This Manufacturer Roundtable took the compilation of questions Facility Cleaning Decisions received from in-house custodial professionals and posed them directly to cleaning industry manufacturers. Here are their responses:

Jason Welch
Spartan Chemical Co. Inc.
Maumee, Ohio

Sara Snow
Senior Scientist
Clorox Professional Products Company
Oakland, Calif.

Q: What role do cleaners/disinfectants play in the prevention of hospital-acquired infections (HAI)?

Welch — The first line of defense for combatting HAIs  is Hand Hygiene - Since HAIs are primary spread through person-to-person contact, hand hygiene is a primary part of preventing transmission. Facilities should ensure that healthcare personnel are familiar with proper hand hygiene technique as well as its rationale.

Although microbiologically contaminated surfaces can serve as reservoirs of potential pathogens, these surfaces generally are not directly associated with transmission of infections to either staff or patients. The transferal of microorganisms from environmental surfaces to patients is largely via hand contact with the surface. Although hand hygiene is important to minimize the impact of this transfer, cleaning and disinfecting environmental surfaces as appropriate is fundamental in reducing their potential contribution to the incidence of healthcare-associated infections.

Cleaning is the necessary first step of any sterilization or disinfection process. Cleaning is a form of decontamination that renders the environmental surface safe to handle or use by removing organic matter, salts, and visible soils, all of which interfere with microbial inactivation.  The physical action of scrubbing with detergents and surfactants and rinsing with water removes large numbers of microorganisms from surfaces. If the surface is not cleaned before the terminal reprocessing procedures are started, the success of the sterilization or disinfection process is compromised.

It is also important to consider the nature of the item to be disinfected - For example, Tuberculosis is an airborne disease, it does not survive on hard surfaces, and therefore surface disinfection would play no role in controlling it.  An example where it would play a role would be a pathogen like VRE which is known to persist on environmental surfaces, so cleaning and disinfection is critical in breaking the mode of transmission.

Snow — Using hospital-use cleaner disinfectants as part of a bundled infection prevention program, can minimize the transmission of microorganisms in the healthcare environment and reduce infections rates. Many clinical studies and articles have measured the impact of using disinfectants in healthcare settings, and impressive reductions in infection rates have been shown.

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Developing A Disinfecting Plan
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Proper Use Of Cleaners And Disinfectants