During a community tour of a new critical access hospital, I was shocked to see carpet leading from the main entry of the hospital, up the stairs and throughout the entire patient care area. Hallways and nursing station areas all carpeted. This was not continuous carpet, it was carpet tiles with visible seams and edges. Perfect sites for microbes to harbor. I am thrilled to say that the patient rooms were not carpeted!
When I asked about the ability to effectively clean the carpet, the exchange went like this:
“It is antimicrobial.”
“Oh, okay. What exactly does that mean?”
“It is continually disinfecting.”
The answer was given in such a way that everyone believed, with every step we took, the microbes from our shoes were being destroyed instantly.
No such thing
Recent conversations with healthcare professionals have also caused me to stop to catch my breath. The belief that surfaces are “self-cleaning” can lure people into a false sense of security. ATTENTION: There is no such thing as a self-cleaning surface!
Every surface in every healthcare facility must be thoroughly cleaned and disinfected regularly!
Today there are many different antimicrobial products on the market. All work in different ways. Some need water, some need light, some need to be free of any kind of coating, some need to be reapplied on a regular basis. Understanding how the antimicrobial surface works and how it can be cleaned and disinfected is extremely important.
Is there a chance that a surface may be overlooked or the due diligence necessary to effectively clean the surface will not be followed because staff members believe antimicrobial surfaces are “self-cleaning?” Will we see an increase in the number of infections as a result of this misunderstanding? Remember, the goal is to mitigate the spread of infection.
After asking a series of questions in countless interviews with manufacturers of antimicrobial products, not one representative has ever claimed that a surface was capable of cleaning itself continuously, even though that was the initial impression given when the conversation started. Asking the right questions is key, since misunderstandings happen quickly.
My first question is always “What do you mean by antimicrobial?” Here are just a few of the responses I have heard:
- We use pine and linseed oil in our manufacturing process. Both of these products have natural antimicrobial properties
- The surface slows down the bacteria
- The antimicrobial properties of this product provide a backup to regular cleaning and disinfection procedures, so you don’t need to clean it as often
- The savings come from not having to clean this material as often
- Since our product is non-porous, it is naturally anti-bacterial. (Hmm, anti-bacterial or antimicrobial?) Bacteria can’t survive on the surface.
Another important question that is often not asked has to do with quantifying efficacy. Has this antimicrobial product reduced the number of infections within a healthcare facility? By how much? The majority of antimicrobial surfaces show a 99.999% reduction of microbes over time in a testing laboratory. But does this reduction in a controlled laboratory environment translate into a measurable reduction in a real world active healthcare environment?
I believe there are good products on the market that can be an effective part of a multimodal solution. However, I am concerned that some people believe that “self-cleaning” surfaces actually exist. This will likely lead to reduced attention on required cleaning and disinfection protocols, setting facilities up for failure.