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Analysis and Recommendations for Reducing Risks of Patient Crosscontaminations Via Noncritical Medical Devices

Wright, Edward William DM; Marvel, Jon H. PhD, PE; Neubrander, Judy EdD, FNP-BC, CNE; DesMarteau, Kathleen MBA

doi: 10.1097/HCM.0000000000000015

Based on the serious problem of health care—associated infections and the understanding that patient crosscontamination is essentially preventable, opinions were sought from health care providers for insight into likely sources of crosscontamination in US hospitals, probable causes, and areas for additional investigation. Respondents indicated that inadequate disinfection of noncritical, patient care devices pose an underrecognized threat to patient crosscontamination. This led the researchers to question reliance upon the current Centers for Disease Control and Prevention (CDC) Guideline for Disinfection and Sterilization in Healthcare Facilities for such items. The CDC Guideline follows the Spaulding approach, which categorizes items and their disinfection treatment based on the risk of infection from the intended use of the item. A failure modes, effects, and criticality analysis approach is recommended as an additional refinement to the CDC Guideline whereby likely sources of cross-contamination are identified irrespective of intended use. Enhancing infection control practices with this approach promotes the development of preventive plans for cleaning and disinfection that can mitigate such risk.

Author Affiliations: Department of Global Management and Strategy, College of Business (Dr Wright and Dr Marvel), and School of Nursing, College of Health and Human Sciences (Dr Neubrander), Western Carolina University, Cullowhee, North Carolina; and Responsible Research & Writing, LLC, Marietta, Ohio (Ms DesMarteau).

The authors have no conflict of interest.

Correspondence: Edward William Wright, DM, Department of Global Management and Strategy, Western Carolina University, Culowhee, NC 28723 (

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