Professional Comment

Keeping Care Homes Clean: Practical Advice for Preventing Infections

By Professor Neil Bacon, Medical Director of GermErase and CEO of JVS Health (www.germerase.com)

For care homes across the country, the Covid-19 pandemic gave “cleanliness” a new meaning. While hygiene has always been a priority – vital in ensuring that residents are both comfortable and well protected against infections – Coronavirus has given it a newfound importance.

As the Covid-19 infection rate continues to decline and more and more healthcare workers are vaccinated, we now face a pivotal moment in determining practices going forward. Will we continue to follow the “hands, face, space” mantra, or simply go back to the way we were working before?

Looking forward, it is clear that it would be a missed opportunity to revert to old hygiene standards – and not just due to the lingering threat of a coronavirus resurgence. Across the globe, the risks posed by superbugs, antibiotic resistance and future pandemics is growing, and we must ensure that the hygiene practices implemented during the past year due to COVID remain in place in order to minimise risks of new, potent infections. For care homes, maintaining scrupulous levels of hygiene does not need to be an additional source of stress on already pressured and busy carers . A few simple steps can ensure that residents have protection from infections, even those which pose as large a threat as COVID.

CHOOSE THE MOST EFFECTIVE SANITISER, AND ENSURE THAT IT IS SAFE

Over the past year sanitising hands has become a regular part of our daily routines. Care homes have encouraged the use of sanitisers amongst both staff and, when permitted, visitors, in order to prevent Covid transmission through contact.

Regular sanitising will be just as vital in protecting against infections in the future. However, staff must care- fully consider the sanitisers used in the care home setting order to keep vulnerable residents as safe as possible.

The standard alcohol-based sanitisers widely used in care homes hold a number of risks when used by vulnerable residents. Not only can they exacerbate skin conditions such as eczema and psoriasis, but if accidentally ingested they can cause alcohol poisoning resulting in serious illness.

During the pandemic cases of alcohol poisoning due to hand sanitiser have increased dramatically, particularly amongst children and older people.

A lower-risk option for care homes is ultra-low toxicity, non-alcohol based sanitisers. These carry fewer risks, meaning that staff can keep sanitisers in accessible spaces without worrying about residents.

This also promotes more frequent use of sanitiser, increasingly high cleanliness standards and efficacy of hygiene practices.

DISINFECTING SURFACES WITH PROTECTIVE DISINFECTANTS

Staff must also consider the disinfectants used on surfaces in care home settings. Opting for a disinfectant with the highest efficacy possible against the broadest range of microbes will ensure protection against the widest range of infections, whether transmitted through droplets, spores or blood.

Looking at the percentage of micro-organisms killed by a disinfectant is one good indicator of its efficacy. Although a disinfectant killing 99.9% of microbes may sound highly effective, it is vital to remember that one eliminating 99.9999% of microbes has 1000x higher efficacy.

Care home managers should also look for protective disinfectants, which not only kill the pathogens on a surface at the time of application but continue to kill those that come into contact with the surface for a specified period afterwards.

This is particularly important for communal spaces such as reception desks or dining tables, which may be coming into regular contact with different people, and so would need to be disinfected with a traditional disinfectant more regularly than possible in order to best protect against bacteria and viruses.

MAINTAIN SOCIAL DISTANCE AND VENTILATE SPACES WHERE POSSIBLE

The phrase ‘social distancing’ has become synonymous with Coronavirus, but social distancing and mask- wearing do not only reduce the transmission of the SARS-CoV-2 virus, they can also give protection against airborne infections such as TB and MRSA.

Even when social distancing and mask-wearing are no longer legal requirements, care homes should continue to consider ways to limit physical contact between staff, visitors and vulnerable residents, so far as this is possible without affecting the mental health of staff, residents and visitors.

This may include mask-wearing by those non-exempt, or limiting physical touch as and when necessary.

The past year has demonstrated the devastation that viruses can cause. Going forward we must learn from the pandemic and deploy the knowledge gained about infection prevention to reduce risks of further harm.