Decontamination in Hospitals and Healthcare
- 2nd Edition - November 25, 2019
- Latest edition
- Editor: James T. Walker
- Language: English
Decontamination in Hospitals and Healthcare, Second Edition, enables users to obtain detailed knowledge of decontamination practices in healthcare settings, including surfaces,… Read more
Decontamination in Hospitals and Healthcare, Second Edition, enables users to obtain detailed knowledge of decontamination practices in healthcare settings, including surfaces, devices, clothing and people, with a specific focus on hospitals and dental clinics.
- Offers in-depth coverage of all aspects of decontamination in healthcare
- Examines the decontamination of surgical equipment and endoscopes
- Expanded to include new information on behavioral principles in decontamination, control of microbiological problems, waterborne microorganisms, pseudomonas and the decontamination of laundry
Microbiology laboratories and Disinfection laboratories, Healthcare workers who use disinfectants, Students in microbiology, Clinicians, Members of Institute of Decontamination Sciences/Central Sterilisation Club and those employed in Central Sterile Services and Departments
1 The importance of decontamination in hospitals and healthcare
J.T. Walker
1.1 Introduction
1.2 Microbial resistance and infection control
1.3 Maintaining safe water provision
1.4 Issues of prion transmissibility in healthcare
1.5 Conclusion
References
Further reading
2 The history of decontamination in hospitals
S.W.B. Newsom, G.L. Ridgway
2.1 Introduction
2.2 Healthcare-acquired infection
2.3 Key figures in decontamination control
2.4 Heat for sterilization and disinfection
2.5 Chemical disinfectants
2.6 Testing disinfectant activity
2.7 European medical devices directives
2.8 Incidents of contamination as a result of human error
2.9 Conclusion
Acknowledgments
References
Further reading
3 Quality and supply of water used in hospitals
E. Maynard, C. Whapham
3.1 Introduction
3.2 Compliance in the healthcare environment
3.3 Water treatment and water purification technology
3.4 Water quality monitoring
3.5 Specialist departments and their unique requirements for water quality control
3.6 Sustainability and conservation in healthcare water management
3.7 Conclusion and future trends
References
Further reading
4 Control of Legionella in hospital potable water systems
Julianne L. Baron, Laura Morris, Janet E. Stout
4.1 Introduction
4.2 Systemic disinfection methods
4.3 Emergency disinfection methods
4.4 Selection and validation of disinfection method
4.5 Regulatory requirements, standards, and guidelines
4.6 Conclusion 000 References
5 Waterborne transmission of Pseudomonas aeruginosa
M.I. Garvey, C. McMurray, E. Holden, J. Walker
5.1 Pseudomonas aeruginosa 5.2 P. aeruginosa microbiology and pathogenicity
5.3 Epidemiology and infections
5.4 Environmental reservoir and nosocomial outbreaks
5.5 What clinical settings and patient populations are affected by P. aeruginosa?
5.6 What are the potential sources of P. aeruginosa?
5.7 What are the potential transmission routes for P. aeruginosa outbreaks?
5.8 What control measures can be implemented to stop P. aeruginosa outbreaks?
5.9 Infection prevention measures
5.10 Conclusion
References
6 Mycobacteria chimaera infections and their transmission from heater-cooler units
J.T. Walker
6.1 Introduction and background
6.2 Waterborne nontuberculous mycobacteria (NTM)
6.3 NTM transmission routes
6.4 What is a heater cooler device?
6.5 How are waterborne pathogens able to grow within HCUs?
6.6 How was M. chimaera transmitted from the HCU to the patients?
6.7 Clinical features and diagnosis
6.8 Manufacturer’s instructions for the decontamination of microorganisms in HCUs
6.9 Compatibility of manufacturer’s equipment
6.10 Decontamination, containment, or relocation of HCUs
6.11 Implications for ECMO equipment
6.12 Summary
References
7 Decontamination of hand washbasins and traps in hospitals
David C. Coleman, Emily C. Deasy, Elaine M. Moloney, James S. Swan, Mary J. O‘Donnell
7.1 Water and wastewater networks in healthcare facilities
7.2 Hand washbasins in the healthcare environment
7.3 Nosocomial infection associated with washbasin traps
7.4 Approaches used to minimize contamination of washbasin traps
7.5 Cleaning of hand washbasins
7.6 Outlook
References
8 Infection control in Europe
S. Brusaferro
8.1 Introduction
8.2 Data available in Europe
8.3 Standards for structures and organizations
8.4 Training of personnel
8.5 Conclusion and future trends
Appendix: Abbreviations
Acknowledgments
References
9 The role of the nurse in decontamination
R. Gallagher 9.1 Introduction
9.2 Regulatory standards and decontamination
9.3 Key principles
9.4 Challenges associated with nursing and decontamination of the patient care environment
9.5 Provision of cleaning services
9.6 Management of cleaning services
9.7 Decontamination of patient equipment
9.8 Conclusion
9.9 Sources of further information and advice
References
Further reading
10 The role of protective clothing in healthcare and its decontamination
K. Laird, L. Owen 1
10.1 Introduction
10.2 Disposable clothing
10.3 Reusable clothing
10.4 Microbiology
10.5 Cleansing and disposal
10.6 Conclusions and future trends
References
Further reading
11 Cleaning and decontamination of the healthcare environment
Lisa Hall, Brett G. Mitchell 1
1.1 Introduction
11.2 Pathogens survive in the healthcare environment
11.3 Evidence that contaminated surfaces contribute to transmission of hospital pathogens
11.4 Key components of a successful environmental cleaning program
11.5 Conclusion
References
12 Biocides and decontamination agents including sporicides for decontamination in hospitals
E.S. Gilchrist, P.J. Collier
12.1 Introduction
12.2 Currently available biocides and sporicides for use in healthcare and their limitations
12.3 Testing standards for actives and sporicides
12.4 Incidence of resistance and risk to the hospital patient
12.5 Strengths/weaknesses of different disinfectants for a range of microorganisms
12.6 Future trends
12.7 Sources of further information and advice
References
13 The role of antimicrobial surfaces in hospitals to reduce healthcare-associated infections (HAIs)
Michael G. Schmidt
13.1 Introduction
13.2 Relevance of the built environment to HAIs
13.3 Antimicrobial surfaces
13.4 Antiadhesive surfaces
13.5 Nature inspired antifouling surfaces
13.6 Nature inspired antibacterial surfaces
13.7 Antimicrobial coatings
13.8 Antimicrobial coatings—Triclosan
13.9 Antimicrobial coatings—Utility of bacteriophages
13.10 Antimicrobial coatings—Silver surfaces
13.11 Light-activated antimicrobial surfaces
13.12 Antimicrobial coatings—Copper surfaces
13.13 Continuous microbial debulking of the environment mitigates HAI risk
13.14 Perspectives—A role for antimicrobial surfaces in hospitals to reduce hospital-acquired infections
References
Further reading
14 Use of gaseous decontamination technologies for wards and isolation rooms in hospitals and healthcare settings T. Pottage, J.T. Walker
14.1 Introduction
14.2 Challenges and considerations for gaseous decontamination in a healthcare setting
14.3 Validation methods to determine efficacy
14.4 Practical use of gaseous decontamination in hospitals
14.5 Conclusion and future trends
14.6 Sources of further information and advice
References
15 An overview of automated room disinfection systems: When to use them and how to choose them
J.A. Otter, S. Yezli, F. Barbut, T.M. Perl
15.1 Introduction
15.2 Why consider an ARD system?
15.3 What level of surface contamination is a risk for transmission?
15.4 Limitations of conventional cleaning and disinfection
15.5 Overview of ARD systems
15.6 When to consider an ARD system
15.7 Using, validating, and regulating ARD systems
15.8 Sources of further information and advice
15.9 Future trends
15.10 Conclusions
References
16 Testing strategies and international standards for disinfectants
C. Woodall
16.1 Introduction
16.2 Selecting the standards to test against
16.3 Design of test procedures
16.4 Measuring different applications of disinfectants. Surface, hand, instrument, mechanical action, and zonal disinfection
16.5 Europe, Middle East, Africa, and the rest of the world
16.6 USA and the Americas
16.7 OECD
16.8 Canada
16.9 Australia
16.10 China and India
References
17 The role of standards in decontamination
R. Bancroft
17.1 Introduction
17.2 Relationship of standards to law and guidance
17.3 Key aims and principles of standards
17.4 Types of standards
17.5 Vienna agreement
17.6 European standards
17.7 International standards
17.8 How standards are drafted
17.9 How to read and understand a standard
17.10 Accessing the most relevant standards and guidance documents
17.11 Conclusion and future trends
Sources of further information and advice
Appendix 1: Standards in decontamination
References
18 Decontamination of prions
G. McDonnell, E. Comoy
18.1 Introduction
18.2 Prion diseases: Transmissible spongiform encephalopathies (TSEs)
18.3 What are prions?
18.4 Clinical transmission risks
18.5 Decontamination investigations
18.6 Future perspectives
References
Further reading
19 Decontamination of dental devices in the hospital and general dental practice setting
Andrew Smith
19.1 Introduction
19.2 Historic background of dental surgery
19.3 Evidence of infections associated with dentistry
19.4 The role of vCJD in raising standards
19.5 Challenges associated with dental instrument decontamination
19.6 Instrument decontamination processes for dental surgery
19.7 Centralization of dental instrument reprocessing
19.8 Quality management systems
19.9 Future trends
19.10 Conclusion
19.11 Sources of further information and advice
References
Further reading
20 An overview of current surgical instrument and other medical device decontamination practices
S. Holmes
20.1 Introduction and background to central decontamination units (CDUs)
20.2 Purpose of decontamination practice of surgical instruments in CDUs
20.3 Current regulations, standards, and guidance
20.4 Risk minimization strategy
20.5 Decontamination process
20.6 Activities impacting on the decontamination process and the quality of sterile instruments
20.7 Future trends
References
Further reading
21 Efficacy of current and novel cleaning technologies (ProReveal) for assessing protein contamination on surgical instruments
D. Perrett, N.K. Nayuni
21.1 Introduction
21.2 General principles of protein detection
21.3 Current general methods of protein detection (ninhydrin, Biuret, dyes): Sensitivity, specificity, and validation
21.4 Methods of protein detection based on fluorescence
21.5 Other possible technologies
21.6 Strengths and weaknesses of new technologies
21.7 Conclusion
References
22 Decontamination of flexible endoscopes
Peter Hoffman
22.1 Types of endoscopes
22.2 Structure of endoscopes
22.3 Risk assessment
22.4 Flexible endoscope decontamination
22.5 Decontamination process
22.6 Decontamination of duodenoscopes
22.7 Rinse water
22.8 EWD selection
22.9 Testing
22.10 Endoscopy accessories
22.11 Tracking and traceability
22.12 Documentation
22.13 Staff training
22.14 Extrinsic recontamination
22.15 Intrinsic recontamination
22.16 Storage of endoscopes
22.17 Design of decontamination facilities
22.18 Reasons for decontamination failure
References
23 Sterilization of flexible endoscopes
Michael Mikhail, Tony Young
23.1 Introduction: Key principles of sterilizing flexible endoscopes
23.2 Why sterilize flexible endoscopes?
23.3 Problems associated with sterilization of flexible endoscopes
23.4 Methods used in the sterilization of endoscopes
23.5 Testing effectiveness and application of standards
23.6 Chemical indicators
23.7 Biological indicators (BI)
23.8 Using indicators
23.9 Example of an “in use” application
23.10 Future trends
Sources of further information
References
Further reading
24 Future trends in decontamination in hospitals and healthcare
J.T. Walker
24.1 Introduction
24.2 The future of antibiotic resistance
24.3 Decontamination in water systems
24.4 Use of biocides in water systems
24.5 Use of point of use filters
24.6 Use of TMVs and design and use of outlets
24.7 Exogenous contamination of water outlets
24.8 Role of drains in the spread of infections
24.9 Risks from medical equipment such as heater coolers
24.10 Microorganisms in the built environment
24.11 Control of microorganisms in the built environment
24.12 Hand hygiene
24.13 Hand contact sites and environmental cleaning
24.14 Manual cleaning
24.15 Automated decontamination systems in the built environment
24.16 Decontamination of prions
24.17 Guidance and the rapid detection of protein on surgical instruments
References
Index
- Edition: 2
- Latest edition
- Published: November 25, 2019
- Language: English
JW
James T. Walker
Dr Jimmy Walker worked as a Scientific Leader in water microbiology and decontamination at Public Health England (PHE), Porton UK. He has 30 years’ experience in public health microbiology with an extensive publication record, and regularly attended national and international scientific conferences. His particular interests were the presence of opportunistic pathogens in hospital water systems and advised hospitals on incidents and outbreaks associated with waterborne pathogens such as Legionella spp., Pseudomonas aeruginosa and Mycobacteria spp. He worked closely with the Department of Health (DH England) and Health and Safety Executive in writing and developing national and international guidance on the microbiology of water and decontamination in healthcare.
Affiliations and expertise
Former Scientific Leader in Water Microbiology and Decontamination, Public Health England (PHE), Porton, UKRead Decontamination in Hospitals and Healthcare on ScienceDirect