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Global Cleaning 2014

| IN PRACTICE | DISINFECTION IN HOSPITALS From WHO to RKI to VAH Infection prevention goes by many names Chief coordinating body and authority over the individual states and health authorities disinfecting agents and the Association for all institutes is the United Nations World as well as that of the relevant hygiene Applied Hygiene (VAH), the successor of Health Organization, or WHO. The mission commissions. The RKI touches on all the DGHM, are only peripherally involved in of the WHO and its 194 member states is to relevant topics that relate to hygiene and the fight against infectious diseases. Rather, fight disease, with a special focus on infection protection. It publishes the VAH has the mission of verifying and infectious diseases and pandemics, i.e. recommendations and guidelines, which, if validating the efficacy of disinfectants based global infections, as well as promoting not respected, may lead to sanctions. These on testing protocols and evaluation general health of the global population. publications, however, have no regulatory procedures, studies and trials. All This also includes the global fight against character. Only the provisions of the disinfecting agents and products used in tuberculosis, HIV and leprosy. To achieve Infection Protection Act (Infektions - hygiene-sensitive facilities must appear on these goals, the WHO collects data from schutzgesetz - IfSG) are legally binding and the VAH list. In addition, the VAH list also around the world on infections, the rate at may lead to criminal prosecution if indicates the product’s efficacy against which they spread as well as the risk of disregarded. germs, in what concentration and over which contagion that can emanate from a The German Federal Institute for Vaccines duration (soaking period) the product must pathogen, and the death rate. The data is and Biomedical Drugs is better known as be used. The VAH list covers all possible evaluated, and based on these facts, the Paul Ehrlich Institute. The PEI verifies and types of disinfection in the areas of WHO then determines the risk to the validates the efficacy of vaccines and instrument prepping, washing, area population on a regional level, e.g. for antidotes, and issues approvals for their use. disinfection and sterilization. The VAH list Europe, or in the case of a pandemic, for Comparable to the Food and Drug Admin- is not the same as the RKI list of approved the global population. Based on these facts istration in the US, the PEI thoroughly disinfection agents and products. The and findings, the WHO develops checks antidotes and vaccines as to their disinfecting agents, products and recommendations and provides them to all efficacy and compatibility, including through procedures in the RKI list are mandatory countries around the world to facilitate clinical studies and lab trials. When vaccines and must be strictly abided by in case of combatting the infection. In addition, the need to be developed urgently, as was the prescribed disinfection measures or in the WHO publishes figures in bulletins that case with the outbreak of EHEC in Germany case of an epidemic or pandemic. Final provide updates on the spread of a disease in 2011, the PEI takes on the role of project disinfection in the case of MRSA, for and on the aggressiveness of a pathogen. leader and coordinator for the various instance, must be conducted with These figures are subsequently evaluated research facilities involved. It also provides disinfectants and disinfecting procedures on a country-by-country basis and on the ground support to medical listed in RKI list. recommendations and/or warnings are professionals, if necessary. For the day-to-day operations of cleaning issued. For Germany, this is the The Friedrich Loeffler Institute is the service providers, this means that only VAH responsibility of the Robert Koch Institute. German federal authority for infectious and RKI-approved disinfecting agents and The data is also useful in determining early diseases related to livestock. It is involved products and procedures may be applied in on whether or not a vaccine of antidote has when the origin or the spread of a disease hygiene-sensitive facilities. If non-listed to be distributed on a large scale – as was is of animal nature. disinfecting products and/or procedures the case of Tamiflu for H1N1. For instance, the FLI was put in charge when were used in hygiene-sensitive facilities, the The Robert Koch Institute, based in Berlin, the outbreak of Creutzfeldt-Ja kob disease cleaning services provider would, upon the federal institute for infectious diseases, (the human variant of BSE or mad cow patient request, have to be able to prove – acts as the main monitoring and research disease) and H5N1 virus (avian flu) occurred; in case of a nosocomial infection, for facility in Germany. The RKI is the official through strict directives and quarantining instance – that the infection cannot be organ in charge of developing and issuing of the mass livestock production business- traced back to the use of non-listed disin- guidelines and recommendations with es concerned, the institute was instrumen- fecting products and procedures, which is regard to hygiene and infection prevention. tal in containing the risk. pretty much a lost cause in practice. It is The institute also determines when and how The German Society for Hygiene and thus important to bear in mind that the they are to be implemented. Verification of Microbiology (DGHM), previously cleaning services provider is the liable par- the implementation is the responsibility of responsible for the classification of ty for any and all consequential damages. 30 GLOBAL CLEANING | April 2014  


Global Cleaning 2014
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