Wiped Out: Disinfecting Hard Surfaces

When one of our team went in for surgery a few years ago, his wife brought along a couple of jars of disinfecting wipes to his room, so that there would be no reason for personnel not to wipe down every area after every interaction.  Not long before, that might have seemed excessive. But with what we now know about healthcare acquired infections (HAIs), it’s both common practice and common sense.

Since contact is with intact skin, environmental hard surfaces are considered to be noncritical items with little risk of directly causing infections in patients or staff. However, hard surfaces are touch points where bacteria can be spread and cross contamination can occur. Further, detergents or cleaning utensils can become contaminated and actually foster the spread of infections they are being used to prevent. For those reasons and to simplify environmental services training and practices, it generally makes sense for hospitals and healthcare facilities to disinfect environmental surfaces, rather than merely wash them with detergents. Individual facilities use protocols that match their needs and situations.

Ultimately, hard surface cleaning protocols boil down to a balance among contaminant elimination, product efficacy and resources (cost and available labor). The CDC provides guidelines for disinfection of equipment or environmental surface that can be summarized by the fact that more numerous or more resistant microorganisms require more potent disinfectants or more contact time (length of exposure of the item to germicide).

Disinfectants are available in spray, disposable wipe, or liquid detergent form, and alcohol, chlorine, quaternary ammonium, and phenolics each have their advantages in specific applications for hard surfaces. Surfaces that are likely to be touched more frequently may need more frequent disinfection, usually via disposable wipes. Other areas of the room may do well with spray or mop applications and reusable wipe cloths or mop heads.

As effective as hard surface disinfection protocols have become, though, there’s still a place for the extra jars of wipes brought in by a vigilant spouse because disinfecting happens at a single point in time and frequent recontamination is common. (See this article in the American Journal of Infection Control.)