Understanding The Need for Disinfection
By J. Darrel Hicks, BA, REH, CHESP
There are a lot of questions surrounding disinfection – which products to use, how often does it need to be done, in what areas is disinfection required and what are the proper methods to disinfecting? All these questions are addressed in this most recent "An Ounce Of Prevention" column.
Who needs to understand disinfection?
The short answer to that question is everybody in the business of cleaning, no matter the type of facility. Not all the sick people in the world are in hospitals.
If you are responsible for the cleaning and disinfecting activities of a facility, you need to understand disinfection. Without a basic understanding of the principles of disinfection, there is a greater chance for the spread of illness and perhaps life-threatening diseases. The primary use of disinfectants is to eliminate or greatly reduce microbial pathogens and thus prevent the transmission of disease and illness.
Do I need a disinfectant?
Yes, 1) If health regulations require the use of specific disinfectants for the cleanup of blood, body fluids or excrement; 2) If you are concerned with the possibility that environmental surfaces such as tables, chairs, telephones, toilet seats, sink faucets, food preparation surfaces, handrails and doorknobs have become contaminated with bacteria or viruses; 3) In the absence of government oversight, use your best judgment to determine if the surfaces around you or in your work place should be ridded of dangerous microorganisms.
That being said, one must exercise caution when considering the purchase of all cleaning chemicals and disinfectants. Be very concerned about the toxicity (both oral and dermal) of all chemicals used in your area of responsibility.
As housekeeping professionals, we are guardians of the health of our staff, the customers we serve and the environment. We must be vigilant, educated and tireless in our pursuit of safe cleaning chemicals and disinfectants.
Why, and where, do you need disinfection?
Why do you need a disinfectant? The most pathogens can survive or persist on surfaces for months and can thereby be a continuous source of transmission if no regular preventive surface disinfection is performed.
When deciding where to disinfect, you must consider guidelines established by governmental, regulatory agencies or your infection prevention team. Common sense dictates the “high touch” or “touch point” surfaces are routinely disinfected. Best practice dictates that Universal Precautions be used. Universal Precautions is based on the premise that there is a potential for infection with every drop of blood and certain other body fluids (e.g., semen, vaginal secretions, cerebrospinal, synovial, pleural, peritoneal, pericardial and amniotic fluids). Those who believe that all body fluids, not just blood, are potentially infectious use Body Substance Isolation (BSI).
How do I disinfect properly?
Universal Precautions with the appropriate personnel protective equipment should always be used when dealing with contaminated surfaces during cleaning and disinfecting procedures. Surfaces must be thoroughly cleaned before being disinfected because dirt, blood, mucous and tissue may interfere with the action of the disinfectant.
The disinfectant in sufficient concentrations and at the correct temperature must remain in contact with the surfaces for a specific period of time to allow penetration of all the microbial cell walls and deactivation. This is often referred to as dwell time. The concentration, temperature and exposure times are different for each disinfectant and the manufacturer's directions for use and dwell time must be followed carefully. Manufacturer recommendations are often found on the disinfectant packaging or material safety data sheets.
Common practice is to always allow a wet, disinfected surface to air dry. The surface should remain wet for at least three minutes, which will give the chemical disinfectant the maximum killing/contact/dwell time.
Chemical disinfectants should not be mixed with each other or with detergents, since this may inactivate their disinfecting properties or create dangerous fumes.
Darrel Hicks is the author of "Infection Control for Dummies" and is recognized as one of the top experts on infection control issues.