Single-Use Disinfecting Wipes at the Bedside May Reduce In-Hospital Mortality Rates

Although rates of hospital-acquired infection (HAI) were not affected by single-use disinfecting wipes at the bedside, their use resulted in reduced rates of in-hospital mortality and multidrug-resistant (MDR) acquisitions. These study results were published in The Journal of Hospital Infection.

This unit-level crossover, interventional study was conducted at Shamir Medical Center in Israel from October 2016 to January 2018. Researchers evaluated the effect of single-use disinfecting wipes at the hospital bedside on outcomes among hospitalized patients in multipatient rooms. Departments within the medical center were randomly assigned to either implement single-use disinfecting wipes at the bedside (intervention) or continue standard cleaning practices in subsequent 6-month periods. The primary outcome was the rate of device-related HAI, including central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs). Incident rate ratios (IRRs) and differences per 10,000 patient-days were evaluated via Poisson regression.

The final analysis comprised 7725 hospitalized patients, representing a total of 46,670 patient-days. Of these patients, 3793 were hospitalized in rooms that underwent the intervention and 3932 were hospitalized in rooms that underwent standard cleaning practices.

There was no significant difference in combined CLASBI and CAUTI rates observed between the intervention and standard cleaning periods (IRR, 1.6; 95% CI, 0.7-3.5; P =.3). However, the frequency of cleaning was significantly increased during the intervention period (odds ratio [OR], 3.73; 95% CI, 2.0-7.1; P <.0001).

Further analysis showed that the risk for MDR environmental contamination across all hospital departments was reduced in the intervention vs standard cleaning periods, though the difference was not statistically significant (OR, 0.7; 95% CI, 0.5-1.0; P =.06).

New MDR acquisitions were significantly lower during the intervention (n=9) vs standard cleaning (n=20) periods (hazard ratio, 0.4; 95% CI, 0.2-1.0; P =.04). In addition, the incidence of in-hospital mortality was also significantly lower during the intervention period (IRR, 0.8; 95% CI, 0.7-1.0; P =.03).

Limitations of the study include the single-center design and the lack of blinding.

According to the researchers, “Additional studies are warranted, that propose and trial additional interventions that could increase the level of cleanliness in hospitals.”