Page 51 - CIJ JAN 2024 - Digital Edition

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.

Clean India Journal•JANUARY 2024 51
www.cleanindiajournal.com