Not all detergents are compatible with all types of disinfectants. Sometimes the residues from the detergent can stop the disinfectant from working properly.
Cleaning and Disinfection on the ward: 10 points for success By Tim Sandle There are two important aspects of contamination control on the hospital ward. These are: Through the use of cleaning and disinfection agents on surfaces, like floor, bedpans and bed frames, and mattresses. Ensuring that hands are clean. Hands, whether gloved or ungloved, are one of the main ways of spreading infection or for transferring microbial contamination. To avoid this, the use of a good hand sanitiser is required. To ensure contamination control is effective, the cleaning and disinfection agents need to be used appropriately. Failure to do so could lead to contamination being missed or, worse still, microorganisms becoming resistant.
There are 10 points for successful cleaning and disinfection. These are:
1. Use a detergent first When beginning cleaning, always use a detergent first. This is because disinfectants only work when dirt, grime, grease etc. have been removed from a surface. The order is always clean, then disinfect. 2. Pick a good detergent Not all detergents are compatible with all types of disinfectants. Sometimes the residues from the detergent can stop the disinfectant from working properly. Normally a neutral, low foaming detergent is best. 3. The type of disinfectant. Will the disinfectant kill all of the intended microorganisms? A good disinfectant will kill bacterial spores as well as vegetative bacteria (what is known as a ‘wide spectrum of kill’). 4. Compatibility The disinfectant used needs to be compatible with the different surfaces found within the ward or operating theatre. This includes lino, stainless steel and cotton. If the disinfectant is not compatible it will either not work very well (fail to kill all of the microorganisms) or it will damage the material. Furthermore, not all disinfectants work well at different temperatures. If there is a cold store, for example, it must be verified whether the disinfectant works at this temperature.
5. Residues Some disinfectants leave residues on surfaces. This can lead to bacterial resistance and can also leave the surface as sticky or discoloured, which is unpleasant for the nurse and the patient.
6. Action time The disinfectant must have a rapid in action with an ideal contact time of less than ten minutes. The contact time is the time taken for the disinfectant to bind to the microorganism and kill it. The longer the contact time, then the longer the surface needs to be left for prior to use. For the contact time the surface needs to remain ‘wet’. 7. Validation Not all disinfectants work or do not work for their intended use. Reputable manufacturers will validate their disinfectants against European standards. Check that the disinfectant has been CEN validated.
8. Practical use An important consideration is if the disinfectant is practical to use. Disinfectants come in all shapes and sizes. Some need to be made-up in buckets by adding different concoctions of chemicals together, others come ready-to-use in handy trigger sprays. Related to this is cost, the disinfectant must be affordable for the hard pressed hospital budget. 9. Health and safety It is necessary to check if the disinfectant is safe to use on the ward and what protective measures are needed. For example, should gloves be worn? Does the disinfectant generate fumes? Manufacturers should provide a COSHH sheet for each of their disinfectants. 10. Effective hand sanitisation Hand sanitisation is an important feature of working on and visiting a ward. As with surface disinfectants, it is important to know whether a hand sanitiser has been validated and meets the manufacturer’s claim. For use, it is important that the hand sanitiser is safe to use and does not dry out the skin. When using the hand sanitiser it is important to follow the correct technique: to rub the sanitiser into the skin and to cover all parts of the palm, back of the hand and the fingers and to keep rubbing for 30 seconds.
By following these ‘ten points for success’ detergents and disinfectants, along with hand sanitisers, can be used effectively on the hospital ward. It is important to be aware of each point and to incorporate many of them as part of the daily routine.
