Disinfecting Processes That Reduce HAIs

When processing a patient room, Hicks recommends starting with the cleanest part of the room and working toward the dirtiest part: the patient’s bed and three feet around it. The restroom should be treated as a separate room, rather than an extension of the patient’s room, and cleaned with a different color microfiber cloth to avoid cross-contamination.

Fellows also recommends applying disinfectant to the cloth rather than spraying it directly on the surface.

“People assume that when they spray disinfectant on the surface and let it sit for 10 minutes, they’ve disinfected that surface,” he says. “In reality, anywhere from 30 to 60 percent of that surface has no liquid on it at all, so nothing is being disinfected in those areas.”

Instead, Fellows advocates using a bottle with a flip-top lid to saturate the cloth with disinfectant and wipe the surface. He also suggests turning the cloth to a clean side when moving to a new surface or reapplying disinfectant to a large area.

“Typically, a microfiber cloth is folded so that you have four sides to work with, and then you turn it around and use another four sides,” he says. “If used correctly, you can get eight sides to disinfect with, at which point the cloth should be put in a bag for cleaning, and a new cloth should be used.”

But even clean cloths can be called into question, which is why facilities should pay close attention to how microfiber cloths are laundered and whether or not the process removes contaminants.

“There are a lot of conversations going on about whether microfiber cloths are being properly processed, and how many launderings it takes before they are no longer effective,” says Hicks. “If the laundry doesn’t kill all the bugs, is the disinfectant fighting what’s in the cloth rather than what’s on the surface?”

Further studies are needed to determine the effectiveness of microfiber cloths after they are laundered and how many launderings are acceptable before clothes should be disposed of. To avoid uncertainty, some hospitals are using disposable microfiber cloths. Hicks is also aware of one company that claims its microfiber cloths can be washed with chlorine bleach according to CDC guidelines.

“Not all microfiber is created equal,” Hicks concludes, “so you have to do your research.”

It Takes A Team

Despite the focus on training EVS staff, cleaning and disinfecting is not solely the department’s responsibility. A successful program requires the support and cooperation of all hospital personnel — especially when it comes to disinfecting durable medical equipment.

Recently, Solomon audited a group of 15 healthcare facilities throughout Maryland and found that the highest ATP readings were on glucometers that were moved from room to room.

“A lot of times, with durable medical equipment, there’s finger-pointing,” she says. “Nursing says EVS is responsible for the cleaning; EVS says nursing is, so it never gets done. It comes back to defining who is responsible for cleaning every surface in the hospital.”

Hick concurs: “There has to be a meeting of the minds,” he says. “Everything that goes in and out of that room needs to have a determination made regarding who cleans it and at what frequency.”

But proper cleaning and disinfecting practices should extend well beyond hospital walls. With the rise in drug-resistant organisms, everyone plays a role in preventing the spread of infection, according to the experts.

“People may be infected and not even know it,” says Hicks. “Meanwhile they’re using the same shopping carts as you and going to the same public places. The need for cleaning protocols is universal. If we don’t have a way of stopping these microorganisms, then proper cleaning and disinfecting may be the only thing that saves us.”

Kassandra Kania is a freelance writer based in Charlotte, North Carolina.