While looking around the internet, I keep seeing funny (and some times crude) pictures with a caption “___________ like a Boss!” You can fill in the blank by doing a Google search of “Like a Boss”. From what I can tell, the term is the equivalent of “Numero Uno”, “Top Dog”… Being an older adult who wants to seem cool, hip, off the chain, the bomb, lets talk about “Disinfecting like a BOSS!”
Of course, I am talking about infection prevention or infection control. You, too, can “Disinfect like a BOSS!” So, let’s get started with some things you need to know if you’re going to be BOSS.
Read a disinfectant’s label like a BOSS! Did you know that a disinfectant’s label is a legal, enforceable document? The label supersedes what the salesman told you or what the sales brochure claims. It is important for you and your staff to know what is on that disinfectant’s label. Look for the following information for proper selection and use in the workplace:
- EPA Registration Number—either as a set of two numbers (e.g., 9999-8888) or three numbers (e.g., 9999-8888-7777)
- Organisms on the “kill list” (look for the ones that you are most concerned about in your facility [i.e., MRSA, VRE, Acinetobacter baumannii, influenza A & B, Norovirus, etc.]);
- Is the disinfectant efficacious against both gram positive and gram negative organisms?
- Dilution instructions—clear and specific (what ppm water hardness, in the presence of blood, different pathogens, in order for the disinfectant to be tuberculocidal, can it be mixed in potable water or does it have to be “mixed in sterile water only”;
- Does it have a shelf-life? (if so, how does your facility insure that the disinfectant is not out of date?);
- Use and reuse instructions—clear and specific. Is the product a “One Step Cleaner and Disinfectant”, or, is it only effective on pre-cleaned surfaces?
- If the product has differing kill times for 7 different organisms, you have to go with the highest number of minutes. Since you don’t know what organism is on the surface, you have to go with the organism with the longest time to kill.
Apply the disinfectant like a BOSS! Have you considered the manner in which your disinfectant is being delivered to the surface by the Housekeeping staff? Have you investigated how long the disinfectant remains wet on the surface once it is applied? Which disinfectant delivery is BEST PRACTICE: sprayer, flip top or open bucket?
- Using a sprayer (spray-maker) on a bottle of disinfectant is akin to “spray and pray”; the end-user has to “spray and pray that the surface remains wet enough to remove the soil burden and the pathogens that dwell there.” Using a spray-maker is wrong on two levels: 1. The surface is not made and kept sufficiently wet for a label’s prescribed amount of time to kill organisms; 2. Spraying disinfectants and other cleaning chemicals may cause chronic asthma and upper respiratory problems for Housekeepers who suffer the long-term effects (see my blog titled “A ‘Breathtaking Experience'” on www.darrelhicks.com.). Disinfectants are registered as pesticides by the U.S. EPA (Environmental Protection Agency). When that pesticide (disinfectant) is atomized by a Housekeeper as she sprays it on practically every surface in a patient’s room, that Housekeeper breathes the chemical into his/her lungs. What would a prudent man do? If you want to keep your facility out of the cross-hairs of OSHA (U.S. Occupational Safety and Health Administration), find a better way to deliver disinfectants; your staff will thank you. The elimination of atomized cleaners and disinfectants is covered in OSHA’s General Duty Clause which basically asks, “What would the prudent man (woman) do?” One exception to “no spray-maker” rule is when the sprayer actually produces a clinging foam cleaner/disinfectant such as P&G Liquid Comet that is used on porcelain tubs, sinks and toilets. The sprayer produces a foaming product that clings to vertical surfaces.
- Using a flip top spout on a bottle will deliver a more consistent stream of disinfectant to a surface or a microfiber cloth. Flip top bottles steer clear of the problem of atomizing disinfectants and causing chronic respiratory problems for housekeepers or others applying them. Thus, the flip top keeps you and your organization out of OSHA’s cross-hairs.
- The best practice for applying disinfectants is by the open bucket method with the qualification that a soiled/used cloth never goes back in the bucket. a. The clean bucket is filed with properly diluted disinfectant and then clean microfiber cloths are added to the bucket. b. Wring the excess disinfectant from the cloth, fold it in half, then half again. This practice provides 8 cleaning/disinfecting surfaces. c. Use one cloth for the patient’s room and a 2nd cloth for the rest room. d. The guiding principle is that the soiled cloth goes into a laundry bag when finished; not in the bucket. The surface is wet enough to do a proper job of cleaning and remain wet for 4-6 minutes. The CDC (U.S. Centers for Disease Control and Prevention) states that if a disinfectant is applied to a surface and that surface remains wet for 3 minutes, that should be sufficient “kill time” or “dwell time” to kill the pathogens.
“Disinfecting Like a BOSS!” Part 2 is coming.