Surface Wipe Disinfectants: Part II
Nancy Andrews, RDH, BS
The evolution of environmental surface cleaning and disinfection--from the early use of 2 x 2 gauze squares moistened with alcohol, soap and water, or other solutions, to generalized spraying of rooms--now continues with the popular use of presaturated wipes that disinfect quickly and efficiently. Part I (http://staging.thenextdds.com/Articles/Surface-Disinfectant-Wipes--Part-I/) of this article focused on the considerations for using pre-saturated surface disinfectant wipes and a review of the two-step process for cleaning and disinfecting, part II will present selection criteria.
Features that should be considered when selecting surface disinfectant wipes:
1. EPA-registered hospital disinfectant. Use an EPA-registered hospital disinfectant that is effective against HBV and HIV or with a tuberculocidal claim (eg, intermediate-level disinfectant). Refer to the product label for EPA-approved uses. Examples of approved uses are cleaning and disinfecting hard, nonporous surfaces (not skin).
2. Time necessary to kill tuberculosis (TB)—ie, time a product should be left on a surface to destroy TB (a difficult organism to inactivate), and presumably other organisms that are easier to kill.
3. Cleaning ability--the ability to dissolve organic materials and lift debris from surfaces. Products with less than approximately 23% alcohol are likely to clean well, and many also have rapid TB kill times.
4. Tendency to damage materials. Products with high alcohol or bleach may corrode or rust surfaces, while other products may likely stain surfaces.
5. Toxicity. Toxic chemical ingredients are usually present in EPA-approved surface disinfectants only in amounts considered safe to use as directed. However, some patients may be highly sensitive or allergic, and may wish to limit exposure to toxic chemicals.
5. Alcohol content. A high content (over about 23%) means the product should be used only for step 2 (disinfection) following the use of an appropriate pre-cleaner. Select a pre-cleaner with compatible chemistry.
6. Directions on most surface disinfectants indicate that use on “hard nonporous surfaces” is acceptable; this does not include chair upholstery. Today, plastic chair covers are favored to preserve both the upholstery and the electronics inside the chair. Wipes should be used sparingly in a combined protocol with barriers and will reduce dripping, damage, and oversaturation of equipment, which may seep into the electrical wiring or electronic circuitry.
7. Suggested rinsing. Some products should be rinsed at intervals to prevent buildup of chemical residue, surface damage, and discoloration.
8. Cost. The cost of using a presaturated surface disinfectant wipe, compared to spray disinfectants, should be weighed against the cost of paper towels and waste, possible long-term damage to surfaces, and possible health risks from spray aerosols. If the option of “making wipes” by saturating gauze in containers is considered, it should be remembered that the solution may be affected and altered by the gauze over time. Any unused wipes should be discarded at least daily, and again, employee time must be considered. In contrast, presaturated wipes are stable when stored.
9. Container design. Lid should seal to prevent evaporation.
10. Towelette size and quality. Some brands use towelettes that tear, are difficult to handle, or are too small.
11. Availability of both spray and presaturated wipes in a single product (compatible chemistry).
*OSAP member and consultant on infection control.