Limited reduction in Clostridioides difficile and Methicillin-Resistant Staphylococcus aureus with the use of an aerosolized hydrogen peroxide disinfection system in tertiary health care facilities in Alberta, Canada - 18/03/24
Résumé |
Background |
Nonmanual room disinfection systems may reduce the transmission of infections. A variety of systems have emerged; however, a paucity of evidence exists to make an evidence-informed decision for the implementation of a specific system. Alberta Health Services assessed one of these systems.
Methods |
A quasi-experimental prepost design assessed an aerosolized hydrogen peroxide disinfection system on 6 units at 3 acute care facilities in Alberta. To assess clinical effectiveness an interrupted time-series analysis with Poisson distribution compared changes in hospital-acquired Clostridioides difficile infection (HA-CDI) and hospital-acquired Methicillin-resistant Staphylococcus aureus (HA-MRSA) between preintervention, intervention, and postintervention periods. To assess operational feasibility cleaning turnaround time, time to operate, and utilization were considered. A participatory research framework was used to understand the benefits and challenges of operationalization.
Results |
Incidence rate ratio (IRR) of HA-CDI decreased by 25.7% on FMC-A and 6.9% on RAH-B. Following withdrawal, the IRR of HA-CDI continued to decrease. IRR of HA-MRSA decreased by 25.0% on RAH-B. Following withdrawal, the IRR of HA-MRSA continued to decrease. None of the results were statistically significant. The average time to operate was 3.2 hours. Utilization was between 1.7% and 25.6%. Most staff reported benefits and challenges.
Discussion |
None of the changes observed in HA-CDI and HA-MRSA after the introduction of the aerosolized hydrogen peroxide system were statistically significant. While most respondents reported multiple benefits and challenges in using the system, the core challenge was delays in inpatient admissions due to the time operate the system.
Conclusion |
Successful implementation of a nonmanual room disinfection system as an addition to standard cleaning and disinfection requires significant investment and must consider a variety of factors.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Utilization of aerosolized hydrogen peroxide disinfection system was low in units. |
• | Operating the system took time and led to delays to inpatient admissions. |
• | Hospital-acquired Clostridioides difficile infections did not decrease. |
• | Hospital-acquired methicillin-resistant Staphylococcus aureus did not decrease. |
• | Participatory Research informed benefits and challenges of system implementation. |
Key Words : Hospital-acquired, Infections, Nonmanual, 'No-touch', Cleaning, Disinfection
Plan
| Conflicts of interest: Two authors presented at the 2019 Canadian Agency for Drugs and Technologies in Health (CADTH) Symposium: Supporting Health System Transformation on the use of a collaborative, systematic approach in exploring the use of a technology for implementation within a complex health care system. With a focus on the use of an interdisciplinary working group and the use of a short-term and long-term evaluation. |
Vol 52 - N° 4
P. 410-418 - avril 2024 Retour au numéro
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