Bundling: a complete approach to infection prevention

Bundling, also known as layering, is the practice of applying multiple products and methods to infection prevention and control protocols. Many infection preventionists take the bundling approach to disinfection in order to limit the spread of HAIs in their facility. 

Why use the bundling approach?

 The bundling approach to disinfection is multi-faceted- it covers the gaps created by using a single disinfection method. This approach utilizes numerous evidence-based practices that improve the patient outcome when performed simultaneously. There are challenges with using a single disinfection method in terms of efficacy, variability and compatibility.

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Efficacy

UV light systems may not meet EPA standards

UV light systems are not required to be registered with the EPA. Reviews of UV light systems often reveal that these systems are "low in quality" and therefore do not meet the minimum federal government performance standards for hospital disinfection. Studies show that these treatments may only achieve a 1-3 log reduction, leaving a significant number of untreated microorganisms, like C. difficile, that can easily grow in population. 

Variability

Manual disinfectant wipes

Chemical disinfectant wipes require many steps to properly disinfect items. Following proper contact times is a main component in the variability of disinfectant wipes. Contact time can range from 15 seconds to 10 minutes and depends on the surface of the item and the target organism. Often times, medical staff may be unfamiliar with contact times and may also lack sufficient time to reference every device's instructions for use.

Compatability

Disinfectant chemicals can damage devices

Disinfection methods may damage medical equipment, which can incur a high cost for healthcare facilities. Environmental stress cracking (ESC) is the result of plastic exposure to harsh chemicals like bleach and Quaternary ammonium. Avoiding ESC damage requires multiple disinfectants at the point of care.