Rapid evaluation of the implementation of a disinfectant spray in hospital during the COVID-19 pandemic: a mixed-methods qualitative study.

Background A spray-based disinfectant (VIRUSEND TM ) was developed in collaboration with the British Army to provide protection for its service-people from COVID-19. The Critical evaluation of the implementation of VIRUSEND TM in clinical settings (CLEAN) study sought to assess the potential utility of the spray-based disinfectant to enhance infection prevention and control (IPC) in hospital settings during the COVID-19 pandemic. It is a study of the rapid evaluation of a novel product in a high-pressure environment. Methods We conducted a single centre, prospective, rapid mixed-methods, implementation study. Participants were recruited to use the spray as part of their routine IPC practice and data collection followed. Initial observations and pre-implementation survey informed the framework for the post-implementation survey and interviews. Rapid qualitative analysis methodology was used. The study was conducted at a major tertiary referral teaching hospital in the United Kingdom. One hundred and eighty-two staff participants were recruited from ten different clinical environments, selected to represent a diverse level of COVID-19 infection risk. Results One hundred and two participants completed the first survey, 66 completed the second survey and 23 participated in interviews. The interviews with staff regarding their views and experiences of the spray-based disinfectant illuminated the survey responses. Five themes were identified: Is there a need for a spray-based disinfectant? integration of the spray into IPC processes; issues of cleaning vs disinfection; design and functionality; negative consequences of spray use. Conclusions Most people liked using VIRUSEND TM and said that they would continue to use it at work if it was available to them. A key barrier was that VIRUSEND TM whilst being a multi-organism disinfectant, was marketed specifically at COVID-19. In hospitals cleaning and disinfection needs to address a range of infectious organisms. Furthermore, economic evaluation will be required prior to any wider uptake. A rapid evaluation approach identified key issues related to feasibility and acceptability of a novel product in a high-pressure environment. This approach could be usefully applied to the assessment of other potential healthcare interventions where timely information is needed.