Disinfectant Doubts Should Lead to a More Robust Infection-Prevention Program

Disinfectant Doubts Should Lead to a More Robust Infection-Prevention Program

Antimicrobial pesticides are designed to destroy or suppress harmful bacteria, viruses, and other microorganisms on inanimate objects and surfaces in hospitals and other settings.

The U.S. EPA (Environmental Protection Agency) has a testing program–the ATP–whose purpose is to ensure that EPA-approved hospital disinfectants and tuberculocides in the marketplace continue to meet stringent efficacy standards. Products found to be effective are reported to the public on an EPA website, and those that do not meet the ATP efficacy standards need to be brought into compliance.

On September 19, 2016, the Inspector General (IG) for the EPA issued the latest in a long line of reports identifying flaws in EPA’s process for ensuring the efficacy of hospital-grade, hard-surface disinfectants. The IG concluded that EPA’s Antimicrobial Testing Program “does not assure that hospital disinfectant products continue to be effective after they are registered” and that some products listed as effective on EPA’s ATP website “could now be ineffective” (emphasis mine) due to inconsistencies in manufacture products, product degradation or improper quality assurance. {EPA IG, EPA Needs a Risk-Based Strategy to Assure Continued Effectiveness of Hospital-Level Disinfectants, Report No. 16-P-0316 (Sept. 19, 2016) (“2016 IG Report).

The report’s findings suggest that hospitals and other health care facilities should use diligence in selecting hard-surface disinfectants while avoiding overreliance on disinfectants alone and develop robust infection prevention protocols in order to minimize the risk of increased HAI rates among patients and staff, and the related legal exposure and reimbursement consequences.

Having an effective infection prevention and control program is a key Condition of Participation (CoP) under Medicare. Although, in general, the CoP rules allow hospitals flexibility in aligning their programs with nationally recognized practices and guidelines, hospitals are expected to use EPA-registered disinfectants. Moreover, federal regulators are proposing to strengthen the infection prevention CoP and heighten the role and accountability of a hospital’s governing body in program implementation and oversight. As hospitals assess the effectiveness of their infection prevention programs, the 2016 IG Report suggests that hospitals may not necessarily want to rely on EPA registration alone.

When re-tooling your infection prevention program to meet the CoP, don’t neglect those on the front-line of infection prevention, the cleaning professionals in your organization. The time has come to turn cleaning professionals into Certified Environmental Services Technicians (CEST). Moreover, infection prevention will only become a reality when the CEST is properly regarded, educated and equipped.

The CEST must be:

  • Well trained
  • Equipped with the best in class tools to clean, sanitize and disinfect
  • Allotted time to do the necessary tasks
  • Provided the tools to enable scientific measurement to “measure clean”
  • Educated about the prevention and transmission of disease

For information regarding the CEST Program, go to:

About Darrel Hicks

J. Darrel Hicks, B.A., is the author of Wiley Publishing's "Infection Prevention For Dummies", and is nationally recognized as one of the top experts in infection control. Darrel Hicks is also the Past President of the IEHA and is an active member in AHE where he holds the designation of CHESP. View all posts by Darrel Hicks

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