When it comes to preventing healthcare-associated infections (HAIs), the importance of thoroughly and effectively disinfecting surfaces might seem self-evident. But the process is more nuanced than it may appear, with far reaching implications for infection prevention.
What is compatibility?
Surface material compatibility – the ability of material to be exposed to a disinfectant’s chemistry without exhibiting reduced functionality as a result – exists when a material’s chemical resistance aligns with a disinfectant’s particular chemical profile. When the two are in sync, a healthcare facility’s devices can be properly cleaned and maintained, ensuring patient safety and streamlined operations. When overlooked or administered improperly, a lack of compatibility can lead to more rapid wear and tear of equipment material, a situation with serious implications for infection prevention and healthcare facilities overall.
Why is compatibility an issue?
It is important to develop a fluency in hospital infection prevention protocols to know what disinfecting products to use, and how frequently the surface materials of devices should be disinfected. Materials selected by manufacturers to design devices were not necessarily chosen for their compatibility with disinfectants in mind. But while there are more disinfection options than ever before, the range of formulations that have been tested and approved for specific devices is limited, due to the effort and cost associated with validation testing. Demand for decreased costs is always top of mind, encouraging standardization measures that often push compatibility considerations to the side. As a result, it is impractical for every healthcare facility to carry every formulation, and even a small formulation change can lead to a dramatic difference in how a disinfectant interacts with a given surface, making the understanding of compatibility all the more important.
Tighter regulations to improve patient safety have also resulted in an increased frequency of surface disinfection. Since hospitals are disinfecting surfaces more frequently than ever before, there is customer demand for disinfectants that kill more, faster, to help offset the time required by staff. These advanced disinfectants often require high-performing surface materials with increased chemical resistance to help avoid wear and tear to the material over time.
What influences compatibility?
Device surface materials have varying degrees of compatibility with different disinfectant formulations, but hospitals often strive for standardization, limiting the variety of disinfectant formulations in the name of cost reduction, and in an effort to ease staff training and help with compliance. Ultimately, this can lead to using formulations that are not compatible with the surface material they are used to clean, which can lead to the deterioration of surfaces of expensive medical equipment, hastening frequent breakdowns that can incur significant costs to the facility over time. In a worst-case scenario, when medical devices and the disinfectant chemistries used to disinfect them do not meet the compatibility requirements of the healthcare environment, the devices can no longer be used at all. The need to replace the devices can result in increased costs to the customer in the long run.
Compatibility can also be affected by many outside factors, the most important of which is the amount of time a formula is in contact with a surface, and exactly how it is applied. Elevated temperatures can also affect the exposed parts of an equipment surface by accelerating the chemical reaction. Additionally, the presence of stress within a device enclosure, such as injection molded thermoplastic components, tends to both initiate and accelerate failure. Stress can be trapped within a material during molding, shaping, or forming operations and can also result from an applied load experienced during operation of the equipment.
Problems with compatibility manifest in issues that can have a profound impact on the patient. When disinfected improperly, surfaces may wear down and harbor more bacteria than would likely be present on materials in good condition. Medical equipment must be safeguarded against contamination while also remaining in working order – a balance only possible when compatibility is maintained. The breakdown of medical devices may put them out of commission when needed to treat patients, resulting in prolonged hospital stays and an altered quality of overall care. This scenario puts patients at greater risk of HAIs – challenging infection prevention, garnering significant financial costs to the healthcare facility and negatively impacting patient perception.
How to take action
Healthcare facilities should adhere to the correct disinfecting protocols for each type of surface material, as maintaining compliance can ultimately result in reduced costs and improved patient outcomes. In order to achieve such compliance, it is important for personnel to have an understanding of the specific instructions for each device and corresponding type of disinfectant, and to correct a lack of adherence when spotted. Identifying, educating and empowering the staff responsible for cleaning each surface, including nurses, technicians, central processing or environmental services is critical in maximizing the benefits of surface compatibility.
It is recommended that staff obtain and maintain knowledge of proper disinfecting protocols for individual devices: what products to use, recommended contact time and frequency, and how to alert staff that equipment has already been disinfected or needs to be. Consider labeling devices with this information, or have it posted nearby. Position disinfecting products within reach of the equipment for convenience, and have access to manufacturer disinfecting instructions and contact information in case of any questions. But perhaps most importantly, make sure the facility verifies the disinfecting instructions before buying capital equipment, to ensure it can be cleaned using products on their current formulary, and that the equipment can be cleaned by staff in a timely manner that is in accordance with the facility’s disinfecting protocol.
With equipment manufacturers, consider communicating the facility’s disinfecting protocol for a given device, and how frequently that device is disinfected. Tell manufacturers what products the facility buys, and advocate for products on the current formulary to be tested. Communicate any disinfecting challenges, such as equipment that does not have adequate disinfecting instructions, equipment that does not use a “common” disinfectant, or that does not use a disinfectant the hospital has on formulary. With disinfectant manufacturers, communicate any challenges faced with disinfectants or equipment, and advocate for them to be tested.
By taking the time to consider and promote compatibility, healthcare facilities can help ensure both patient safety and the most productive, efficient administration of care possible.
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