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HealtHcare Hygiene






                                                                                  hile the importance of
                                                                                  implementing robust
                                                                                  cleaning practices to prevent
                                                                                  Healthcare Associated
                                                                     WInfections (HAIs) is widely
                                                                     recognized, there is a need for focus on
                                                                     the specifics, including optimal methods,
                                                                     timing, and locations for cleaning. A renewed
                                                                     interest in removing and monitoring surface
                                                                     bioburden could significantly contribute
                                                                     to the adoption of risk-based practices in
                                                                     hospitals.
                                                                       Furthermore, a significant challenge arises
                                                                     from the absence of universally accepted
                                                                     standards for cleanliness on hard surfaces
                                                                     within healthcare settings. Defining when a
                                                                     surface is truly ‘clean’ remains a question —
                                                                     specifically, determining the acceptable level
                                                                     of contamination for various surface types
                                                                     in diverse areas, wards, or units to ensure
                                                                     reduced risk of HAI.
                                                                       Complicating matters is the diversity
                                                                     in methods for sampling hard surfaces,
                                                                     which include culture and identification
                                                                     techniques that are not only varied but also
                                                                     prone to inaccuracy, unreliability, high cost,
                                                                     time consumption, and the necessity of
                                                                     microbiological expertise. Moreover, surfaces
                                                                     are susceptible to a myriad of influences,
                                                                     such as the daily application of cleaning
                                                                     fluids, antimicrobial surface coatings, wear
                                                                     and tear, and the formation of biofilm.
                                                                       Establishing a set of microbiological
                                                                     standards encompassing common hand-touch
                                                                     sites both within and outside near-patient
                                                                     areas would serve as a valuable benchmark
                                                                     for assessing HAI risk. This standardization
                                                                     would not only benefit infection control
                                                                     and domestic agencies but also provide
                                                                     an early indication of potential outbreaks.
                                                                     Additionally, aging hospitals with poorly
                                                                     maintained fabric and internal fixtures face
                                                                     challenges in cleaning. Cleaning intact
                                                                     surfaces on furniture, fixtures, fittings,
                                                                     and floors is much more manageable
                                                                     than attempting to clean surfaces that are
                                                                     disintegrating. Requesting staff to clean areas
                                                                     that are stained, damaged, torn, scratched,
                                                                     cracked, or non-existent not only diminishes
                                                                     motivation but also creates additional
                                                                     environmental niches for potential pathogens.





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