Bioluminescence-based hygiene evaluation of public washroom environment: Repeated measurement of posthandwashing facilities on baseline and before and after cleaning schedule

Compliance with infection control practices among healthcare workers in radiology departments: a participant observation study and adenosine triphosphate assay evaluation of environmental cleanliness

Background

Increased risk of healthcare-associated infections (HAIs) in radiology departments has been reported in recent years. Optimal infection control practices (ICPs) are the key to controlling HAIs, but few studies have investigated the ICP compliance of healthcare workers (HCWs) in radiology departments.

Aim

To assess the level of ICP compliance of HCWs in a radiology department.

Methods

A participant observation supplemented with adenosine triphosphate (ATP) bioluminescence assay evaluation of environmental cleanliness was conducted. More than 1000 hand hygiene (HH) opportunities and 960 opportunities for the other core ICP elements were observed in different study units of a radiology department. An online checklist powered by eRub was used to record the HCWs' ICP performance. A total of 125 environmental samples were collected for ATP assay evaluation.

Results

In the participants observation, the overall performance score was 41.4%. The lowest score was found in HH (10.4%), followed by use of personal protective equipment (29.4%) and gloves (68.2%). The HH performance was significantly associated with study units (χ2 = 42.55, P < 0.001), professional groups (χ2 = 110.21, P < 0.001), and patient-to-staff ratio (F = 8.76, P < 0.001). With relative light units of ≤250 set as a pass benchmark, less than two-thirds of the environmental samples passed the ATP assay.

Conclusion

The overall ICP compliance among the HCWs in the radiology department was suboptimal. Revisions of current ICP guidelines and policies that are tailored to the setting-specific needs and barriers in radiology departments is necessary.

Transmission of SARS-CoV-2 infections and exposure in surfaces, points and wastewaters: A global one health perspective

The persistence of SARS-CoV-2 or its RNA on surfaces, points, or wastewaters may increase the risk of transmission of this virus. Therefore, we conducted this review to discuss the places and surfaces with the highest potential for infection and spread of the SARS-CoV-2 virus. Several common and public areas, hospitals, elevators, public transport, local markets, and surfaces such as public toilets, door handles, untreated and treated wastewaters, wastewater plants, and public washrooms are also considered major points for spreading of SARS-CoV-2. Highly contaminated surfaces or places often have materials or contain items made of materials on which the SARS-CoV-2 virus can persist (e.g., metal, wood, and plastic). For example, SARS-CoV-2 can exist up to 4 days on doorknobs made by those materials. For public places such as public transports, elevators, and local markets, crowding and enclosed spaces are major source for transmission. Several measures such as using copper alloy surfaces instead of metal surfaces, disinfectants, and suitable personal protective equipment have been suggested. Our research could be the basis to help develop studies on the existence and transmissibility of SARS-CoV-2 as well as its RNA to take measures to prevent and limit the harmful effects of COVID-19 pandemic.

What is the risk of acquiring SARS-CoV-2 from the use of public toilets?

Public toilets and bathrooms may act as a contact hub point where community transmission of SARS-CoV-2 occurs between users. The mechanism of spread would arise through three mechanisms: inhalation of faecal and/or urinary aerosol from an individual shedding SARS-CoV-2; airborne transmission of respiratory aerosols between users face-to-face or during short periods after use; or from fomite transmission via frequent touch sites such as door handles, sink taps, lota or toilet roll dispenser. In this respect toilets could present a risk comparable with other high throughput enclosed spaces such as public transport and food retail outlets. They are often compact, inadequately ventilated, heavily used and subject to maintenance and cleaning issues. Factors such as these would compound the risks generated by toilet users incubating or symptomatic with SARS-CoV-2. Furthermore, toilets are important public infrastructure since they are vital for the maintenance of accessible, sustainable and comfortable urban spaces. Given the lack of studies on transmission through use of public toilets, comprehensive risk assessment relies upon the compilation of evidence gathered from parallel studies, including work performed in hospitals and prior work on related viruses. This narrative review examines the evidence suggestive of transmission risk through use of public toilets and concludes that such a risk cannot be lightly disregarded. A range of mitigating actions are suggested for both users of public toilets and those that are responsible for their design, maintenance and management.

Monitoring the cleanliness of reusable surgical instruments in central sterile supply department by adenosine triphosphate method

BACKGROUND

Cleaning is very important in reusable surgical instruments (RSI) reprocessing. Adenosine triphosphate (ATP) method is widely used for cleanliness assessing while few studies focused on using this method on RSIs.

OBJECTIVE

To assess the effectiveness of ATP Bioluminescence Assay for monitoring the cleanliness of RSIs.

METHODS

The study conducted in three central sterile supply departments (CSSD) from 2015 to 2020, surgical scissors, haemostatic forceps, and other non-lumen instruments after cleaning were sampled. Each instrument was swabbed in a uniform manner on the surface including hinged joints and teeth, the amount of ATP (amol) was calculated.

RESULTS

A total of 871 RSIs after cleaning were tested, the mean ATP lg (amol) was 2.829 ± 0.539 and the qualified rate was 80.57%. Washer-disinfector cleaning was more efficiency than manual cleaning, the mean ATP lg (amol) were 2.776 ± 0.513 and 2.948 ± 0.575, respectively; the qualified rates were 84.97% and 70.59%, respectively. The qualified rate was decreased with the time of instruments after cleaning exploring to environment increased (P  trend = 0.044).

CONCLUSION

ATP level are stable and repeatable for continuous monitoring the cleanliness of RSIs, it is a rapid and viable method for assessing the cleanliness of RSIs. Washer-disinfector cleaning is recommended and cleaned instruments should go on packing for sterilization in time.

HIGHLIGHTS

- ATP method is viable for assessing the cleanliness of reusable surgical instruments in CSSDs.- Reusable surgical instruments suggested washer-disinfector cleaning and should go on packing for sterilization in time.