From arguments to evidence: when should you recommend using disinfectants in healthcare settings?

Evonne T Curran, NursD1

1Glasgow Caledonian University

In this presentation, I am going to look at the evidence used to support national recommendations as to when disinfectants should be used in healthcare settings. I will apply 2 ‘critical’ tests to the guidance: The DIMS Test (Does It Make Sense Test), and the TAT Test (The Appropriate/ly Test). The first looks at the logic behind recommendations and the second looks for clarity, i.e. does the guidance make it easy for the healthcare workers (HCWs) to do the right thing, and for them to be sure what the right thing to do is.

Current guidelines recommend that disinfection is only required for the non-invasive care equipment / environments (NICEE) of patients who are known to have alert organisms. However, I will argue this premise is wrong as HCWs are unable to identify with certainty all patients who are colonised with, and thus disseminating, alert organisms. It has been shown that alert organisms can be found on the NICEE of people who are not known to be colonised long before HCWs are aware that they are positive. Logically, if NICEE of people colonised with alert organisms should be disinfected, then disinfectants are also required for NICEE of people who are not (yet) known to be positive – but whose NICEE unknowingly is.

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