Enhancing Infection Control in Long-Term Care Facilities: The Impact of Dry Hydrogen Peroxide

Mary L. Cole, MS, RN, CNRN, CCRN, SCRN, CIC

Environmental infection transmission is a perennial problem in long-term care facilities (LTCFs). In LTCFs, managing environmental infection transmission is a complex and ongoing challenge. Factors such as shared living spaces, cognitive impairments among residents, staffing shortages, and less-than-optimal cleaning practices contribute to the persistence of this issue.

A study recently evaluated the impact of dry hydrogen peroxide (DHP) as a supplement to manual decontamination on bioburden within an LTCF neurobehavioral unit. Mary L. Cole, MS, RN, CNRN, CCRN, SCRN, CIC, infection control specialist and project manager at The Highlands at Brighton, presented the study's results in a poster at the 2024 Association for Professionals in Infection Control and Epidemiology (APIC) 2024 Annual Conference & Exposition (APIC24) held from June 3 to 5 in San Antonio, Texas.

The study was a prospective environmental cohort study conducted in a 15-bed neurobehavioral unit within an LTCF. A total of 264 surface microbial samples were collected from 8 patient rooms and 2 communal areas at 3 different time points: before DHP deployment and on days 14, 28, and 55 post-DHP deployment. The objective was to measure the reduction in bioburden, characterized by total colony-forming units (CFUs) at each sampling site, before and after the deployment of DHP.

Additionally, volatile organic compound (VOC) levels were measured in each patient area on all sampling dates. Multivariate regression was used to analyze microbial reductions associated with DHP exposure, controlling for sample and treatment sites.

The study found a statistically significant relationship between DHP exposure and surface microbial load reduction (P < 0.00001). Postintervention, the average VOC levels in patient areas were significantly lower than baseline levels (P = 0.0031). These findings indicate that DHP can reduce surface bioburden in occupied spaces, enhancing infection prevention and control efforts in LTCFs.

The deployment of DHP in the neurobehavioral unit of an LTCF significantly reduced the surface bioburden, highlighting its potential as an effective supplement to traditional manual decontamination methods. By lowering the microbial load on surfaces, DHP can play a crucial role in infection prevention and control, particularly in environments with vulnerable populations such as those in LTCFs.

The results of this study are significant for infection preventionists working in LTCFs. The ability to significantly reduce surface bioburden using DHP presents a valuable tool in the ongoing battle against health care-associated infections. This method offers a proactive approach to managing infection risks, particularly in facilities with high-risk populations and challenging environments.

Moreover, the study's findings on reducing VOC levels post-DHP deployment add another layer of benefit, as lower VOC levels contribute to healthier indoor air quality, which is essential in maintaining overall resident health and comfort.

Incorporating DHP into the infection control protocols of LTCFs could be a game-changer. This study demonstrates the efficacy of DHP in reducing surface bioburden. It underscores the importance of innovative approaches in enhancing the safety and well-being of residents in long-term care settings. As we continue to navigate the complexities of infection control, embracing such advancements will be crucial in safeguarding our most vulnerable populations.