New Technologies for Cleaning Hospital Environments
When I first began as an Infection Preventionist, staff often asked about terminally cleaning a room by fogging it. This was usually requested after a particularly contaminated case or for patient with lice. The staff was referring to a practice of fogging a room with a chemical or steam in an attempt to destroy any microbes and other living things like a pesky louse.
I'd never actually seen this method. It was abandoned because there was no scientific evidence that it changed the "flora" of the patient room. Additionally, one of the chemicals used - paraformaldehyde - is no longer registered for use with the EPA. And finally, it was inconvenient because the room was unusable for a period of time.
More recently, the recognition that a patient's room can serve as a fomite for transmission of organisms has renewed interest in more encompassing methods of room disinfection. For example, in a 2006 article, Kramer and his colleagues report that Klesbiella species can last from 2 hours - months and C. difficile spores can last for 5 months!
Technologies to address this concern have been introduced in hospitals. One technology is the use of vaporized aqueous hydrogen peroxide. A portable machine is wheeled into a vacated area and the vapor is delivered into this closed space. Another example is the use of ultraviolet radiation to decontaminate a room. The unit is placed in a room and is timed to work while the environmental service staff remains safely outside the room. Both of these technologies have been used in other industries - air handling and water treatment (UV) and pharmaceutical and medical device sterilization (peroxide). Both methods have been shown to reduce microbial contamination.
Rooms must still be physically cleaned before use of these technologies. But traditional cleaning is sometimes ineffective and these technologies have the advantage of disinfecting all surfaces that are exposed to the light or the chemical.
While far from commonplace, these technologies have been successfully implemented for cleaning high risk areas such as OR and isolation room so keep an eye out for them in your facility.