title: Bedpan washer disinfectors: an in-use evaluation of cleaning and disinfection.
abstract: BACKGROUND
  As part of a comprehensive approach to decreasing Clostridium difficile in our health authority, an evaluation of the in-use performance of 2 brands of bedpan decontaminators (BPDs) in 2 acute care facilities was performed.
  
  
  METHODS
  A continuous quality improvement approach consisting of 5 BPD audits and 4 intervention phases was used over a 16-month evaluation period. Visible fecal soil on processed items was used as the progress indicator, and infection preventionists performed audits.
  
  
  RESULTS
  A total of 1,982 observations was recorded. Percent failures rates ranged from 7.6% to 33% dependent on the intervention phase. Polypropylene materials had fewer failures compared with stainless steel. The addition of rinse agent significantly improved results particularly in polypropylene items (1% failure rate). A number of human factors issues and equipment design features compromised the BPD's ability to function adequately.
  
  
  CONCLUSIONS
  Users should thoroughly evaluate the in-use efficacy of BPDs and use a step-wise approach to identify and correct both human and equipment deficiencies. Forced function and compliance features for correct loading of machines, detergent and rinse agent dispensing, and ability to operate the machine only when detergent is present should be integral to the BPD design.
authors.affiliation: Infection Prevention and Control, Vancouver Coastal Health, British Columbia, Canada. Elizabeth.Bryce@vch.ca
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bryce
authors.forename: Allison
authors.initials: A
authors.lastname: Lamsdale
authors.forename: Leslie
authors.initials: L
authors.lastname: Forrester
authors.forename: Linda
authors.initials: L
authors.lastname: Dempster
authors.forename: Sydney
authors.initials: S
authors.lastname: Scharf
authors.forename: Michael
authors.initials: M
authors.lastname: McAuley
authors.forename: Ian
authors.initials: I
authors.lastname: Clearie
authors.forename: Sharon
authors.initials: S
authors.lastname: Stapleton
authors.forename: Sheila
authors.initials: S
authors.lastname: Browning
mesh_terms: D016360:Clostridioides difficile / Q000187:drug effects* / Q000302:isolation & purification; D004202:Disinfectants / Q000494:pharmacology*; D004203:Disinfection / Q000379:methods*; D004389:Durable Medical Equipment; D004866:Equipment Contamination / Q000517:prevention & control; D017743:Equipment Reuse; D004865:Equipment and Supplies, Hospital; D011126:Polypropylenes; D013193:Stainless Steel
chemical_list: D004202:Disinfectants; D011126:Polypropylenes; D013193:Stainless Steel