A recent announcement from the U.S. Environmental Protection Agency (EPA) might make the job of cleaning and disinfecting much more difficult for those in the business of providing clean and sanitary public spaces. Managers in the know may have already read the report, but not all realize how it relates to a hospital, medical facility, ambulatory, or long-term care center.

It is common knowledge that antimicrobial pesticides are designed to destroy or suppress harmful bacteria, viruses, and other microorganisms on inanimate objects and surfaces in healthcare settings.

Most managers also know that the EPA has a testing program — the Antimicrobial Testing Program (ATP) — which has a purpose to ensure that EPA-approved hospital disinfectants and tuberculocides in the marketplace continue to meet stringent efficacy standards. Products found to be effective are reported to the public on the EPA website, and those that do not meet the ATP efficacy standards need to be brought into compliance.

But according to the Office of Inspector General for the EPA, there are flaws in the process of ensuring the efficacy of hospital-grade, hard-surface disinfectants. The findings were revealed in a report titled “EPA Needs A Risk-Based Strategy To Assure Continued Effectiveness Of Hospital-Level Disinfectants” on September 19, 2016.

The Inspector General (IG) report concluded that the EPA’s Antimicrobial Testing Program, “does not assure that hospital disinfectant products continue to be effective after they are registered,” and that some products listed as effective on the EPA’s website, “could now be ineffective” due to inconsistencies in the manufacturing, product degradation or improper quality assurance.

As a result, the EPA is re-registering all antimicrobial products and, thereby, recertifying the efficacy of these disinfectants. This one-time review of registered disinfectants is comprehensive and includes an examination of product efficacy. It is expected that the re-registration of disinfectants will be completed by fiscal year 2021.

But until then, the report’s findings suggest that managers within hospitals and other healthcare facilities use diligence in selecting hard-surface disinfectants. They should also avoid overreliance on disinfectants alone, and develop robust infection prevention protocols in order to minimize the risk of increased hospital-acquired infections.

Having an effective infection prevention and control program is the key to compliance with the Conditions of Participation (CoP) under the Center for Medicare and Medicaid Services (CMS). Although, in general, the CoP rules allow hospitals flexibility in aligning their programs with nationally recognized practices and guidelines, hospitals are expected to use EPA-registered disinfectants. Moreover, federal regulators have proposed the strengthening of the infection prevention CoP, and heightening the role and accountability of a hospital’s governing body in program implementation and oversight.

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Selecting And Using Disinfectants