Developing A Disinfecting Plan

This Manufacturer Roundtable took the compilation of questions Facility Cleaning Decisions received from in-house custodial professionals and posed them directly to cleaning industry manufacturers. Here are their responses:

Contributors:
Jason Welch
Microbiologist
Spartan Chemical Co. Inc.
Maumee, Ohio

Sara Snow
Senior Scientist
Clorox Professional Products Company
Oakland, Calif.

Q: Are there standard operating procedures regarding VOCs and chemical odors of cleaners/disinfectants used in the health care setting?

Welch — Neither the EPA nor OSHA has developed a standard.  [There are] a range of solutions for facilities that require VOC and/or fragrance-free products.


Q: How often do you recommend cleaning/disinfecting when patients are present?

Welch — This is a decision the facility has to make based on the specific application.

Snow — Occupied patient rooms are generally cleaned and disinfected daily, after adverse events (where gross soil is produced), and upon patient discharge. Every facility should have a cleaning standard agreed upon by environmental services, infection prevention, and management. The CDC indicates:
•    Clean housekeeping surfaces (e.g., floors, tabletops) on a regular basis, when spills occur, and when these surfaces are visibly soiled.
•    Disinfect (or clean) environmental surfaces on a regular basis (e.g., daily, three times per week) and when surfaces are visibly soiled.
•    Use a one-step process and an EPA-registered hospital disinfectant designed for housekeeping purposes in patient care areas where 1) uncertainty exists about the nature of the soil on the surfaces (e.g., blood or body fluid contamination versus routine dust or dirt); or 2) uncertainty exists about the presence of multidrug resistant organisms on such surfaces.


Q: There are various bacteria and harmful organisms present throughout any health care facility. How should environmental service staff select cleaners/disinfectants to fit their cleaning need?

Welch — The CDC publishes guidelines for criteria deemed necessary. But, Spartan recommends the following considerations when developing a disinfection program:
•    Types of microorganisms involved: pathogenic or nonpathogenic organisms
•    Contaminated areas and types of surfaces that need disinfection
•    Disinfectant concentrations and economics
•    Product stability, performance and storage conditions
•    Application method- labor and contact time allowed
•    Safety precautions
•    Environmental impact

Snow — First, always make sure you are using an EPA-registered hospital disinfectant. Second, check the product label to insure it has kill claims for the most relevant healthcare microorganisms—in other words those responsible for most HAIs and outbreaks. Third, check the kill times on the product—the shorter the kill times, the faster your staff will be able to disinfect each room. It is also important to test the product to make sure it can keep a surface wet long enough to meet its kill times—if it doesn’t, that means your staff may have to re-wipe the surface to kill necessary microorganisms. Finally, check other product attributes that are important to you/your facility by asking yourself: Is it a one- or two-step product? What is the toxicity signal word? What personal protective equipment is required? What is the product shelf life?