CS CONNECTION The do’s and don’ts of cleaning with chemicals by Kara Nadeau P

atients expect to leave a healthcare facility healthier than when they came in, but healthcare-associated infections (HAIs) and antibiotic-resistant organisms pose a real danger to patient safety and care. These dangers can come from the items used on patients (e.g., non-invasive diagnostic equipment) or in patients (e.g., surgical instruments and devices), and even those in the patient care environment (e.g., high touch surfaces, pens, cell phones).

While disinfectants and sterilants are critical weapons in a healthcare facility’s arsenal when it comes to fighting HAIs, their effectiveness comes down to a number of factors, including proper product selection, safe shipping and storage, and correct usage in conjunction with safety data sheets (SDS) and instructions for use (IFU).

We reached out to manufacturers to obtain their insights on the top factors healthcare organizations should take into consideration when selecting disinfectants and sterilants, as well as the latest trends and products in this area.

Stick to standards for quality and safety

Healthcare organizations have increasingly adopted best practices from other industries, such as manufacturing, to improve quality, efficiency and safety. One key learning has been that process variation increases the risk for errors, while standardization improves outcomes. As quality management expert W. Edwards Deming is quoted as saying: “Un- controlled variation is the enemy of quality.” With regards to disinfectants and sterilants in healthcare, experts agree that standardized processes based on industry guidelines and manufacturer recommendations promote effectiveness and safety.

IFUs Central sterile/sterile processing de- partment (CS/SPD) professionals and manufacturers acknowledge that the manu- facturer’s IFU is the ultimate guide to sterile processing. As Melinda Benedict, MS, CIC, CFER, Manager of the Infection Control Program for Olympus Corporation of the Americas, points out, the IFU includes recommendations for

Melinda Benedict

detergents, disinfectants and sterilants used in the processing of the item.

“It is most important that those responsible for reprocessing instruments follow the FDA- validated reprocessing instructions provided by the manufacturer,” said Benedict. “The integrity and safety of instruments is depen- dent upon the instructions being followed carefully.”

Safety data sheets and labels

But it’s not enough to follow the instructions for the instruments being processed. Health- care staff members must also familiarize themselves with the disinfection and steriliza- tion methods being used. That’s where safety data sheets (SDS) and product labels come in. While healthcare organizations are focused on the safety and care of patients, they can’t forget the safety of their own staff, especially when it comes to disinfectant and sterilant use. According to the World Health Or- ganization (WHO), hospital cleaners and disinfecting chemicals can cause respiratory and reproductive disorders, eye and skin ir- ritation, central nervous system impairment, cancers and other human health effects.1 These products are designed to kill. While that’s beneficial for eradicating dangerous microbes, it presents a real danger to the healthcare staff using them. Under the U.S. Occupational Safety and Health Administration’s (OSHA) Hazard Communication Standard (HCS) (29 CFR 1910.1200(g)), chemical manufacturers, distributors or importers must provide SDS (formerly known as material safety data sheets or MSDS) to communicate the hazards of hazardous chemical products.2


includes the properties of each chemical; the physical, health, and environmental health hazards; protective measures; and safety precautions for handling, storing and trans- porting the chemical.

“Any item that can kill organisms can also harm humans, so consideration must always be taken,” said Emily Lorcheim, Brand Manager for ClorDiSys. “A tool that can bet- ter assist a user is to review the SDS, which describes necessary precautions that need to be made during and after application.” Lorcheim points out how all disinfectants

and sterilants used in U.S. healthcare facilities must be registered with the U.S. Environ- mental Protection Agency (EPA) before sale or distribution; therefore, the product’s EPA label is another good source of information. “When determining whether or not to choose between a disinfectant or a sterilant,


one must first consider how high of a kill level is needed,” said Lorcheim. “Disinfection is de- fined by the EPA as the kill of bacteria, where- as sterilization is the statistical elimination of all viruses, bacteria and spores, and results in a 99.9999 percent, or 6-log, kill. Sterilization methods are needed for certain circumstances in healthcare such as implantable medical devices, the outbreak of significant disease, etc. An EPA label will provide information such as what it can kill, the level of kill it can provide and usage instructions.”

Staff education

As with IFUs, effective use of SDSs and prod- uct labeling information for disinfectants and sterilants requires more than providing staff with these resources and expecting them to follow the instructions. Healthcare organiza- tions must invest in ongoing staff education to promote learning and best practices for pro- cess standardization based on these materials. “Disinfectants and sterilants are registered by the EPA or the U.S. Food and Drug Admin- istration (FDA) and all label instructions are carefully considered and reviewed in order to provide correct usage for the most effec- tive outcome,” said Alison Behn-Gartland, Customer Technical Sales Director for Micro Scientific. “Because these chemicals provide an important task, users should ensure they are reading, understanding and following these labels in their fullness.” Penny Sabrosky, Clinical Educator for Kem

Medical Products, explains how education should go beyond routine disinfectant and sterilant use, to encompass unexpected events such as spills and other emergency situations. “It is of utmost importance to educate staff to the standard nomenclature of the chemicals being used in applications throughout the department,” said Sabrosky. “In the event of an emergency, staff must be able to correctly identify the chemical being utilized in order to properly reference the SDS. During an emergency, simply referring to brand names of a process, rather than the correct names of the specific chemical substances, can lead to confusion and delayed response times.” Kem Medical’s KemSure Spill Control

Kits provide all components necessary to rapidly respond to small spills of hazardous liquid chemicals used in sterile processing departments. Kits contain Chemsorb Spill Response Pillows to absorb and collect liquid, KemSafe neutralizing powders to deactivate and neutralize hazardous chemicals, and

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