infection prevention

The world became hyper-aware of the importance of maintaining a clean and hygienic environment when the COVID-19 pandemic struck. Cleaning consultant Darrel Hicks, an authority on infection control, recalls how interest surged in cleaning for health. But he explains that “hygiene theater” overshadowed, and often replaced, good cleaning practices during the pandemic.  

The world watched as cleaning crews donned head-to-toe personal protective equipment (PPE) to disinfect streets. The public was inundated with advice to stay indoors, keep children away from playgrounds, and meticulously wipe down groceries to battle a virus that turned out to have a relatively short lifespan on surfaces. 

Now, as public safety starts to normalize, Hicks worries that cleaning teams are going back to business as usual, and facilities aren’t ready for future threats. He stresses that the lessons learned during this outbreak should not be forgotten. The brief spike in cleaning consciousness must evolve into a sustained commitment to public health — one where jan/san distributors can play a crucial role in specifying the right products and training people to use them properly. 

Put Policy in Place 

David Trinks, 30-year infection prevention veteran and owner of Trinks Consulting Group, Franklin, Massachusetts, agrees with Hicks that jan/san professionals need to step up. He emphasizes that as the world navigates this new era, there is a greater need for the cleaning industry to renew its focus on infection control fundamentals. He believes that the cornerstone of effective infection control lies in identifying the problem, a process that varies significantly from facility to facility.   

“A nursing home, daycare, sports facility, or school all have different needs,” emphasizes Trinks. “While a nursing home may grapple with concerns related to C. diff, an athletic facility might prioritize MRSA prevention. Meanwhile, daycares and schools must remain vigilant against outbreaks of the common cold, flu, or RSV.” 

Shari Solomon, president of CleanHealth Environmental LLC, Silver Spring, Maryland, adds that after identifying concerns and establishing objectives for end users, it is essential to recommend a comprehensive cleaning and disinfecting program.  

“Good infection control hinges on implementing a consistent and all-encompassing program that is rigorously monitored, adhered to, and updated as necessary,” she says. “It’s a dynamic policy that delineates the right chemicals to use and procedures to follow, with cleaning and disinfection at its core.” 

Solomon underscores the importance of including step-by-step procedures and cleaning frequencies when creating recommendations for end users. However, she emphasizes that there isn’t always a universally recommended standard to follow, and often end users must make these determinations based on their unique requirements and circumstances. 

Despite a lack of standards, experts agree that all cleaning schedules should prioritize high-touch surfaces, such as doorknobs, handrails, light switches, elevator buttons, and more. To prevent infections from spreading, distributors should also stress the need for daily cleaning. 

“With daily cleaning, all areas of the facility get cleaned regularly with a focus on high-touch surfaces,” says Solomon. “In a hospital, the schedule might specify that common areas are cleaned daily, patient rooms are cleaned twice a day, and high-touch surface areas are tended to three times a day, for example.” 

According to Dr. Charles Gerba, a University of Arizona professor specializing in microbiology and infection control, daily cleaning is a must, but restrooms should be a top priority.   

“When you clean restrooms regularly, you keep germ and bacteria levels down,” he says. “The toilet area should be a top concern. Sinks and faucet handles are also important.”  

Restrooms are an obvious culprit for germs that most end users keep on top of. Where distributors see infection prevention programs lacking is in floor care. 

“The floor is the most contaminated place in most facilities,” says Gerba. “About 90 percent of the shoes we’ve tested had fecal bacteria on the bottom, and what’s on the floor gets pushed up into the air as people walk over it.”  

In addition to floors, distributors should work with end users to provide tools for interim cleaning by occupants. According to Gerba’s research, using disinfecting wipes for interim cleaning can reduce germs like E. coli, Klebsiella pneumoniae, Streptococcus, Salmonella, and Staphylococcus aureus by up to 99 percent. 

Disinfecting wipes are a great option for interim cleaning help from occupants, but experts stress that cleaning and disinfecting programs done by custodial teams should be a two-step process. Most distributors recommend pairing microfiber cloths with general cleaning chemicals to remove surface soils before moving on to disinfection. 

According to Hicks, most disinfectants only work if the surface has less than 5 percent soil on it. He stresses that surfaces that look dirty might have a more than a 20 percent soil level. In these situations, the disinfectant won’t work because it’s challenged by the soil load on the surface. Educating end users that cleaning these surfaces first will pave the way for more effective disinfection. 

Specify the Right Products

As most distributors know, a plethora of chemical solutions are available to combat infections, each tailored to specific threats. The key, say consultants, is to recommend chemicals that target the germs that are hardest to kill, something the industry strayed from during the pandemic. 

Hicks explains facilities scrambled to buy disinfectants bearing an U.S. Environmental Protection Agency’s (EPA) designation for SARS-CoV-2 (the virus responsible for COVID-19) during the pandemic. Yet, he underscores, “On the hierarchy of pathogens — from easy to kill all the way to hard to kill — COVID-19 occupies the lower rung.”  

He recommends distributors push disinfectants that are potent enough to combat formidable adversaries like C. diff, MRSA, and other resilient pathogens instead. Pay attention also to Candida auris (C. auris), a yeast strain capable of causing severe illness and rapid transmission within healthcare settings.  

According to Hicks, C. auris has a 30- to 60-percent fatality rate among the immunocompromised because it often resists antifungal treatments. Eradicating it is also challenging because of its ability to develop biofilm on surfaces. Experts agree that removing this yeast strain requires a powerful disinfectant.  

“If we use sporicidal disinfectants, we can neutralize this fungus or spore and also eliminate potential threats further down the list,” says Hicks. “Our aim should be higher — a broad net that captures and eradicates everything beneath it.”  

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Protocols Pivotal to Successful Infection Control