3 Strategies for Reducing Hospital-Acquired Infection

Hospital Acquired Infections in China: How Air-Disinfection Technology Can Help – Part 1

Given these ongoing challenges, any serious plan to control hospital-acquired infections requires a combination of three core strategies:

1. Improve Hand Hygiene Among Hospital Staff

Proper hand hygiene is essential, as more than 30% of hospital-acquired infection cases are spread via hand transmission, according to Wenlong He of Tianjin Medical University.

Yet hand hygiene — at hospitals in China and worldwide — is “abysmally low,” in the words of the World Health Organization. Even when hand rub is readily available, dispensers are functional, procedures are posted, and healthcare workers know they are being observed, nurses and doctors often fail to rub their hands long enough, cover their wrists, or remove gloves properly.

It is not due to laziness. Rather, these dedicated healthcare professionals are hyper-focused on patient care and, as humans, naturally engage in automatic, unconscious behaviors.

“Good knowledge and positive attitude of the physicians was not translated into good hand hygiene compliance.”

— Report on Shanghai Hospitals (PLOS ONE)

Furthermore, a review article on Chinese hospitals concluded:

• 80% of medical staff do not wash their hands or wear masks before and after sterile operations or treating critical patients.
• 60% of medical staff do not follow the six-step hand-washing method, do not wear masks before entering the ward, and do not wash hands after contacting patient records or personal items.

These studies may actually underestimate the problem. In studies using head-mounted cameras to unobtrusively observe doctors and nurses on their rounds, actual hand hygiene compliance was as low as 1% to 5%.

2. Improve Surface Cleaning Protocols

Given hand-hygiene limitations, hospitals must thoroughly clean all surfaces, medical devices, and surgical instruments. The higher the contamination level on a surface, the higher the likelihood of pathogen transfer to patients or staff.

When a patient checks out of a room, environmental services staff must disinfect:

• Bedframes and call button cords
• Trash can lids and closet handles
• Doorknobs, sinks, and curtain rails

Between patient uses, medical equipment must also be disinfected, including stethoscopes, glucometers, keyboards, telephone handles, blood pressure cuffs, ultrasound machines, ECG leads, and ventilators.

However, thorough surface cleaning is frequently missed. Bingwei Sun, M.D., Ph.D., of Jiangsu University, noted in Chinese hospitals a “lack of standardized or complete disinfection of surgical instruments, failure to implement surgical standards, failure to consider oxygen humidifiers as an important source of lower respiratory infection, and inappropriate measures of disinfection.”

Surface Disinfection Gaps

• Stethoscopes: Easily disinfected with alcohol, yet the Shanghai hospital survey found that only 29% of physicians disinfected their stethoscopes after each patient. Nearly half of respondents did not know stethoscopes and pocket watches serve as vectors for infection.
• Apparel Laundering: Less than half of doctors and nurses reported laundering their white coats or uniforms twice or once per week. Only intensive care unit clinicians laundered uniforms daily as required by hospital policy.

The Rapid Rebound Effect

Even when best-in-class cleaning methods are used, pathogens quickly return. In an American study, 36 bed rails were sampled before cleaning and at intervals afterward. Within just three hours, bacterial burdens rebounded to unsafe levels.

“Our study suggests that cleaning approximately every 2 hours would be necessary to maintain the population of this pathogen at the proposed non-detectable level.”

Furthermore, pathogens like Acinetobacter baumannii — commonly found across Chinese hospitals — have proven impervious to extreme cleaning methods. Visual inspections offer no assurance either: a British study proved a surface can look spotless while remaining heavily contaminated.

3. Disinfect the Air Continuous Protection

To compensate for the human limits of hand hygiene and surface cleaning, hospitals must deploy a continuous third line of defense: disinfecting the air.

Vomiting, coughing, talking, and even breathing launch infectious microbes into the air. Air currents transport these floating particles throughout the hospital, where they settle onto lab coats, IV poles, stretchers, supply carts, bed rails, and computer keyboards.

In one study of Chinese hospitals, only 26.1% of physicians and 39.5% of nurses reported placing a mask on patients during transport. Unmasked movement, combined with incoming staff and visitors, constantly introduces dangerous airborne microbes into lobbies, corridors, stairwells, and patient rooms.

It is critical to inactivate these floating particles before they settle on surfaces. As researcher Wenlong He notes, airborne pathogen transmission “easily” causes infections, and to decrease infection rates, “air quality of the inpatient area should be improved.”

Advanced Air Disinfection vs. Standard HEPA

By far the most effective method of continuous air disinfection is low-temperature plasma technology.

Novaerus' NanoStrike™ technology cleans air 24 hours a day, inactivating airborne pathogens on contact. It operates safely around vulnerable patients and requires no human intervention or compliance.

• Comprehensive Pathogen & Pollutant Control: Novaerus is proven to eliminate bacteria, viruses, and fungi, while reducing volatile organic compounds (VOCs) and fine particulate matter.
• Outdoor Air Protection: On high-pollution days, outdoor toxins enter healthcare facilities, aggravating patient respiratory conditions. NanoStrike mitigates these outdoor elements.
• VOC Neutralization: Neutralizes internal chemical off-gassing from furniture, cleaning solvents, hand sanitizers, lotions, flooring, and laboratory plastics.
• Beyond HEPA Filters: Standard HEPA filters only trap — rather than kill — dangerous microbes, leaving live pathogens in the filter matrix that create infection risks for maintenance staff during filter replacements.

Conclusion

As Dr. Bingwei Sun noted, hospital infection management “in China and worldwide has a long way to go.”

👉 The first step is to clean the air with Novaerus.

Cleaner hands and surfaces save lives, but unless the air is continuously disinfected, traditional protocols alone will not stop the spread of infection at healthcare facilities around the globe.