Membership Assistance Program

Member Assistance Program   Question Posted: August 21, 2013 We are currently utilizing Cavi wipes, for nursing staff, to wipe down equipment between patients. Our infection Prevention team has recommended we switch to either Virox 5, Virox TB or Virox Prevention wipes for this purpose, as well as switching from a Quat. to a Hydrogen Peroxide based product such as Virox 5 for all of our cleaning process’s.   During my investigation I am hearing a number of concerns about issues with the HP based products. The lab, Diagnostic imaging and Dialysis units do not want us to use it on their equipment and we are getting reports that long term use of these products has resulted in damage to chrome such as bed rails chrome fixtures, mattress’s etc.   If you use any of these products I would appreciate your feedback.   If you use the products;   Have you noticed damage to equipment if yes what types of equipment.   Do your staff rinse all surfaces cleaned with Hydrogen peroxide based products as recommended by the vendor instructions.   Any other comments or suggestions will be appreciated. Hypochlorite based products are not an option due to safety concerns from our JOHSC.   Question Feedback:

  1. 1.      Don’t do it! We use Cavi-wipes, Dialysis was using a virox product and it did damage to their equipment.

 

  1. 2.      Here at our hospital we are currently using Virox 5 concentrate for general cleaning and floors. We use Virox RTU wipes on certain equipment but as you said there is the 10 minute contact time and there is the eating away of equipment. For this purpose in our ultrasound department we have been using SaniCloth Plus. However, with all that being said I am moving our hospitals (3) and other businesses who buy their AHP from us to a new Virox Technologies product called Accel PREVention. This is the newer and better Virox version. Contact time is now only 3 minutes. It is green certified. It does not eat any equipment. Our ultrasound equipment can be wiped using these ready to use wipes and other equipment such as IV poles without changing our equipment warranty (I have had this researched as well). Accel PREVention also now covers two additional pathogens: fungalcidals and tubercolicidals where as the Virox 5 did not. The concentrate is called Oxyveer Plus (not 100% sure on the spelling) but has a contact time of 5 minutes. I did a time study on cleaning a regular discharge room and we saved approximately 23 1/2 minutes using this new product! The cost of the Accel wipes is actually cheaper than the Virox wipes and the concentrate is twice as much but is more concentrated so you are getting a better deal because of the reduced contact time.As far actually cleaning and disinfecting, we here at the Yukon Hospital Corporation love it! It does the job well.
  2. 3.      The only concern we’ve had at TSH is some discolouration of some equipment and breaking down of mattresses (but this may be a process issue with over wetting the mattresses).  Also if you run a Dialysis program you will need to find and alternate product as this product is not compatible with bleach and bleach is used to disinfect the interior of the Dialysis machines. For flooring it is not recommended as it will break down the wax. We use a neutral cleaner for the floor and for general cleaning your Virox ratio will have to be set up accordingly but this will not be an issue if you’re switching to wipes or RTU.
  3. 4.      At the RVH we use Clorox wipes for most of our cleaning. We do use Virox 5 in areas such as Imaging, NICU and  OR. For the most part our nursing staff use Clorox wipes for between patient cleaning, however in high traffic areas we use Cavi XL 1. I hope this helps. If you have further questions please contact me directly.
  4. 5.      We have been using Hydrogen Peroxide products for over 10 years.  With the original products we experienced rust and corrosion issues.  With the new generation of the products and some fine tuning of procedures, very few surfaces have an issue.  We did try Cavi-wipes and had a distinct  jump in HAIs.  We reverted back to the (Virox) Accel RTU and no longer have that issue. Cavi-wipes are not allowed in any part of our hospital. Hard clear plastics and the vinyl mattress covers are sensitive.  We do not have a lot of chrome so I cannot help you there. Some clear plastics have turned translucent but does not detract from the look and function.  We keep an eye on the plastics to ensure they do not become brittle.  So far do good.  The new items like our paper towel dispensers are 6 years old and going strong. The mattress covers are rinsed/wiped down after the kill time is completed.  Other items will only be rinsed/wiped if it will come into contact with tender skin.  We are keeping an eye on the mattress covers and so far it is a toss up between long term patient creating pressure wear and tear or due to hydrogen products.  We limit when to use the hydrogen products.  The neutral cleaner we use kills most of the germs/viruses that doctors and public health and Infection Control group are concerned with. We (housekeeping) only use Accel RTU and Rescue Gel in VRE/C-diff Isolation rooms.  Our Neutral cleaner works well for all other areas including MRSA isolations. Manufacturer’s cleaning procedures and cleaning products for the equipment in Lab/DI have all been reviewed. All areas are supplied with a pour top bottle of our neutral cleaner they use with disposable cloths and they have the option of Accel Wipes.  Both are used in all the areas.  They determine if and when Accel is needed. We do not do dialysis here so I am not sure what the issue is.  I cannot help you there either. Our infection control committee believes a hammer is not always needed.  We have enough germs and bacteria that are smart.  We do not need to give them any extra opportunities to practice their mutations.    If good cleaning practices and procedures are executed, hydrogen peroxide products are used only as the hammer.
  5. 6.      We have been using Virox 5 for many years and have not had any problems with damaging anything. We also use the Virox wipes as well and had no problems.
  6. 7.      Nursing, OTA, etc. currently use the Virox Wipes for between patients on wheelchairs, stretchers,  etc. We currently use the Virox 5 for all Isolation Cleans including MRSA, VRE, C-Diff, etc.  We use the Virox 5 for second cleans as well. We use the Virox 5 in the Operating Room as well. We are currently considering the Rescue for C-Diff Isolations for cleaning toilets, commodes, sinks, as per the PIDAC Recommendations. We do not rinse as the Virox 5 is diluted 1:16. We are not finding that it is damaging the equipment  immediately.  I believe that overtime it is causing wear on  the beds and mattresses. We use Profill 12- Quat Cleaner/Sanitizer on all regular cleaning.  We do not use Virox 5 on screen monitors, in the lab, x-ray or diagnostic imaging equipment. We do use Virox in Dialysis Unit for isolation purposes but the nursing staff cleans the machines as per usual.
  7. 8.      We use VIROX wipes only in areas identified as infectious such as C-Diff cases, outbreak and or high touch points such as call bells, doorknobs.  We also use this wipe for telephones and key board which are made of plastic. Otherwise the product does  after time ruin equipment made of metal, because the standard  clean indicates to air dry.  Our infection team and environmental service use Best Practices therefor your standard disinfectant cleaner if using proper ratio should be adequate.
  8. 9.      We have been using Virox5 and Cavi wipes for several years. We have seen damage from both but more certainly from Virox5. The damage ranges from dulling/removal of chrome off of faucets, dulling of laminate counter tops, degradation of rubber coated mattresses and furnishings, damage/ cloudiness of screens on electronic devices and degradation of plastics. We feel very confident that it was the best choice for disinfection but struggled with the ill side effects seen over time. We did not rinse as is recommended. Our purchasing department altered the criteria for the purchase of new equipment to manufacturers that would support the use of Virox5 and still honour their warranty. We have recently made a change from Cavi wipes and Virox5 to Prevention wipes and cleaning solution which we are thrilled about. We still strongly believe in the disinfection achieved with accelerated hydrogen peroxide and still appreciate the benefits of the 5 min contact time (3 minutes with the wipes). Prevention is diluted at a ratio of 1:40 compared to 1:16 dilution ratio of Virox5. It is therefore gentler on surfaces, does not require a rinse step, is less expensive and also boasts a broader spectrum of kill. Another bonus is that Prevention is Ecologo certified. I believe that they have a claim to being the first hospital grade disinfectant to achieve this environmentally friendly designation. We were the test site for their product dispensers that will dilute cleaning solution at 1:40 for disinfection and 1:126 for general cleaning (in our case floors). I hope that this information helps. Feel free to contact me if you have any further questions. Best of luck with your decision,
  9. 10.  We moved into a new facility Feb 2011 and switched our low level disinfectant throughout  to Virox 5. , however in time, there was damage to delicate equipment and since we have switched our wipes to Caviwipe XL  that seems to be more gentle on delicate equipment.