Continuously active disinfection (CAD) takes traditional surface disinfection to the next level. Published evidence demonstrates the effectiveness of CAD in certain healthcare settings where its use can be extremely effective and efficient.
In a May Becker's Hospital Review webinar sponsored by PDI Healthcare, Marc-Oliver Wright, MT(ASCP), MS, CIC, FAPIC, clinical science liaison at PDI Healthcare, discussed the science behind CAD, reviewed evidence supporting its performance, identified healthcare settings for its use and suggested ways to avoid unintended consequences.
Four key insights were:
- Traditional surface disinfection is effective for only one moment in time, and insufficient evidence is available to support costly heavy-metal-based room disinfection technologies. According to Mr. Wright, surfaces often transmit germs through contaminated hands. "The more contaminated the surface, the more likely it can serve as a direct or indirect source of transmission," he said. "Traditional surface disinfectants offering near germ-free results only do so at a single point in time." Copper- and silver-coated surfaces have been studied as solutions, but insufficient evidence is available to support the high cost of implementation.
- CAD technologies have been proven effective in controlled lab settings. "Lab-based studies, both during and after product development, are carefully controlled evaluations," Mr. Wright said. "The EPA specifies the language that can or must be used on any manufactured product, specifically on its master label." While not all organisms were reduced equally 24 hours post application, CAD provides 24 hour coverage on certain organisms, something traditional disinfectants cannot. It is important to review the product’s master label to confirm the kill claims and contact times.
- CAD disinfectants reduce transmission in real-world efficacy studies. CAD was tested by disinfecting inpatient bedrails in the ICU of the Medical University of South Carolina. In this study, CAD-treated surfaces had significantly fewer organisms recovered at one hour, six hours and 24 hours post-application than routine healthcare disinfectants. Non-dedicated patient care equipment such as vital signs carts, EKG machines and mobile computer stations were tested at the Cleveland VA Medical Center and an affiliated long-term care facility.
- Facilities must over-communicate and enforce disinfection protocols to mitigate the unintended consequence of stretching the expected performance time of CAD disinfectants. "You can't just drop off a case of a continuously active disinfectant in a setting and expect the label to just explain it all," Mr. Wright said. "For the overworked front-line care provider, a solution that says it keeps killing organisms for 24 hours is, perhaps understandably, a license to cut corners." To mitigate these issues, it's critical to educate staff on what CAD means and what it doesn't, reinforce standards and policies, educate on what organisms are covered under the 24 hour claim and monitor and provide feedback.
CAD disinfectants have been proven effective. By incorporating CAD into disinfection protocols, hospitals and other healthcare facilities can reduce the spread of infection on high-touch surfaces and equipment, further protecting both staff and patients from dangerous infections.
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