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Hi List members,
At our facility we have carpeted patient care areas. We are currently reviewing how this carpet should best be cleaned on a routine basis and after caring for a patient on transmission based precautions. I would appreciate hearing from other facilities who face this challenge to hear how they have addressed this problem.
I know that carpets in healthcare are a sensitive issue and I am happy for people to contact me off line if they prefer.
Kind regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076If you are not the intended recipient you are hereby notified that any dissemination, distribution or reproduction of this message
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At our facility we have 2 acute rooms left with carpet after removing it
from the rest of our acute rooms, due to the problem of cleaning on a
daily basis. The 2 rooms are kept for mental health patients, but of
course when we get full and need to isolate a patient, these rooms are
used.The carpet must be shampooed following a patient on additional
precautions, and must be left to dry before admitting the next patient.
This is the best we can do.We are currently on a crusade to have the carpet removed from the
corridors and nurses station as well as these 2 rooms, as day to day
vacuuming just doesn’t keep these high wear areas clean enough, as well
as issues with dust allergies, etc.wash, wipe, cover, don’t infect another
Sandi Millington
Northern and Remote Country Health Service (NRCHS)
CN Infection Control Geraldton Hospital.
Midwest Region
Northern and Remote Country Health Service
Shenton St| Geraldton WA 6530
PO Box 22| Geraldton WA xxx
P (08) 99562437 | F (08) 99562342
Working together for a healthier country WA
Our Values: Community | Compassion | Quality | Integrity | Justice
________________________________
Behalf Of Fiona de Sousa
Hi List members,
At our facility we have carpeted patient care areas. We are currently
reviewing how this carpet should best be cleaned on a routine basis and
after caring for a patient on transmission based precautions. I would
appreciate hearing from other facilities who face this challenge to hear
how they have addressed this problem.I know that carpets in healthcare are a sensitive issue and I am happy
for people to contact me off line if they prefer.Kind regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
185 Fox Valley Road, Wahroonga, NSW, 2076
information intended for the addressee named above.
If you are not the intended recipient you are hereby notified that any
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is prohibited. If you have received this message in error please notify
the sender immediately, then destroy the original message.
Any views expressed in this message are solely those of the individual
sender, except where the sender is specifically authorised
by Sydney Adventist Hospital to state that they are the views of Sydney
Adventist Hospital.
_____________________________________________________________________
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Hi Fiona,
Find attached the following:
a) Recommendations from CDC – Guidelines for Environmental Infection
Control in Health-Care Facilities, June 6, 2003 / 52(RR10);1-42 andhttp://www.cdc.gov/hicpac/pdf/guidelines/eic_in_HCF_03.pdf
b) Further discussion on page 78 79 Carpets and Floor coverings
c) A summary of some of the literature on carpets on HCF that I have
collected over the years ago which may be of use/interest.GUIDELINES FOR ENVIRONMENTAL INFECTION CONTROL IN HEALTH-CARE FACILITIES,
JUNE 6, 2003 / 52(RR10);1-42Environmental Surfaces in Health-Care Facilities – III. Carpeting and Cloth
FurnishingsA.Vacuum carpeting in public areas of health-care facilities and in
general patient-care areas regularly with well-maintained equipment designed
to minimize dust dispersion (280). Category II
B.Periodically perform a thorough, deep cleaning of carpeting as
determined by facility policy by using a method that minimizes the
production of aerosols and leaves little or no residue (44). Category II
C.Avoid use of carpeting in high-traffic zones in patient-care areas
or where spills are likely (e.g., burn therapy units, operating rooms,
laboratories, or intensive care units) (44,305,306). Category IB
D.Follow appropriate procedures for managing spills on carpeting.
1. Spot-clean blood or body substance spills promptly (293,301,304,307).
Category IC (OSHA: 29 CFR 1910.1030 d.4.ii.A, interpretation)
2. If a spill occurs on carpet tiles, replace any tiles contaminated by
blood and body fluids or body substances (307). Category IC (OSHA 29 CFR
1910.1030 d.4.ii interpretation)
E.Thoroughly dry wet carpeting to prevent the growth of fungi; replace
carpeting that remains wet after 72 hours (37
,160). Category IB
F.No recommendation is offered regarding the routine use of fungicidal
or bactericidal treatments for carpeting in public areas of a health-care
facility or in general patient-care areas. Unresolved issue
G.Do not use carpeting in hallways and patient rooms in areas housing
immunosuppressed patients (e.g., PE areas) (37
,44). Category IBLITERATURE – CARPETING IN HOSPITALS
A. CARPETING IN HOSPITALS AN EPIDEMIOLOGICAL EVALUATION
1) Carpets contain much higher levels of microbial contamination
(approx 105bacteria per square inch) than hard surfaces (approx 102
bacteria per square inch).2) Patients in carpeted room (but not the non-carpeted room) were
colonised with the same type of organisms that contaminate the carpet.3) There was no association between hospital acquired infection and
carpet contamination.4) Members of the family Enterobacteriaceae (Enterobacter Spp., K
pneumoniae and E coli) were more frequently isolated from carpet material
than from bare flooring. These varying levels of contamination
probably resultedfrom differences in floor-cleaning procedures.
Conclusion:
Because carpets are easily contaminated, costly to clean, difficult to
disinfect and do not dry as quickly as bare floors it may be wise not to
use carpets in the following areas:- intensive care units (except cardiac),
nurseries, paediatric patient care rooms, isolation rooms, operating room,
kitchens, laboratories, autopsy rooms, bathroom and utility rooms.Evaluation. Journal of Clinical Microbiology, Vol 15, 1982:408-415.
B. HOSPITAL CARPETING AND EPIDEMIOLOGY OF CLOSTRIDIUM DIFFICILE
A bacteriophage-bacteriocin typing system was used to determine the possible
significance of environmental contamination.The relationship between the prevalence of pseudomembranous enterocolitis
(PME) and room carpeting was studied.Conclusion:
1) This study did not document acquisition of Clostridium difficile
from the hospital environment in a nonepidemic setting of PME.2) Carpeted rooms were contaminated significantly more heavily and
for longer periods with clinical strains of Clostridium difficile than
non-carpeted rooms.3) There was no evidence that environmental contamination resulted
in an increased frequency of occurrence of PME in patients housed in
carpeted rooms.4) Because acquisition of Clostridium difficile from the environment
in nonepidemic settings is possible and there is evidence of exogenous
acquisition during epidemic outbreaks, carpet should be considered as a
potentialreservoir of this organism.
John P Phair. American Journal of Infection Control . August 1994. Volume
22, Number 4. Pages 212-217.C. PREVENTION AND CONTROL NOSOCOMIAL INFECTIONS
Prospective studies have not linked an increase in infection rates to use
of carpets in hospitals. Nevertheless because data have shown that carpets
contain much higher levels of microbial contamination than do hard surfaces
and are more costly and difficult to clean, it may be judicious not to use
carpets in the intensive care unit or other locations where severely ill
patients are located and heavy soiling occurs.– 489.
D. ASPERGILLOSIS DUE TO CARPET CONTAMINATION
During a 9 month period in a 22 bed inpatient bone marrow
transplant/oncology unit with Hepa filtered air system (12 to 15 air
exchanges per hour) and hallway carpeted that was impregnated with a
fungistatic/bacteriostatic agent ( a durable quaternary amine complex)
there were 13 cases of Aspergillus infection, 10 had pulmonary infections,
one each had skin, bone and sinus infections. Eight of the 13 patients
survived, all who died had a relapsed or treatment resistant malignancy.The carpet was identified as the source of infection and contamination was
thought to have occurred following a fire in a nearby building during which
time a patient was known to be repeatedly opening the window of his room.No antimicrobial activity was detected in the carpet due to large amounts of
dirt, debris, wax and soap buildup. The carpet was being cleaned weekly
during the period of outbreak.It was speculated that the residual soap served to block the inorganic
bacterostatic compound in the base of the carpet from wicking up to the top
fibres and that this was the reason there was no antimicrobial activity
detected.After consultation with the manufacturer weekly water extraction of the
carpet was undertaken. Following this less debris was noted and
bacteriostatic/fungistatic activity was detected within the carpet.After institution of the water extraction method of carpet cleaning the rate
of Aspergillus species infections on the transplant/leukemia service again
fell to the level seen prior to the epidemic.Reserve University School of Medicine Cleveland, Ohio. Aspergillosis Due to
Carpet Contamination. Infection Control and Hospital Epidemiology Vol
15.No4:221-223Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
ABN 47533508426
Of Fiona de Sousa
Hi List members,
At our facility we have carpeted patient care areas. We are currently
reviewing how this carpet should best be cleaned on a routine basis and
after caring for a patient on transmission based precautions. I would
appreciate hearing from other facilities who face this challenge to hear how
they have addressed this problem.I know that carpets in healthcare are a sensitive issue and I am happy for
people to contact me off line if they prefer.Kind regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
185 Fox Valley Road, Wahroonga, NSW, 2076
information intended for the addressee named above.
If you are not the intended recipient you are hereby notified that any
dissemination, distribution or reproduction of this message
is prohibited. If you have received this message in error please notify the
sender immediately, then destroy the original message.
Any views expressed in this message are solely those of the individual
sender, except where the sender is specifically authorised
by Sydney Adventist Hospital to state that they are the views of Sydney
Adventist Hospital.
_____________________________________________________________________
This e-mail has been scanned for viruses by Symantec Hosted Services
Scanning Services – powered by MessageLabs. For further information
visit http://www.messagelabs.comMessages posted to this list are solely the opinion of the authors, and do
not represent the opinion of ACIPC.Archive of all messages are available at http://aicalist.org.au/archives –
registration and login required.Replies to this message will be directed back to the list. To create a new
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the quotes) to listserv@aicalist.org.auMessages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
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