Environmental Services

This report addresses the process by which sodium hypochlorite, the active ingredient in commercial bleach products, destroys disease-causing pathogens. It explains the science of how and why bleach is an effective disinfection agent, and presents information to address common misconceptions about bleach.

Clostridium difficile infection (C. difficile) is the most significant cause of hospital-acquired diarrhea. Data from the Center for Disease Control and prevention (CDC) reports, 14,000 Americans die every year from diarrhea causing C. difficile (2012). The organism is responsible for greater than 337,000 hospitalizations yearly and at least $1 billion in extra cost for healthcare.  According to Burnett, et al. (2013), there have been significant epidemiology changes over the past decade related to C. difficile contamination.

Standard terminal cleaning of hospital rooms is a fundamental Infection Prevention process performed by the Environment of Care staff. It is defined as physical cleaning followed by disinfection with an approved hospital disinfectant. Monitoring consistency of this process, however,is difficult and not assured. There can be as many variations of the process as there is staff performing the task. It is not unusual that significant residual bacteria are left in place.Alternative disinfection technology utilizing a product derived from saline and electricity, "superoxidized water," produces a cidal activity 50-100 times that of household bleach, addressing growing resistance issues of standard terminal cleaning agents. Electrolyzed sodium hypochlorous acid (HOCL), produces an efficient disinfecting adjunct to standard terminal cleaning and provides many advantages in optimizing infection prevention in the hospital environment. The wand spray device distributes the product in a sequential back and forth motion producing a uniform distribution of the powder coating to all areas of the environment. Due to the neutral pH of the HOCL, it is non-toxic, does not leave residue on environmental surfaces, and is not corrosive to hospital equipment as traditional bleach and phenolics have long demonstrated.

This Pulse addresses cleaning and disinfection best practices in a variety of specific healthcare settings including the patient room, emergency department, operating room and intensive care unit. Some experts believe that in terms of cleaning, a hospital should not be considered a single entity, and that different patient-care areas should be treated as separate environments, and cleaning protocols should be adjusted accordingly.