Effectiveness of a hydrogen peroxide mist (Trophon) system in inactivating healthcare pathogens on surface and endocavitary probes

they are considered noncritical and require at least low-level disinfection between patients. Endocavitary probes (eg, transvaginal, transrectal, or transesophageal probes) are considered semicritical because they have direct contact with mucous membranes (eg, vagina, rectum, or pharynx) or nonintact skin. While one could argue that the use of the probe cover changes the category for the endocavitary probe, the Centers for Disease Control and Prevention (CDC) guideline for disinfection and sterilization recommends that a new condom/probe cover should be used for each patient, and because condoms/probe covers and low-level disinfection may fail, high-level disinfection of the probe should be performed. The relevance of this recommendation is reinforced by the finding that sterile ultrasound probe covers and condoms can have a perforation rate from 0% to 81% before and after use. These studies underscore the need for high-level disinfection of endocavitary probes between examinations.Ultrasound probes are used in sonographic scanning and are commonly used as either surface probes or endocavitary probes. Surface probes are used on intact skin, such as the abdome

Disinfection, sterilization, and antisepsis: Principles, practices, current issues, new research, and new technologies

Health care−associated infections are an important source of morbidity and mortality, with an estimated 1.7 million infections and 99,000 deaths annually in the United States.1 The major source of health care−associated pathogens is thought to be the patient’s endogenous flora, but an estimated 20% are acquired via other transmission routes such as the environment, and 20%-40% are attributed to crosstransmission via the contaminated hands of health care personnel

Disinfection, sterilization, and antisepsis: An overview

All invasive procedures involve contact by a medical device or surgical instrument with a patient's sterile tissue or mucous membranes. The level of disinfection or sterilization is dependent on the intended use of the object: critical (items that contact sterile tissue such as surgical instruments), semicritical (items that contact mucous membrane such as endoscopes), and noncritical (devices that contact only intact skin such as stethoscopes) items require sterilization, high-level disinfection and low-level disinfection, respectively. Cleaning must always precede high-level disinfection and sterilization. Antiseptics are essential to infection prevention as part of a hand hygiene program as well as several other uses such as surgical hand antisepsis and pre-operative skin preparation

Best practices for disinfection of noncritical environmental surfaces and equipment in health care facilities: A bundle approach

Over the past decade, there is excellent evidence in the scientific literature that contaminated environmental surfaces and noncritical patient care items play an important role in the transmission of several key health care–associated pathogens including methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Acinetobacter, norovirus, and Clostridium difficile. Thus, surface disinfection of noncritical environmental surfaces and medical devices is one of the infection prevention strategies to prevent pathogen transmission. This article will discuss a bundle approach to facilitate effective surface cleaning and disinfection in health care facilities. A bundle is a set of evidence-based practices, generally 3-5, that when performed collectively and reliably have been proven to improve patient outcomes. This bundle has 5 components and the science associated with each component will be addressed. These components are: creating evidence-based policies and procedures; selection of appropriate cleaning and disinfecting products; educating staff to include environmental services, patient equipment, and nursing; monitoring compliance (eg, thoroughness of cleaning, product use) with feedback (ie, just in time coaching); and implementing a “no touch” room decontamination technology and to ensure compliance for patients on contact and enteric precautions. This article will also discuss new technologies (eg, continuous room decontamination technology) that may enhance our infection prevention strategies in the future

Reprocessing semicritical items: Outbreaks and current issues

Semicritical medical devices are defined as items that come into contact with mucous membranes or nonintact skin (eg, gastrointestinal endoscopes, endocavitary probes). Such medical devices require minimally high-level disinfection. As many of these items are temperature sensitive, low-temperature chemical methods must be used rather than steam sterilization. Strict adherence to current guidelines is required as more outbreaks have been linked to inadequately cleaned or disinfected endoscopes and other semicritical items than any other reusable medical devices

Gastrointestinal endoscopes a need to shift from disinfection to sterilization?

More than 10 million gastrointestinal endoscopic procedures are performed annually in the United States for diagnostic purposes, therapeutic interventions, or both.1 Because gastrointestinal endoscopescontactmucosal surfaces, use of acontaminated endoscope may lead to patient-to-patient transmission of potential pathogens with a subsequent risk of infection

Reprocessing semicritical items: Current issues and new technologies

Semicritical medical devices are defined as items that come into contact with mucous membranes or nonintact skin (eg, gastrointestinal endoscopes, endocavitary probes). Such medical devices minimally require high-level disinfection. Because many of these items are temperature sensitive, low-temperature chemical methods are usually used rather than steam sterilization. Strict adherence to current guidelines is required because more outbreaks have been linked to inadequately cleaned or disinfected endoscopes and other semicritical items undergoing high-level disinfection than any other reusable medical device

Occupational Health Update: Focus on Preventing the Acquisition of Infections with Pre-exposure Prophylaxis and Postexposure Prophylaxis

Health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, Clostridium difficile). An effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and isolation of potentially infectious patients, and hand hygiene; (2) assuring immunity to vaccine-preventable diseases; and, (3) immediate availability of a medical evaluation after a nonprotected exposure to an infectious disease

Response to letter to the editor regarding “Occupational health risks associated with the use of germicides in health care”

To the Editor: We thank the authors of the letter for their comments on the benefits and risks of using low-level disinfectants on environmental surfaces in hospitals based on our recent article “Occupational health risks associated with the use of germicides in health care.”1 We take exception to many of the issues and criticisms raised by these authors

Disinfection and Sterilization in Health Care Facilities: An Overview and Current Issues

When properly used, disinfection and sterilization can ensure the safe use of invasive and noninvasive medical devices. The method of disinfection and sterilization depends on the intended use of the medical device: critical items (contact sterile tissue) must be sterilized before use; semicritical items (contact mucous membranes or nonintact skin) must be high-level disinfected; and noncritical items (contact intact skin) should receive low-level disinfection. Cleaning should always precede high-level disinfection and sterilization. Current disinfection and sterilization guidelines must be strictly followed