Thanks
Brett
Associate Professor Brett Mitchell
Associate Professor of Nursing, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
Faculty of Nursing and Health and Director Lifestyle Research Centre, Cooranbong
Avondale College Ltd trading as Avondale College of Higher Education
http://www.avondale.edu.au | http://www.designedforlife.me
185 Fox Valley Road, Wahroonga NSW 2076 Australia
Hello,
We are interested in hearing from sites who currently use UV light as a part of their cleaning package to decontaminate the environment and the equipment to a high level of efficacy.
If you could please make contact with me if you use UV light, we have some questions we’d like to ask.
Thank you.
Kind regards,
Kristie
Kristie Popkiss
Infection Prevention and Management Lead SERCO – Fiona Stanley Hospital
M 0437 358 042
CD012 Main Hospital
Barry Marshall Drive, Murdoch WA 6160
kristie.popkiss@serco-ap.com.au kristie.popkiss@health.wa.gov.au
Next Organisation Wide Survey June 2016
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