While medical settings have always prioritized cleaning and disinfection of environmental surfaces, the need to protect healthcare workers and patients has become even more of a focus due to the COVID-19 pandemic. According to Deb Delisi, clinical affairs specialist at McKesson Medical-Surgical, "While COVID-19 didn't change protocols or base practices, it might have changed behavior if people had previously been taking shortcuts."
Read on to find out how your facility can make sure it's using best practices.
1 | Use the right formula for the right surface
One of the biggest mistakes Delisi sees in environmental disinfection is staff not using the right formulas for proper environmental cleaning and disinfection of patient areas. In particular, she mentions the importance of knowing the differences between "disinfectants," which kill germs, and "cleaners," which physically clean the surfaces.
In provider settings, there are multiple environments that present different risks and thus require different protocols. "No one product is appropriate for everything," she says. "Pay attention to what you're using it for and also the surface you're using it on."
For example, Delisi recommends looking at the instructions for use for exam tables, desks and other surfaces, as they can all vary. It's also important to consider frequency; high touch surfaces and high traffic areas generally require more frequent cleaning and should be cleaned once a day or more often, according to the CDC.1
For more information on choosing the appropriate product, she refers practitioners to "List N," a tool from the Environmental Protection Agency (EPA), to understand which products meet the EPA's criteria for use against COVID-19.2 The database makes it easy to search existing products by inputting the EPA Registration Number from the label or find a disinfectant to use from the product list. List N also shows what other viruses a product can help kill.
2 | Follow directions for application carefully
Not only do you need the right product, but you need to use it correctly, such as diluting it as indicated. One factor that is often overlooked is contact time, also called kill or dwell time, the length of time a surface needs to remain wet with a disinfectant in order to achieve the claimed disinfection activity. "Some products need to stay wet on the surface for a certain amount of time to work effectively," says Delisi, cautioning healthcare workers to always refer to directions and follow them closely.
In addition, staff must use the appropriate personal protective equipment (PPE), whether it's a mask to avoid inhaling harsh chemicals, eyewear to protect from harmful splashes or gloves to keep products off your hands. And make sure you have adequate ventilation to reduce any fumes.
3 | Train staff thoroughly on environmental disinfection
On the same note, it's important to make sure that staff understand the procedures for cleaning various surfaces. According to the OSHA Emergency Temporary Standard (ETS), at least one safety coordinator should be designated to implement and monitor COVID-19 infection control principles and practices.3 Then, set a cleaning schedule for all surfaces in your medical facility.
The safety coordinator should have the authority to ensure full compliance with the COVID-19 ETS plan.3 They can monitor the cleaning schedule and help establish policies to protect and train workers, such as how to read labels on cleaners and disinfectants and what PPE to wear when using hazardous chemicals, referring to the safety data sheet for specific cleaning and disinfection products.
4 | Make your environmental cleaning & disinfection practices clear to patients
Sometimes, it's not practical to clean in front of patients, especially if a surface has to stay wet for a certain amount of time. However, the more you can highlight your facility's protocols, the more comfortable your patients may feel. That might mean posting references to explain the various precautions you are taking, including the precautions you take to clean areas like exam rooms between patients.
Take care to adhere to sanitation procedures when patients are present whenever you can, such as using proper hand hygiene and focusing on safety measures in the reception area. "Wipe down the desk while patients are waiting, space out chairs, have separate bins for clean and used pens... these touches can make visitors feel confident that sanitation is a priority," Delisi says.
Check out these posters you can download and post in your facility to remind both patients and staff about best practices:
- Five critical moments for infection prevention (primary care)
- Five critical moments for infection prevention (extended care)
- How to hand wash
- Steps for proper handwashing
- New facility protocols for primary care
- New facility protocols for extended care
© 2021 McKesson Medical-Surgical Inc.