Patient Room disinfection

Patient Room disinfection
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Disinfection
Since 1950, Betco has been an industry leader
in supporting facilities maintenance professionals.
Our journey has taken us through a resource
evolution, from chemical cleaning compounds
to equipment and from programs to processes
for success.
Patient Room
Better Resources.
Better Results.
Patient Room
Disinfection
Training Library
Workbook
Contents
1.
Introduction
2.
Types of Disinfectants
3.
Safety Precautions
4.
Preparation
5.
Disinfecting Procedures
a) Daily Clean - Occupied
b) Daily Clean - Isolation/Occupied
c) Detail Clean
d) Project Clean
6.
Clean Up
7.
Summary
8.
Supply Checklist
9.
Certification Exam
Appendix
Glossary
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Section 1.
Introduction to Patient Room Disinfection
With today’s onset of antibacterial products and modern
scientific advancements, one would assume that the fight
against infection would be a diminishing battle. In
actuality, it just means that new, more resistant, diseasecausing microorganisms are evolving. One major area for
concern is health care facilities. Hospital acquired
infections often referred to as nosocomial infections, rank
among the 10 most frequent causes of death in the United
States. Interest in disinfectant efficacy has increased in
response to the growing numbers of nosocomial infections
as well as to the number of immune deficient patients, who
are susceptible to infections.
Proper disinfection is extremely important to limit and
control the growth of microorganisms and the spread of
infection. Your job is critical in controlling the spread of
harmful organisms and in turn creating a healthier
environment …which may even save someone’s life.
This training module, which is one in the Betco Resource
and Process Management™, or RPM Library series,
focuses on procedures and recommendations for proper
disinfection of a patient room in a hospital or long term
care facility.
The module will cover:
• Types of Disinfectants
• Safety Precautions
• Preparation
• Patient Room Daily Clean - Occupied
• Patient Room Daily Clean - Occupied/Isolation
• Patient Room Detail Clean - Discharge
• Patient Rooms - Project Cleaning
• Cleanup Procedures
Betco has over 300 specialty cleaning products and a full
line of equipment and accessories. We recommend the
following Betco cleaning system to assist in disinfecting
areas for patient rooms:
• Quat-Stat™ - broad-spectrum disinfectant excellent
for meeting the requirements of the OSHA Bloodborne
Pathogen Standard.
• Deep Blue - or Clear Image glass and surface cleaner·
• Glybet™ - disinfectant spray·
• Winning Hands® Premium Antibacterial Hand Cleaner
• pH7 - All Purpose Neutral Cleaner for vents light
fixtures and porous surfaces.
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Section 2.
Types of Disinfectants
A disinfectant is an agent that destroys, or inhibits the
growth of disease causing microorganisms. Hospital
disinfectants must be efficacious against Staph.,
Salmonella and Pseudomonas.
It is important to understand the different types of
disinfectants that are available.
The most popular types of surface disinfectants are:
•
•
•
•
•
Synthetic phenols
Quaternary ammonium products, commonly referred
to as quats
Chlorine, also called bleach
Iodine
Alcohol
Synthetic phenols kill a wide range of organisms and are
widely used in operating rooms. They are excellent
products for destroying the tuberculosis organism and do
not lose their effectiveness in a soiled environment. They
are corrosive and should never be used around newborns.
Quats are the most widely used disinfectant used in the
market today due to their versatility and cost
effectiveness. They kill a wide range of microorganisms
including Staph, Salmonella, and Pseudomonas. Quats are
less corrosive and are used in schools, institutions,
supermarkets and hospital settings.
Hypochlorite/Bleach is corrosive and should be
restricted in use. It should not be used in general building
operations because of the potential of interacting with
other chemicals, which can result in a toxic gas. Although
it can be used as a disinfectant or sanitizer, it is not an
effective cleaner. Never mix bleach with another chemical.
Iodine is a powerful disinfectant that, when used in the
form of iodophors, will kill a wider range of pathogens than
quats and phenolics. As a primary use disinfectant it is not
desirable due to its staining properties. Because of
iodine's acidic qualities, its use is restricted to specialized
areas, such as surgical settings.
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Alcohol provides an efficient means of killing pathogens.
Typically, ethyl or isopropyl alcohol is used for smaller area
surface disinfection. These products are usually packaged
in sealed aerosols or smaller-use containers, since alcohol
can pose a fire hazard.
See glossary for further definitions on page 18
Disinfecting reduces the risk of cross-contamination. Most
germs must hitchhike to get around and since we touch so
many surfaces throughout the day, the likelihood that we
will pick up germs is virtually guaranteed. Be aware that a
microorganism can hitchhike in various ways. Skin to skin,
on materials such as laundry or sponges, droplets from
coughing and sneezing, airborne dust particles, food,
water and insects or animals are all ways that infectious
microorganisms can be transmitted.
Section 3.
Safety Precautions
Before beginning with any cleaning task be sure that
you fully understand how to use the chemicals and
equipment required for the job. It is regulated by OSHA
that every employee has a right to know about chemical
hazards within their workplace. A Material Safety Data
Sheet, commonly called an MSDS will provide
information regarding the chemicals within your
building. Read and understand the MSDS, as well as
the product label for every product that you use. Your
supervisor will show you where to find your MSDS
information and will also help you to read and
understand each sheet.
Be careful not to use cleaning chemicals on any surface
for which they are not intended. Be especially cautious
when using acid cleaners. Never mix chemicals, it could
cause serious or even fatal injury.
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Practice universal precautions when cleaning any blood
or body fluid spills, or soiled materials that could
contain these or other potentially infectious
substances. Refer to OSHA’s Bloodborne Pathogen
standards for more information. Betco provides a
Bloodborne Pathogen training module within the RPM
Training Library series.
Accidents will be limited when the proper caution signs
are posted prior to cleaning, such as “Wet Floor” signs.
Always wear the proper Personal Protective Equipment
or PPE to protect yourself from exposure to cleaning
chemicals. Gloves and a mask, or goggles will prevent
chemical splashes from coming into contact with your
skin and eyes.
In hospitals, direct contact is the most common mode
of transmission. One of the best ways to reduce crosscontamination, besides proper disinfection, is frequent
hand washing. The physical action of hand washing
will greatly reduce the number of bacteria on the skin,
and reduce the chances of cross-contamination. The
less contamination, the healthier the environment.
Section 4.
Preparation
Review your supply checklist and gather the proper
cleaning equipment such as gloves and goggles, paper
supplies, properly labeled cleaners, a high dusting tool,
dry mop with handle, dust pan and brush, mop and
bucket with wringer, caution signs and any other
applicable supplies.
A supply checklist can be found on page 14
Be sure that the correct dilution rates are used
according to manufacturer’s recommendations. Betco
Chemical Management Systems ensure that dilution
rates are correct and make your job faster and easier.
Always prepare disinfectant solutions fresh daily or
more often if a solution becomes visibly diluted or
soiled in order to ensure their effectiveness.
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Section 5a.
Patient Room Daily Cleaning - Occupied
Never push your cleaning cart into the room. Take only the
supplies and equipment needed for the task.
Always knock and greet the patient and his or her visitors
in a friendly manner and identify yourself explaining why
you are there. It is important to excuse yourself if a doctor,
nurse, minister or other clinical person is in the process of
any type of procedure or discussion. Explain that you will
come back at a more convenient time.
Remember these 3 simple rules for cleaning:
1. Clean from top to bottom. Bringing soil to the
lowest level as you go about your routine.
2. Perform dry procedures before wet procedures,
such as waste removal and paper refilling before
wiping and mopping.
3. When wiping, clean in a consistent pattern such as
up and down then back and forth, to ensure that
you cover an entire surface. Be sure to overlap your
strokes.
First, empty the trash and bring the filled liner to your cart
for disposal. Never compress the trash in case there are
hidden sharps or contaminated materials inside. Spray
the inside and outside of the receptacle with a spray
disinfectant such as Glybet™ and replace with a clean
liner.
If housekeeping is responsible for infectious waste receptacles, be sure to empty them according to hospital
procedure. Follow Bloodborne Pathogen Universal
Precautions for clean up of any spills or spatters. Report
any damage or leakage to your supervisor.
Check all paper dispensers. Clean and refill them, as
needed. Damp wipe the dispenser with a disinfectant.
Betco’s broad spectrum disinfectant Quat-Stat™ can be
utilized for all disinfecting in a Patient Room.
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Spray the outside of the toilet and sinks with a disinfectant. Move on to the next task allowing the disinfectant to
sit for 10 minutes. It is important to come back and wipe
up overspray after the 10 minute contact time. Be sure not
to let anyone enter the area until you have wiped.
Damp wipe the outside of all furniture (except the patient’s
bed). Use a disinfectant on all hard nonporous surfaces
such as window ledges and counters. Use a neutral
cleaner on porous surfaces. Do not open drawers or
disturb the patient’s belongings. Where it is necessary to
move newspapers, magazines, flowers or other articles in
order to clean, be sure to handle them with care and return
them to their original location. Never discard the patient’s
personal belongings.
Beginning at the door and working clockwise around the
room, spot clean all visible soil from walls with a disinfectant. Damp wipe door knobs, hand rails, light switches
and push plates with disinfectant. Be sure to thoroughly
damp wipe the phone, cord and dial plate. Do not wipe
directly over the patient. This includes the over-bed light.
Cleaning cloths should be changed frequently to avoid
cross-contamination.
Return to the restroom and follow Betco Resource and
Process Management™ Restroom Sanitation procedures.
As an additional precaution, use a spray disinfectant, such
as Glybet™ on areas that people continually touch such as
door knobs, push plates and hand rails.
Post “Wet Floor” caution sign and begin to dry and wet
mop the floor from the farthest corner to the door. Collect
the dirt and debris in a dust-pan at the door and dispose
of it in your cart’s trash bag. Use a disinfectant solution
for wet mopping. If there is carpeting, vacuum traffic
areas.
Properly remove your gloves. Wash your hands thoroughly
using plenty of soap, such as Betco’s Winning Hands®
Premium Antibacterial Hand Soap.
Before leaving the room make a final inspection to be sure
that furniture and patient belongings are in there original
location. Also check to make sure that you did not leave
any spray bottles, bags or equipment.
Let the patient, family or visitors know that you are finished and thank them. Remind them that the floor will be
slippery until it is completely dry and ask them to be
cautious.
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It is important to get into the routine of cleaning the room
in the sequence indicated in this training. In addition to
saving time, working the same way each time will reduce
the chances that you might overlook a task or area.
Change the disinfectant solution in the mop bucket if it is
visibly soiled or diluted or if there is a bloodborne pathogen risk or if you used it in an isolation room, otherwise
change the solution every third room.
Section 5b.
Isolation Patient Rooms - Daily Cleaning - Occupied
When cleaning an isolation patient room, always follow the
protocol for your hospital.
Often, signs are posted on the doors to indicate what
Personal Protective Equipment is required. Remember to
practice Universal Precautions. This, in combination with
the PPE ensures your personal safety as well as the
patients.
Clean the room as you would any other occupied room
with the following exceptions:
•
Immediately bag all cloths, wet mop heads, and dust
mop heads used in the room as infectious waste.
DO NOT use them in any other area.
•
Properly remove any gloves, gowns, or masks after
you have cleaned the room and dispose of them in the
proper waste receptacle immediately after leaving the
room.
•
Wash your hands thoroughly.
•
After cleaning the room, decontaminate any
equipment that has been visibly soiled such as mop
handles, buckets and castors with disinfectant.
•
Thoroughly rinse out the mop bucket and wringer
and replace with clean water and disinfectant before
cleaning the next area.
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Section 5c.
Patient Room Detail Clean
Discharge (Regular & Isolation)
Once the patient has been discharged, additional
cleaning procedures are required.
First, check the room for personal belongings that the
patient may have left in the room. If you discover any,
carefully place them into a plastic bag, secure and
label. Take the bag to the nurse's station.
Follow the daily occupied patient procedures but add
the following tasks to your cleaning:
Beginning at the door of the room, move clockwise
around the room, dust everything above shoulder
height with a high dusting tool, finishing back at the
door.
Using a disinfectant, spot clean all visible soil from
the walls, window sills, blinds and other vertical
surfaces, including door frames.
Over-bed lights are major dust collectors and are
prime sites for the transportation of dust particles
onto the patient. Before cleaning the over-bed light,
turn the lamp off. Damp wipe using a disinfectant
and a clean cloth.
Report any burned out bulbs or any other visible
problems such as broken furniture or damaged
fixtures to maintenance.
To clean the over-bed table, wipe the tray top,
inside drawer and underside with a disinfectant.
Wipe down the legs, base and wheels of the table.
Remove any hair from the wheels.
Handle linens and bed making according to
procedure.
Damp wipe the entire bed with a disinfectant
including the frame, headboard and footboard.
Clean all sides of the mattress according to
manufacturers recommendations, and turn it. Fold
it back so that you can wipe off the springs
underneath. Raise the bed up and carefully wipe off
all areas underneath. Be especially careful to clean
the casters as well.
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Thoroughly clean the patient locker with a
disinfectant. Be sure to wipe all corners and edges
carefully.
Damp wipe the TV control unit with disinfectant.
Never spray the controls directly.
Spray and wipe all chairs and other furniture. Be
sure to read label before spraying certain surfaces.
Follow cleaning procedures for fabric chairs.
Clean mirrors and windows with glass cleaner such
as Betco’s Clear Image.
Clean visible soil from the entrance door, door
frame, kick plate, chart holder, room sign and the
general vicinity of the entrance.
Clean the restroom according to restroom sanitation
procedures.
Dust mop the floor followed by wet mopping with
disinfectant. Pay close attention to baseboards,
corners and underneath furniture.
Properly remove gloves and wash your hands.
Make a final inspection of the room. Notify the
appropriate person that the room is clean and ready
for the next admission.
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Section 5d.
Patient Room - Project Cleaning
Project cleaning is usually completed in conjunction
with detail cleaning of the room, anywhere from once a
month to once a quarter or even biannually, depending
on the facility’s needs. Betco’s Resource and Process
Management™ will assist your facility to establish a
schedule for project cleaning as well as detail cleaning.
In addition to the tasks listed for detail cleaning
procedures, the following activities may be included as
project cleaning for patient rooms:
•
•
•
•
•
•
Strip and recoat hard floors
Scrub and recoat hard floors
Carpet bonnet cleaning or extracting
Grout scrubbing restroom tile
Clean all vents and grills with Betco’s pH7 All Purpose
Neutral Cleaner
Wipe down ceiling and walls
Betco provides the complete bundle for any of these
cleaning procedures including a full line of equipment
such as autoscrubbers, carpet extractors, floor
machines, vacuums, grout scrubbers and pads.
Section 6.
Cleanup Procedures
When finished with all necessary procedures and all
surfaces are dry, remove any posted signs.
Bag the soiled mops for daily laundering. Never leave
them sitting in buckets.
Remember to disinfect the used cleaning equipment as
well. Disassemble and disinfect on a routine basis with
Quat-Stat™.
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Section 7.
Summary
In reviewing what has been discussed in this
training you have learned the following:
Understand product labels and MSDS Sheets.
Wear the proper Personal Protective
Equipment (PPE).
Follow OSHA’s Bloodborne Pathogen
Standard with regard to blood and body fluid
clean-up.
Review supply checklist and stock your cart.
Post the proper caution signs before cleaning.
Follow a routine for cleaning.
Remember these three rules when cleaning a
patient room:
1. Always clean top to bottom.
2. Clean from dry to wet.
3. Wipe in a pattern.
Know your daily, detail and project cleaning
procedures and when to perform them.
Wash your hands after cleaning a patient
room.
Be sure to always clean up and wash your
equipment at the end of your shift or at the
end of a workday.
The service you provide is very important to the
well-being of patients, visitors, staff and yourself.
Be proud of the skills you are developing and
know that you truly make a difference in creating a
clean and healthy environment.
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Section 8.
Supply Checklist
Patient Room Disinfection
Betco Products:
Glass cleaner - Deep Blue
Spray disinfectant - Glybet™
Hand cleaner - Winning Hands® Premium Antibacterial
Disinfectant - Quat-Stat™
Neutral cleaner for periodic cleaning - pH7 All Purpose
Neutral Cleaner
Items
Trashcan liners
Cleaning cloths/sponges
Dust mop
High duster
Wet mop
Mop bucket and wringer
“Wet Floor” signs
Dust pan and broom
Paper products
PPE
Gloves
Goggles
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Section 9.
Certification Exam
The following exam will certify you as an official Betco Patient Room Disinfection Specialist.
Please take the time to complete the exam. Fax or mail completed exam to:
Betco Corporation
P.O. Box 3127
Toledo, OH 43607
Fax # 419-321-1954
Attn: Marketing
Exams that are returned to Betco with a grade of 80% or better will receive a certificate of
completion. Exams can also be taken on-line at www.betco.com.
To earn .20 continuing education units (CEU), please mark the box on the information form.
Exams will then be forwarded to IEHA for accreditation. IEHA will send certificates directly
to the contact.
Please fill out the following information and return it with your completed exams:
Your Name: ___________________________________________________________________
Company Name: ______________________________________________________________
Address: _____________________________________________________________________
City ____________________________
State ___________
Zip Code _______________
Phone: _______________________________________________________________________
E-mail address: _______________________________________________________________
Signature: x _________________________________________________________________________
Please forward my exam scores to IEHA for Continuing Education Units.
IEHA Course #10606x .20 CEU’s
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Section 9.
Certification Exam
PATIENT ROOM DISINFECTION IEHA Course Number: 10606x Credit Hours: .20 CEU’s
16
1.
Proper disinfection is extremely important because:
It creates a good smelling environment
It limits and controls the growth of microorganisms
and the spread of infection
It helps make cleaning easier
2.
A disinfectant is an agent that destroys or inhibits
the growth of:
Disease causing microorganisms
Quaternary ammonium products
Airborne dust particles
3.
When cleaning any blood or body fluid spills it is
important to:
Clean the area very well
Practice Universal Precautions
Let the area soak in cleaning solution overnight
Ask your supervisor to handle it
4.
An infection that is acquired while in a hospital is
referred to as:
Germicidal
Nosocomial
Immune deficient
Antibacterial
5.
Disinfectant solutions should be prepared on a
weekly basis.
True
It depends
False
6.
Which is not one of the three cleaning rules you
should follow when cleaning a patient room?
Clean from top to bottom
Perform dry procedures before wet procedures
When wiping, clean in a consistent pattern
Spray disinfectant on all surfaces
7.
Which is not a type of hard surface disinfectant?
Synthetic phenols
Quaternary ammonium
Antiseptic
Iodine
8.
When using cleaning cloths or sponges to disinfect
a patient room, it is important to:
Change them frequently to avoid cross
contamination
Rinse them out with warm water between tasks
Soak them in a mop bucket for ten minutes
9.
What should be done after allowing for the ten
minute contact time after spraying toilets and sinks
with disinfectant?
Come back and wipe up the overspray
Rinse them out with warm water between tasks
Leave the disinfectant on a few minutes longer if
there is gross soil
10. Which Betco product is most appropriate for
disinfecting a patient room?
Deep Blue
Quat-Stat™
Cide-Bet
Stix™
11. Before wet mopping a patient room, what should
you do first?
Post “Wet Floor” caution sign
Spray the floor with disinfectant
Remove all furniture
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Section 9.
Certification Exam (cont.)
PATIENT ROOM DISINFECTION IEHA Course Number: 10606x Credit Hours: .20 CEU’s
12. All trash should be handled as infectious waste
when cleaning an isolation room.
True
False
It depends
13. How often should you change disinfectant solution
in your mop bucket when cleaning a patient room?
Every third room
When it becomes visibly soiled
After every isolation room
All of the above
14. Which type of product would you most likely use to
clean a bloodborne pathogen spill?
Disinfectant cleaner
Glass and surface cleaner
Odor counteractant
All of the above
15. Which procedure would you most likely do only
when cleaning a discharged room?
Dust Mop
High dust lights and corners
Empty trash
16. Which procedure would you most likely do on a
daily basis in a patient room?
Wipe down the bed frame with disinfectant
Clean the locker
Damp wipe doorknobs, hand rails, push plates and
light switches with disinfectant
Clean windows and blinds
17. Which is an example of a project-cleaning task?
Spraying toilets and sinks with disinfectant
Scrub and recoat floor
Spot cleaning walls and doors
18. If you are unsure of how to use a cleaning chemical
you should:
Call an administrator from the hospital
Read the label and MSDS
Use a different cleaner
19. What can you do to reduce your risk of being cross
contaminated from microorganisms?
Take a hot shower after work
Read more training material
Wash hands frequently
20. After learning about Patient Room Disinfection you
should be:
More knowledgeable
Proud
Helpful in creating a safe and healthy work environment
All of the above
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Appendix
Glossary of Common Terms Associated with
Patient Room Disinfection
"Bloodborne Pathogens" - pathogenic microorganisms that are present in human blood and
can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B Virus
(HBV) and Human Immunodeficiency Virus (HIV-1).
"Contaminated" - the presence or the reasonably anticipated presence of blood or other
potentially infectious materials on an item or surface.
"Contaminated Sharps" - any contaminated object that can penetrate the skin including, but
not limited to, needles, scalpels, broken glass, broken capillary tubes and exposed ends of
dental wires.
“Cross-contamination” – the process of passing bacteria or viruses indirectly from one patient
to another through the use of improper sterilization procedures, unclean instruments or recycling
of products.
“Daily Cleaning”- procedures performed on a daily basis such as emptying trash and dust
mopping.
"Decontamination" - the use of physical or chemical means to remove, inactivate or destroy
bloodborne pathogens on a surface or item to the point where they are no longer capable of
transmitting infectious particles and the surface or item is rendered safe for handling, use or
disposal.
“Detail Clean”- cleaning procedures performed 4 to 12 times per year such as vent cleaning,
grout scrubbing and wall washing.
“Disinfectant” – an agent such as heat, radiation or chemical that destroys neutralizes, or
inhibits the growth of disease carrying microorganisms.
“Disinfection” - the process of cleansing as to destroy or prevent the growth of disease
carrying microorganisms.
“Efficacy” – the measure of a disinfectant to produce its desired effect.
"Infectious Materials" - (1) The following human body fluids: semen, vaginal secretions,
cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid,
saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body
fluids in situations where it is difficult or impossible to differentiate between body fluids; (2) Any
unfixed tissue or organ (other than intact skin) from a human (living or dead); and (3) HIVcontaining cell or tissue cultures, organ cultures, and HIV or HBV-containing culture medium or
other solutions; and blood, organs, or other tissues from experimental animals infected with HIV
or HBV.
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“Nosocomial Infection”- an infection acquired in the hospital by either a patient or health
care personnel.
“Project Cleaning”- extensive cleaning procedures performed 1 to 4 times per year such as
stripping and refinishing the floors and carpet extraction.
"Personal Protective Equipment" (PPE) - specialized clothing or equipment worn by an
employee for protection against a hazard. General work clothes (e.g., uniforms, pants, shirts
or blouses) not intended to function as protection against a hazard are not considered to be
personal protective equipment.
“Universal Precautions” – a concept of bloodborne disease control which requires that all
human blood and certain human body fluids are treated as if known to be infectious for HIV,
HBV, and other bloodborne pathogens.
“Synthetic Phenols” – kill a wide range of organisms and are widely used in operating
rooms. They are excellent products for destroying the tuberculosis organism and do not lose
their effectiveness in a soiled environment. They are corrosive and should never be used
around newborns.
“Quats” – the most widely used disinfectant used in the market today due to their versatility
and cost effectiveness. They kill a wide range of microorganisms including Staph,
Salmonella, and Pseudomonas. Quats are less corrosive and are used in schools, institutions,
supermarkets and hospital settings.
“Hypochlorite/Bleach” – corrosive and should be restricted in use. It should not be used in
general building operations because of the potential of interacting with other chemicals,
which can result in a toxic gas. Although it can be used as a disinfectant or sanitizer, it is not
an effective cleaner. Never mix bleach with another chemical.
“Iodine” – a powerful disinfectant that, when used in the form of iodophors, will kill a wider
range of pathogens than quats and phenolics. As a primary use disinfectant it is not desirable
due to its staining properties. Because of iodine's acidic qualities, its use is restricted to
specialized areas, such as surgical settings.
“Alcohol” – provides an efficient means of killing pathogens. Typically, ethyl or isopropyl
alcohol is used for smaller area surface disinfection. These products are usually packaged in
sealed aerosols or smaller-use containers, since alcohol can pose a fire hazard.
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