Re: Virox versus bain tourbillon

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voir recommandation no 2 ci-joint du texte du fabricant entre autre et se référer au produit même qui inscrit l’effet bactéridide recommandé à 5 minutes dans des proportions de 1:16. (VOIR CI-BAS)

source recommandation no 2 :

Selon le guide de la santé publique intitulé recommandations sur le nettoyage et la désinfection des équipements d’hydrothérapie des établissements de soins au Québec ( 2003) p 85-86 -87 indiquent clairement les conduites à tenir pour le nettoyage et la désinfection des bains avec hydromassage.

Dans ce même document p63 concernant le produit Virox il est mentionné de suivre les recommandations du fabricant pour les dilutions et le temps de contact. Notons que le produit Virox est cité à titre d’exemple à la page 66 de ce même document.

Aussi et surtout, ce document nous propose d’évaluer la nécessité de l’utilisation du bain tourbillon pour les résidents entre autre ceux porteurs de bactéries multirésistantes ex: SARM avec bris cutané, ou ERV, etc.

Compte tenu des recommandations de ce document p30 et de la littérature qui stipule que les bains tourbillons sont difficiles à nettoyer et peuvent être responsable d’un certain nombre de colonisation chez certains patients, nous avons opter pour le remplissages des prises d’air et donc pour l’abolition des fonction tourbillons pour nos bains (+ – 600$ par bain ), ainsi nous avons obtenu une surface lisse à nettoyer et beaucoup plus facile d’accès pour le personnel qui doit effectuer la désinfection entre chaque résident. Nous poursuivons avec le produit Virox en même quantité incluant frottage des surfaces, rinçage et asséchage, cependant l’anti-mousse n’est plus requis.

Geneviève Archambault

Recommendations for use of Virox Technologies Inc. Products in Health Care

Recommendation #1: Cleaning in Health Care Settings
The infection control LCDC guidelines (December, 1998) have defined cleaning as « the physical removal of all foreign material, e.g. dust, soil, organic material such as blood, secretions, excretions and microorganisms. Cleaning physically removes rather than kills microorganisms. It is accomplished by water, detergents and mechanical action. Cleaning reduces or eliminates the reservoirs of potential pathogenic microorganisms. » Decontamination has been defined as a general term for killing or removing harmful microorganisms. Proper cleaning is generally sufficient for the decontamination of the inanimate health care environment. This is because the inanimate environment is seldom directly responsible for disease. Environmental surfaces may act as fomites and serve as a vehicle for transmission either by contaminating the hands of health care workers or by contact with medical equipment. Therefore, general housekeeping, using appropriate cleaning agents and strictly following manufactures’ instructions, is necessary for reducing or eliminating the reservoirs of potentially pathogenic organisms.

This desired cleaning would be accomplished using Hydrox Disinfectant Cleaner and diluting it by 56mL of Hydrox to 4L of water. Government testing standards have set a 70% cleaning efficiency as acceptable. This dilution of Hydrox has been determined to offer a 75.8% cleaning efficiency (test method CAN.CGSB-2.160 Method 87 in accordance with CAN.CGSB-2.11 Method 20.3), providing confidence that soil, dust or other foreign material that can harbour pathogens and support their growth, will be removed. Products that are used as cleaners in health care today, such as phenolics, chlorine, and quaternary ammonium compounds, offer a cleaning efficiency of less than 15%.

Recommendation #2: Cleaning in Health Care Settings to Prevent the Spread of Antibiotic Resistant and Pathogenic Microorganisms
Not only is it important to remove organic material, but it is also important to prevent the spread of antibiotic resistant and pathogenic microorganisms. These organisms may be spread by contamination of the tools used for cleaning. Reuse of cleaning cloths may allow for the redistribution of organic material on environmental surfaces. Disposal or laundering of cleaning cloths/mops after use, and not placing them back into the cleaning solution, will offer a higher degree of cleaning efficiency. This may also be accomplished by cleaning less heavily contaminated areas first and changing cleaning solutions frequently.

Using the cleaning procedures described in recommendation #1, along with the disposal or laundering of cleaning cloths/mops after use will ensure a higher degree of confidence that the environmental surface will be free of organic material that may harbour antibiotic resistant and pathogenic microorganisms such as C. difficile, MRSA, and VRE. These procedures ensure that these organisms will not be spread among environmental surfaces.

Recommendation #3: Cleaning in Health Care Settings with the Added Benefit of Broad Spectrum Activity in Short Contact Times
In areas such as nurseries, pediatric settings, critical care units, burn units, emergency rooms, operating rooms and bone marrow transplantation facilities, a higher degree of confidence in the elimination of antibiotic and pathogenic microoganisms from environmental surfaces through cleaning procedures is necessary. The LCDC guidelines define sanitation as ‘a process that reduces microorganisms on an inanimate object to a safe level’. Using the Germicidal and Detergent Sanitizer Action of Disinfectants, Final Action AOAC, XV, 1995, Part 6.3.03 test method, diluted VIROX 5 has been proven to reduce such microorganisms as Pseudomonas aeruginosa, Salmonella Choleraesuis, Staphylococcus aureus (gentamycin- and methicillin-resistant), and Enterococcus faecalis (vancomycin-resistant) by 99.999% in 30 seconds at 20°C in the presence of 200ppm synthetic hard water and 5% bovine serum. Damp areas, such as showerheads, sinks, drains, and hydrotherapy baths, have been associated with numerous infections and outbreaks. VIROX 5, because of its broad spectrum of activity, rapid action, and tolerance to hard water, is the ideal cleaner for use on these surfaces.

Cleaning with VIROX 5 at a dilution of 56mL of Virox to 4L of water offers the added benefit of broad-spectrum activity in a short contact time. The cleaning procedures in recommendation #2 should also be followed in order to prevent the inadvertent spread of microorganisms.

Recommendation #4: Cleaning Followed by Disinfection
Disinfectants are not usually needed for housekeeping purposes in healthcare settings. When decontaminating environmental surfaces it is necessary for one to realize that an environmental surface may harbour a number of microorganisms, ranging from vegetative bacteria to spores. It is also necessary to realize that the inanimate environment is seldom directly responsible for disease, but inanimate objects may act as fomites and serve as a vehicle for transmission either by contaminating the hands of health care workers or by contact with medical equipment. Therefore, because it is impractical to believe that contact times necessary for disinfection to occur will be adhered to on environmental surfaces. Proper cleaning of inanimate objects with a product that has a broad spectrum of activity in a short contact time, such as VIROX 5 used at a dilution of 1:16, is the key to reducing the transmission of pathogenic microorganisms, such as c.difficle, MRSA, and VRE. VIROX 5 Ready to Use may also be used to decontaminate environmental surfaces by placing a small amount onto the environmental surface and spreading it with a damp cloth.

In areas such as surgical suites, ICU’s, and transplant units, disinfectants may be necessary. Disinfection of environmental surfaces only occurs when label instructions for disinfection are followed, i.e. surfaces must remain wet for the recommended contact time.

Recommendation #5: Cleaning and Disinfecting Surfaces of Blood and Body Fluids
Gloves should be worn and all necessary safety precautions should be followed. Excess blood and fluid must initially be removed with absorbent material. Then using VIROX 5 (at a 1:16 dilution), Virox STF (at a 1:16 dilution), or VIROX 5 RTU, the contaminated surface must be cleaned by applying the diluted solution, allowing it to soak for 30 seconds, and then wiping it dry. The contaminated surface can then be disinfected by applying the diluted solution and allowing the surface to remain wet for 5 minutes, followed by wiping the surface dry or by rinsing it.

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