A group of experts have recently introduced a new, unique approach called the Targeted Moments of Environmental Disinfection (TMED). TMED is a method designed to further reduce health care–associated infections (HAIs) and improve patient safety by focusing on disinfecting high-touch surfaces in patient care areas. This avant-garde concept was presented by Jim Gauthier, along with his co-authors Carol Calabrese and Peter Teska in The Joint Commission Journal on Quality and Patient Safety.
During a recent conversation with Infection Control Today (ICT), Gauthier went into depth about the TMED model, elaborating on the urgent need for real-time disinfection, potential dangers of ignored surfaces, and practical strategies for incorporating TMED into routine health care practices. The TMED strategy suggests specific times when disinfection should be conducted by health care workers, like before or after certain procedures that may lead to organisms being left on high-touch surfaces, or to eliminate organisms that may have been deposited during other care procedures.
The TMED design breaks down five critical moments for cleaning high-touch surfaces in patient care areas. Firstly, it is recommended that the over-bed table should be disinfected before placing food or drink on it. The second moment is to disinfect before and after aseptic practices such as dressing changes, line insertions, or catheter care. In the third moment, disinfection is needed after handling anything related to feces or respiratory secretions within the patient’s bed space. The fourth moment advocates that disinfection is needed after any patient bath within the patient bed space. Finally, the fifth moment necessitates that any patient-related item that touches the floor should be disinfected.
The TMED model emphasizes that for it to work efficiently, healthcare providers should have a safe disinfectant wipe within reach when needed. However, it is critical that the wipe selection process considers factors like the quickness it works, whether it leaves surfaces wet around the patient for an extended period, and whether it requires personal protective equipment to be handled. The TMED model suggests that with a bit of education, better disinfecting practices can become an integral part of daily health care practice, thus reducing healthcare-associated infections and improving patient safety.