We tend to think that healthcare environments are rigorously cleaned and disinfected on a regular basis, leaving no safe quarter for microbes. Think again, suggests Linda Lybert, founder of the Healthcare Surfaces Institute (HSI).

Healthcare surfaces play an active role in the transmission of pathogens. There are so-called “high-touch” surfaces, such as sinks, bedrails, and light switches, that get attention, but they “only make up about 25% of surfaces in patient and procedure rooms,” according to HSI. That leaves upholstery, multiple surface materials that interact with patients and medical personnel, bedding and equipment that move throughout the hospital and much more that can serve as fomites carrying infections. “It’s an area of research that is virtually overlooked,” said Lybert during a presentation at the recent Medical Design & Manufacturing (MD&M) West event in Anaheim, CA. She founded HSI to remedy that.

During a Lunch and Learn presentation sponsored by Eastman at the trade show and conference, Lybert painted a fairly harrowing picture of cleaning and disinfection practices in medical facilities. Room turnover times can be as little as 20 minutes, she noted. “There can be 40 different instructions for use for disinfecting the various surfaces in that room. And many surfaces are portable, meaning lots of people interact with them. Disinfection is absolutely critical,” said Lybert. Doing that in 20 minutes? “That’s impossible,” she said.

It gets worse. She gave the example of one type of endoscope containing a part the size of a fingertip that has “seven different surface materials. They can’t all be cleaned and disinfected the same way without causing damage,” said Lybert. Is it any wonder that one in 25 patients will contract a healthcare-associated infection (HAI), she asked.

HSI is committed to reducing preventable infections through collaboration of industry, academia, science, regulatory, and service sectors by interrupting the transmission of surface-related pathogens in healthcare in support of community health, to quote the organization’s mission statement. Lybert founded HSI in 2016, but she has been fighting this battle for some 17 years through her consultancy, Healthcare Surface Consulting, and by engaging with healthcare professionals.

Last year, HSI commissioned an extensive literature review of more than 2,300 articles to identify solutions that will help to reduce the transmission of HAIs through surfaces. “We expected to find gaps,” she told attendees. “We did not expect to find such disparities between test methods and microbes. Nothing was being tested the same way, and claims were being made that had no data to support them.”

Moreover, HSI found 31 different organizations with varying guidelines for disinfection, and 31 different definitions of clean, disinfected, or sterilized. "There is no consistency. How can we guarantee to frontline workers that they are working in a disinfected environment when that many different definitions exist?" asked Lybert. There are many different ideas for reducing the number of HAIs, “but because we have not looked at the whole problem and root cause of materials, it’s difficult to find a sustainable solution,” said Lybert. Difficult, but not impossible, and that’s where HSI and materials suppliers can help bring about change.

Eastman, which sponsored this session, is also an Initiative Group Sponsor of HSI. At MD&M West, it showcased its Tritan copolyester material, which it has tested against more than 30 disinfectants typically used in hospitals. PlasticsToday profiled Eastman’s newest addition to the portfolio, along with innovations in medical polymers from other suppliers, in “Medical Plastics Show Their Mettle at MD&M West.”

For its part, HSI will continue to identify critical surface issues and stem the spread of infection through research, education and the development of guidelines and best practices. As the organization rightly points out, “while the focus of the institute is healthcare, outcomes as a result of the Healthcare Surfaces Institute reach far beyond just healthcare to include education, transportation, tourism and more.”

And that takes on a whole new urgency in the age of the coronavirus pandemic.

Image: Peshkova/Adobe Stock