like C. diffi cile, could decrease the risk of
colonisation or infection with others.
In addition, rooms of infected or
colonised patients could serve as
epicentres for transmission within a
hospital through contamination of shared
medical equipment and healthcare
workers’ hands and clothes. More e ective
decontamination of these rooms,
therefore, could reduce the risk.
ROLE OF ‘MAINTENANCE CLEANING’
“In busy hospitals and clinics, e cient
maintenance cleaning is crucial as there
is rarely enough time for time-consuming
deep cleaning. More stringent hygiene
standards, increasing cost pressures and
competition make things more di cult,”
says cleaning equipment manufacturer
Kärcher. It o ers cleaning and disinfecting
equipment such as scrubber driers for
oors and steam cleaners (pictured,
above right).
Arguing the bene ts of steam is
equipment supplier Osprey Deepclean:
“Dry steam is proven to be e ective
against ‘superbugs’, and when used in
conjunction with an integral vacuum, dry
steam safely and e ectively removes
them – instead of killing them – leaving
little scope for antimicrobial resistance.
“Dry steam reduces the need for
chemicals, and leaves surfaces clean, dry
and ready for reuse. Dry steam cleaner
machines are therefore perfect for
hospitals, clinics, nursing homes, vets and
other health centres.”
Steam cleaners operate along similar
HOSPITAL & MEDICAL – NON-CONTACT CLEANING
lines to pressure cookers – cold
water is poured into a sealed
boiler and is then heated until
it boils and creates a hot supply of
steam. The heat can then be increased
further so that the steam then becomes
superheated.
This so-called ‘dry’ steam contains
little moisture and/or water particles.
The standard of dry steam dictates
that it must not contain more than 5%
moisture. The reason for this is that dry
steam cannot possess any impurities, but
water can. It can be channeled through
di erent cleaning heads. The higher the
temperature, the higher the pressure of
the steam emitted.
A less traditional non-contact
cleaning measure is the use of ultrasonic
nebulising equipment. US-based
Altapure, for example, o ers a highlevel
disinfection system claimed to kill
C. diffi cile, MRE, MRSA, and viruses, in a
treated space in under 50 minutes.
It says: “Merely zapping bugs with UV
light leaves a very dangerous bio-burden
behind in treated rooms that can infect
other patients and hospital personnel.”
The AP-4 is an ultrasonic product
designed to deliver a dense cloud of
sub-micron droplets. The aerosol is
said to deliver gas-like performance
that o ers three-dimensional coverage
and treatment in large areas, multiple
connected spaces, complex geometries,
long horizontal and vertical runs, and the
various surfaces within these spaces,
including any equipment or objects
located there. The result is said to be
a complete coverage and treatment of
all exposed surfaces within the treated
space.
NO SUBSTITUTE FOR SCRUBBING?
But not everyone is convinced. Delia
Cannings, manager of education and
training for the Association of Healthcare
Cleaning Professionals (AHCP), argues
that there is no substitute for good
old-fashioned scrubbing, mopping,
washing and wiping before
conducting any kind of disinfection
in hospitals. She says: “Some people
believe that, in the healthcare sector,
you can go straight into disinfecting
without cleaning. But you must clean
rst, because you have to remove the
soil from the surface in order to get to
the pathogens… physical agitation
is a requirement. How that is done
will depend on who you work for, what
equipment you’ve got access to, how well
trained your sta are.”
So, although physical washing and
wiping could be mechanical using
machines such as steam cleaners or
pressure washers, it seems there’s no
substitute for the mop and bucket.
Cannings points out that there are a
number of disinfectants, sanitisers and
cleaning agents that are used together. In
a con rmed case of a speci c outbreak,
the view is that the area should have
a detailed clean (edges, ledges, highs,
lows, pulling out, pushing in) followed by
decontamination (removing that which is
invisible in the main) either using vapour
technology (which involves bleach-based
disinfectants), ozone generators or
robots (small mobile machines that give
o a vapour).
But, she warns, however wellprepared
you are, the incidence of bio lm
– a result of the residues of cleaning
agents left behind because they haven’t
been measured correctly – is increasing
so, in e ect, the cleaning needs cleaning.
“If cleaners don’t dilute their
disinfectants correctly, they will leave
behind bio lm (essentially a transparent
membrane surfaces that collects germs
and other contamination from the
environment). The link between dilution
and infection prevention is unrealised.
Get the dilutions right and we reduce
infections, in my opinion.”
auremar /stock.adobe.com
June 2019 www.operationsengineer.org.uk 27
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