Contact Patterns During Simulated Vomitus Cleaning By Healthcare Workers
thesisposted on 27.10.2017, 00:00 by Yu-Min Su
Epidemiologic studies have indicated that healthcare workers acquire norovirus when they have close contact with symptomatic patients or residents while performing care or performing environmental cleaning. Contact plays an important role in environmental surface contamination, and worker exposures. In order to have a more precise understanding of norovirus infection risk experienced by healthcare workers as a result of cleaning bodily fluids in healthcare settings. The goal of this study was to characterize how healthcare workers contact environmental surfaces and themselves, while cleaning vomitus emitted by a person with norovirus infection. Seven healthcare workers were recruited to participate in this study. Participants were asked to simulate a vomitus cleaning task in a simulated patient room. Each participant was randomly assigned two of four experimental conditions that differed in simulated vomitus viscosity and location. All simulations were record by a camera surveillance system. Video recordings were watched by researchers to observe the workers’ environmental surface contact and self contact to the face and body while they performing cleaning activity. Participants who are environmental service workers had significantly higher contact frequency on environmental surfaces than participants with other job titles, and touched these surfaces with their fingers, but rarely touched their own face; none touched their mouth. Among environmental surfaces, the cleaning cart was the surface touched most frequently by participants. This contact may contaminate the cleaning cart and result in contamination in other patient rooms if there is no proper disinfection strategy. Participants who complied with the recommended cleaning protocol – used an absorbent material to remove the bulk liquid and cleaned from high to low surfaces – had significantly lower contact frequency on environmental surfaces than participants who did not follow the protocol. This means that protocol compliance may help reduce environmental contamination due to hand contacts, and workers should be trained to comply with the protocol. The knowledge generated by this research can improve the accuracy of the exposure and risk analysis in the future, and also can inform our understanding of related exposures to other bodily fluids and in other settings where cleaning is required.