Automating patient care equipment cleaning and disinfection
Hospitals, long-term care, rehab facilities and other providers share a common objective: Keep patient care equipment clean and infection free. Increasing quality metrics, lower budgets, staff shortages are just some of the business pressures forcing healthcare organizations to do more with less. While costs must come down, standards for disinfecting medical equipment and cleaning are going up, not as a choice, but a requirement.
Wheelchairs, commodes, carts, over-bed tables, etc., are prime candidates to retain pathogens from patient, visitors or staff handling. It is very difficult to keep equipment clean and infection free in the available time at the least costs using manual methods. When manual methods are used, cleaning and disinfection will vary from person to person on any given day. Equipment mobility also makes it difficult to keep track of these tasks and often times may have different people responsible for cleaning and disinfection, each having their own procedure from one day to the next.
Manually cleaning wheelchairs, commodes and other patient care equipment can be thought of as an undervalued function. Casual wiping on minimal surfaces and inconsistent frequency only serves to minimize the importance of the job. In order to keep budgets low, staff efficiently and raise standards for infection prevention, a consistent dependable automated process is required.
Automated cleaning of patient care equipment is not a new technology, debuting around 20 years ago. Like many new technologies, it had its share of problems. But, slowly it improved and today is used throughout healthcare markets. During those 20 years, healthcare facilities have moved away from once or twice a year having a “Big Wheelchair Cleaning Day.” That standard is no longer adequate or acceptable.
Wheelchairs, along with other types of mobility equipment, are touch points for spreading infections. In a similar way, the slow adoption to wash hands thoroughly is being repeated with mobile equipment. The potential of spreading infections in different areas of the facility by contact with patient, staff or visitor is just as likely with equipment as it is with hands.
A recent article in Becker's Infection Control & Clinical Quality on sustaining best practices in mobile equipment says, “One area that is often overlooked, but presents a significant opportunity to reduce infection risk, is the disinfection of mobile equipment… Numerous studies have shown that hospital surfaces and frequently used medical equipment become contaminated by a variety of pathogenic and nonpathogenic organisms. Proper decontamination of mobile equipment, therefore, plays an important role in stopping the spread of HAIs.”
In another publication, the American Journal of Infection Control, the authors write, “Health care-associated infections (HAIs) are prevalent and affect between 1 and 10 and 1 in 25 patients in both U.S; and Canadian Hospitals. Current guidelines, however, do not provide specific instructions on the optimal processes for tracking, cleaning, and disinfecting more complicated hospital equipment, such as wheelchairs”
A standard wheelchair has about 3,000 inches of surfaces, of which 1,500 inches are viewable for cleaning and the other 1,500 are hidden from view. Thorough manual cleaning can take well over 20 minutes per wheelchair. What makes matters worse, these hidden areas can become a place for pathogens to take up residency particularly if liquids or food are on the chair for an extended period of time increasing pathogen numbers.
Disinfection has been neglected because many disinfectants required 5- to 10-minute contact times. People don't want to wait that long. Today, disinfectant contact times have been significantly reduced. In fact, with today's automated technology, washing, rinsing and high level disinfection using Ultra-Violet can be done in six minutes.
While the automated process to clean and disinfect patient care equipment is consistent for one or a hundred pieces of equipment, there are many other benefits. An automated process elevates the value of this function resulting in greater employee satisfaction, morale and improved staff utilization. An automated process emphasizes the importance of thorough cleaning and proper disinfection.
From a financial and staff utilization perspective, labor savings is significant when you compare manual labor time to automation. Automation is the right tool to do the tedious, repetitive, non-interesting job and at the same time frees up the operator for something which has greater employee satisfaction, efficiency and increased productivity.
In addition to the obvious benefits stated above, an automated process has minimal chemical handling, no stooping or bending down to reach more difficult areas of the equipment, chemical dilutions are correct for disinfection claims and the process is measureable. All and all it is a major win for - patient, employee, visitor and for the facility.
Karl Soderquist is president of the The HUBSCRUB Company, a manufacturer of high-performance, automated cleaning and infection prevention systems for durable medical equipment and other equipment requiring the same level of attention.