Cleaning & Disinfecting Environmental Surfaces
Why is cleaning important?
Cleaning is the necessary first step of any disinfection process. Cleaning removes organic matter, salts, and visible soils, all of which interfere with microbial inactivation. The physical action of scrubbing with detergents and surfactants and rinsing with water removes substantial numbers of microorganisms. If a surface is not cleaned first, the success of the disinfection process can be compromised. Removal of all visible blood and inorganic and organic matter can be as critical as the germicidal activity of the disinfecting agent. When a surface cannot be cleaned adequately, it should be protected with barriers.
What is the difference between disinfection and sterilization?
Disinfection destroys most pathogenic and other microorganisms by physical or chemical means. In contrast, sterilization destroys all microorganisms, including substantial numbers of resistant bacterial spores, by heat (steam autoclave, dry heat, and unsaturated chemical vapor) or liquid chemical sterilants. Disinfection does not ensure the degree of safety associated with sterilization processes.
What is the “spray-wipe-spray” or wipe-discard-wipe” technique?
Both techniques refer to the two-step procedure used to clean and disinfect environmental surfaces. If using liquid disinfectant, the user would spray the surface with the disinfectant and wipe it using a disposable towel to clean the surface (“spray-wipe”), followed by another “spray” to disinfect the surface. When using disposable disinfectant wipes, the process is described as wipe-discard-wipe because the user uses one wipe to clean the surface, discards the wipe, and uses a second wipe to disinfect the surface. Disinfectant products should not be used as cleaners unless the label indicates the product is suitable for such use. The Centers for Disease Control and Prevention recommends following manufacturer recommendations for use (e.g., amount, dilution, contact time, safe use, disposal).
What are the different types of disinfectants?
There are three levels of disinfection: high, intermediate, and low. High-level disinfectants, such as glutaraldehyde, are used as chemical sterilants and should never be used on environmental surfaces. Intermediate-level disinfectants are registered with the Environmental Protection Agency (EPA) and have a tuberculocidal claim, and low-level disinfectant are EPA-registered without a tuberculocidal claim (i.e., hepatitis B virus and HIV label claims).
Who regulates disinfectants?
The Environmental Protection Agency regulates low- and intermediate-level disinfectants that are used on environmental surfaces (clinical contact surfaces and housekeeping). The Food and Drug Administration regulates liquid chemical sterilants/high-level disinfectants (e.g., glutaraldehyde, hydrogen peroxide, and peracetic acid) used on heat-sensitive semicritical patient care devices.
The CDC has more specific details on disinfecting environmental surfaces.