Challenges in assessing contamination levels and novel decontamination technologies in the critical care setting

Most studies undertaken are quasi-experimental or have a ‘before-and-after’ design, which limits objective critical appraisal and meta-analysis.1,2 Our research group designed a protocol for a 2-treatment, repeated crossover study over 2 years targeting near-patient sites in an intensive care unit (ICU) to evaluate a novel intervention, namely a custom-built handheld cold-air plasma (CAP) device. A hygiene standard has been proposed such that the recovery of >2.5 CFU/cm2 from a hospital surface constitutes a hygiene failure.7 Applying this standard to our results, 71% of bedrail surfaces of occupied beds sampled harbored >2.5 CFU/cm2 and thus failed to meet the standard. [...]targeting such sites with a cleaning intervention was appropriate and worthwhile. By viewing patients, their families, and hospital staff as stakeholders to research undertaken in the space where care is provided, realistic and feasible studies can be optimized to reflect real-life conditions. * Both authors contributed equally to this work.