Helen FORREST (United Kingdom) Lead nurse infection prevention and control
Derby Hospitals NHS Foundation Trust
We did a research project, taking over eight side rooms and infecting them with C. diff 027. Using the same staff to ensure consistency, each room was treated with a different disinfectant. The eight treatments were chlorine releasing agent, sporicidal wipe, microfibre, microfibre with chlorine releasing agent, hydrogen peroxide vapour, steam, super heated steam, and ozone. We looked at the kill rates for the bacteria, and brought in a health economy team, who looked at the ease of use, time factor and cost.
We graded all to come up with a top three, all statistically similar, of HPV, chlorine releasing agent and sporicidal wipe. At the time we were using chlorine releasing agent and sporicidal wipe, so we stayed as we were.
We had funds available, and wanted to ensure it was spent wisely. We visited other hospitals that were using various types of HPV systems and machines, and spoke to the teams about their experiences – the cost and time factors.
We found some were very expensive and time-consuming. We’re a busy hospital and can’t afford for an area to be out of commission for up to four hours while it is decontaminated.
We came across Oxy’Pharm HPV and learned that it cost considerably less than other systems. Oxy’Pharm’s UK distributor brought in a machine and we did some trials in an empty fourbedded bay with all the normal furniture and an en suite.
We ‘hid’ some indicator strips in what are typically hard to reach areas when doing a deep clean – bed mechanism, curtain track, plug hole, shower head, bedside drawer, for example. The Oxypharm unit was placed in one corner and the door of the en suite left open. Once the room area had been entered it took about six minutes for the actual HPV dry gas dispersal process and about 45 minutes for the contact time. That’s all it needs to do its magic. So in an hour the room was ready to be used. The result was brilliant. All the indicator strips changed colour. I was quite shocked. It does exactly what it says on the tin.
The trial was repeated in a single room with an en suite, again with hidden indicator strips. And again Oxy’Pharm worked perfectly. The beauty of the 6% HPV we use is that it isn’t strong enough to cause any problems – it’s all perfectly safe, yet gives outstanding results. Each trial was completed within an hour.
What sold Oxy’Pharm to me was its flexibility. It’s small, and requires little training and labour. It’s quick and easy to use and reasonably priced. The consumables are, cost-effective too – especially when compared with other suppliers we investigated.
The decontamination team has a four-week schedule to go around each ward and clinical area, enhancing the normal Cleaning. Nursing staff take all the equipment that’s not being used, such asdrips stands, commodes, and note trolleys, into an available side room and we decontaminate everything with HPV. It’s entirely safe for equipment. Oxy’Pharm have done a lot of validations. It gives an ‘icing on the cake’ clean to all the equipment.
We use Oxy’Pharm for norovirus and C. diff in terminal cleans. Whenever the team is doing a four-bedded bay the wards put the equipment in there too.
Besides the bays and side rooms, we’ve done the microbiology lab and some theatres. We use two machines for larger areas. We’ve found we can turn a four-bedded bay with an en suite round in an hour. The curtain goes to the laundry, and we do a normal deep clean using the chlorine releasing agent with a disposable cloth. One of the decontamination team sets up the machine and it does its work.
It’s given us the ability to have an enhanced deep clean service, with minimal disruption in the ward areas. I believe it has a positive effect in reducing the spread of norovirus in our ward areas and helps prevent its return. During the current winter months and norovirus season we’ve had eight full ward closures. Previously we’ve had up to 21 full ward closures in a season.
We’ve good cleaning standards, so we’re effectively, deep cleaning clean. We have the validations from Oxy’Pharm and felt that with the trials we’d done that the 6% concentration is sufficient, and that’s been the case. We know we can go to 12% if we want to.