Hospitals today are under increasing pressure to clean patient rooms quickly and thoroughly in order to accommodate turnover and reduce the spread of infections. Preventing the spread of C. difficile is particularly difficult because its spores are resistant to standard disinfectants and can live on hard surfaces for months.

According to the Centers for Disease Control and Prevention (CDC), approximately 1.7 million patients contract healthcare-associated infections (HAIs) in U.S. hospitals every year, of which 14,000 die of C. difficile infections. A January 2013 survey from the Association of Professionals in Infection Control and Epidemiology (APIC), also found that while 70 percent of infection preventionists adopted additional interventions in their facilities to address C. difficile, only 42 percent saw a decline in their infection rates.

To combat dangerous pathogens and help reduce the risk of HAIs in its facility, environmental service (EVS) managers at Maple Grove Hospital (MGH), a 130-bed community hospital near Minneapolis, Minn., partnered with Ecolab Healthcare in 2011 to test a new non-bleach sporicide.

Proven to kill C. difficile spores in three minutes and other multi-drug resistant organisms and viruses in five minutes, Ecolab’s OxyCide Daily Disinfectant Cleaner is a non-bleach alternative that is not corrosive on most hard surfaces, such as bed tables, bedrails, door handles and bathroom surfaces. Unlike bleach, it leaves no visible residue, is safer to handle and does not require a second step to rinse. As a single disinfectant with a quick dwell time that can be used on many types of materials, OxyCide can make terminal room cleaning faster and more efficient. 

To start, baseline data was collected on 25 rooms to measure cleaning effectiveness with the hospital’s current quaternary ammonium cleaner. MGH used Ecolab’s Dazo monitoring program to mark high-touch objects at the beginning of the day to determine how well they were cleaned, and also took cultures to see how much bacteria remained on the surfaces using the current cleaning product. MGH started using OxyCide in September 2011 after baseline data was collected.

Two weeks after implementing the new product, some initial key learnings emerged. For instance, OxyCide’s distinct new smell – more like a strong vinegar odor instead of the light lemon scent of the old cleaner – was a surprise to EVS staff. 

To rally employees to embrace the change, the hospital also held meetings with EVS staff to discuss apprehensions and provide further education. An industrial hygienist and Ecolab representatives attended to explain that the two main ingredients in OxyCide were simply more concentrated levels of hydrogen peroxide and vinegar, substances used in many of their own homes, which also made them more comfortable. The hospital’s Employee Health and Safety Committees tested OxyCide to ensure it was safe for employees and patients and found no acetic acid exposure.

Sharing the hospital’s own data with staff proved to be a key motivating factor as well. Initial results of using OxyCide at MGH over the hospital’s previous cleaner showed 36.5 percent more cultures had no microbial burden after the product change. Since there were no new cleaning processes implemented with EVS staff, these results were directly correlated with OxyCide use. This compelling data showing a significantly lower presence of potentially harmful bacteria convinced staff that OxyCide was the most effective cleaner for the hospital to use. 

According to Jennifer Perkins, EVS manager at MGH, taking time to engage all of the key staff and departments of the hospital at the on-set of new product implementation was crucial for buy-in and success. Education about the product and its value, as well as listening and finding solutions for concerns, helped EVS staff see the bigger picture and be more open to change. 

After a phased approach, MGH implemented OxyCide use hospital-wide in February 2013 (with the exception of the operating rooms) and has sustained good results to date.