Wiped Out: Disinfecting Hard Surfaces

As effective as hard surface disinfection protocols have become, there’s still a place for the extra jars of wipes because disinfecting happens at a single point in time and frequent recontamination is common.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.)

Infection Prevention and Control Programs: Cohesion and Consistency

Infection Prevention and Control Programs: Cohesion and ConsistencyThe fight against hospital-acquired infections is multifaceted. We at PurThread are proud to be addressing an essential part of that fight: soft surface contamination. Hand washing protocols, maintenance procedures, error-avoidance checklists, and training each make substantive contributions to infection prevention and control. Proper preparation for dealing with infections in most healthcare facilities requires a well-designed and maintained infection control program. Without such a program, addressing infection control would seem like a game of whack-a-mole.

In this day and age, infection control programs are commonplace. However, preparedness for dealing with infectious diseases still varies widely. In “How Prepared are Hospitalists to Handle Infectious Disease Cases?” (The Hospitalist, April 2012) infectious disease physician Dr. Leland Allen describes how a comprehensive infection control program can overcome variations in hospital personnel training and help all staff address the specific types of infections that might be found at their institutions. The payoff is manifested by reduced infection rates and better support for staff physicians.

Resources for hospital and healthcare facility infection control program development and monitoring abound. Here are just a few:

Developing an Infection Control Program

CDC guidelines for infection control

8 Steps to Effective Hospital Infection Control Programs

What are the resources you found most helpful in designing your infection prevention and control program? And which components of your infection control program do you consider most critical?