It’s All About the Cleaning (Part 2)

It's All About the Cleaning (Part 2)

Although cleanliness is next to godliness, it’s also very closely related to disinfection. In fact, cleaning can avert the need to disinfect in some situations because clean and dry surfaces can’t harbor microbial growth for very long.

A disinfectant kills microbes. However, depending on the pathogen, preventing microbes from getting a foothold by removing food and moisture (two essentials for sustaining living organisms), in the long-term, is as effective as a chemical disinfectant. In fact, most chemical disinfectants can’t do their job when high levels of organic soil are in the way. Soil can absorb the active ingredient, provide more places for the germs to hide, and change the chemical nature of the disinfectant. By removing the soil with an appropriate cleaner, you give the right disinfectant a much better opportunity to kill the target bugs.

Removing Soil

Washing or scrubbing a surface physically removes the soil and organic material such as blood and body fluids, and takes with it many pathogens.
The guiding principle is always to remove germs if possible rather than kill them, and then, when necessary, use the least amount of the mildest chemical or other product that will do the job, because stronger often means more toxic to people and the environment.

To reduce airborne dust and germs, wet dust horizontal surfaces daily with cleaning cloths pre-moistened with detergent or a U.S. EPA-registered hospital disinfectant or disinfectant wipes. Or, better yet, use vacuums with HEPA filtration so long as the equipment is maintained so as to ensure efficient particle removal.

Minimizing Contamination While Cleaning

In March 2015, this was a headline on the internet news wire, “Dirty Mops Blamed for the Spread of Norovirus.” It seems as though 33 patients contracted the stomach virus within 48 hours of admission. During the surveillance and attempts to limit or control hospital-acquired Noro, they discovered that the cleaning crew was using dirty mops to clean the floors in patient care areas. These same soiled mops had evidently been used to clean up body fluids from sick patients.

If you read on down in the article, this statement is the real indictment, “Dr. Clive Graham, Director of Infection Prevention and Control, said there were a number of contributory factors, but among those felt to be most pertinent was the need for greater monitoring and assurance regarding cleaning and reinforcing good practice among staff, and a failure to achieve high cleaning and waste management standards. And, in a list of factors contributing to the outbreak of Norovirus, Dr. Graham cited “Poor leadership and support to cleaning teams.”

According to the CDC (Centers for Disease Control) in the United States:

Minimize the contamination of cleaning solutions and cleaning tools. Bucket solutions become contaminated almost immediately during cleaning, and continued use of the solution transfers increasing numbers of microorganisms to each subsequent surface to be cleaned. Cleaning solutions should be replaced frequently. A variety of “bucket” methods have been devised to address the frequency with which cleaning solutions are replaced. Another source of contamination in the cleaning process is the cleaning cloth or mop head, especially if left soaking in dirty cleaning solutions. Laundering of cloths and mop heads after use and allowing them to dry before re-use can help to minimize the degree of contamination. A simplified approach to cleaning involves replacing soiled cloths and mop heads with clean items each time a bucket of detergent/disinfectant is emptied and replaced with fresh, clean solution.

The CDC recommendations represent the minimum standard. The “Best Bucket Method” would be to set up a bucket of properly diluted disinfectant or cleaner, and then place clean cloths into the solution. When needed, the cleaning professional simply reached into the solution, retrieves a clean, charged cloth, wrings excess fluid from it, folds it in half, then half again thus providing 8 surfaces with which to wipe. She/he NEVER returns a contaminated/used cloth to the bucket solution. Instead, the cloth goes into a collection bag for laundering later that day.

When it comes to laundering mops and wipers in a healthcare setting, one should assume that normal “household” laundering methods are inadequate to neutralize pathogenic organisms. A better approach would be to launder at temperatures of 160 degrees F. for at least 20 minutes and dry them in a commercial dryer for at least 45 minutes. After processing the mops and wipers, place them in a clean, sanitary environment until they are ready for use.

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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