Environmental decontamination in Care Homes

There is increasing evidence that the environment plays a significant role in the spread of infection in settings in which vulnerable people are cared for. Potential pathogens can survive on surfaces for considerable periods of time, examples include: MRSA surviving for over a year in dust, and spores of Clostridium difficile remain viable for over five months. Viruses too can survive in the surrounding 

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environment. Influenza can live for two weeks on everyday items, such as door handles. Infected itemsbecome a risk to anyone who may come into contact with them as they may self-inoculate by touching their nose or mouth.

Cleaning and disinfection of frequently touched surfaces e.g. shared equipment, door handles, light switches etc., can help break the chain of transmission from an infected person to another susceptible person, be they a hospital in-patient or a resident of a long-term care facility. Hand hygiene is often described as the most important infection control intervention and this is partly because hands touch patients and clients in addition to a contaminated environment. Reducing the burden of organisms in health and social care settings that are available for potential transmission to vulnerable persons will reduce the risks of transmission should hand hygiene be less than perfect. This will also protect the health of residents who will constantly touch the environment in which they are living.


Infection

One infection that regularly causes outbreaks in settings in which high numbers of people are co-inhabiting (including schools, nurseries, hospitals, workplaces and cruise ships) is a gastroenteric infection known as Norovirus (or winter vomiting disease). Norovirus is a highly transmissible infection and one episode of vomiting can spread over 30 million viral particles into the environment and the infectious dose is only around 10 of these organisms. An additional problem is that there is only short-term immunity from infection following an episode, meaning that outbreaks can occur in the same setting to the same people after only a short time.

Noroviruses are responsible for many outbreaks each year and in themselves they are not hazardous to health as the infection normally lasts for 24-48 hours. However, the dehydration caused by diarrhoea and/or vomiting in a frail elderly person can be extremely serious, sometimes requiring hospital admission. In addition, the disruption caused by such an outbreak, whereby hospital wards and long-term care facilities may be closed to admissions or transfers has a significant impact on the delivery of healthand social care. There is also a risk to staff working in the area and Norovirus is a significant cause of staff absenteeism. This leads to an administrative burden of having to report outbreaks to the Care Quality Commission and local Public Health networks.

 

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The cornerstones of any infection prevention programme in any setting that provideshealth or social care are environmental and hand hygiene.  Traditionally chlorine has been used as the disinfectant recommended for Norovirus control, however there are problems with the use of this in nursing and social care settings. Firstly, surfaces and materials may not be able to tolerate the damaging nature of this disinfectant leading to costs to replace damaged equipment. Secondly, chlorine must be freshly made up every day which means there's potential for dilution errors. Lastly, organic matter such as vomit or faeces rapidly deactivates chlorine.

Clinell Universal Wipes (green), contain a variety of disinfectants that: do not damage sensitive environmental surfaces; are effective against Noroviruses; and have been tested in independent, accredited laboratories. Clinell wipes are trusted by most UK hospitals to reduce the risk of transmission of pathogens responsible for infections. If surfaces are regularly disinfected by the simple measure of wiping them over with a single-use wipe the risk of transmission of infection will be greatly reduced.Additionally, Clinell Universal Wipes (green) are also effective against all significant pathogens

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responsible for bacterial infection, including MRSA and E. coli, with the exception of Clostridium difficile.

C. difficile in the spore form is extremely difficult to kill, requiring an agent that isproven to be sporicidal if it is to be eradicated. Therefore, should spores be a potential problem in a healthcare setting, and if a wipe is required, Clinell Sporicidal Wipes (red) can be used. This wipe contains peracetic acid and clinical research studies have demonstrated its effectiveness at removing and preventing the transmission of spores. These wipes are also non-damaging to most surfaces that may be damaged by chlorine. Clinell Sporicidal Wipes (red) are also trusted by most UK hospitals, which is reflected by many hospitals using the wipes as part of a C. difficile reduction strategy.

 Surface disinfection is now a routine part of healthcare for most UK hospitals and is a critical part of infection prevention and control programmes. Trusted by hospitals, Clinell disinfectant wipes are integral to risk reduction strategies and can be used in nursing and social care settings to reduce risk of infection and disruption, especially when Norovirus comes calling.

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