Infection Control Today - 10/2001: Chemical Management Involves WorkerSafety and Economics

Chemical Management Involves Worker Safety and Economics

By Tom Bach

Oneof the most important factors in getting effective results with any disinfectantor detergent disinfectant is the type and quantity of soil to be removed.Different areas within a facility will contain different soil types that requireproducts designed specifically to attack and remove these soils. For example,the soil found in a food service operation is quite different than what may befound in a shower room. Excessive soil reduces the germicidal efficacy of anydisinfectant. Soil removal prior to disinfection is critical under certaincircumstances, such as food service cleaning and sanitizing, and in manyhospital departments for instrument reprocessing, bloodborne pathogen clean-up,and other critical equipment cleaning. Typically, floors and vertical surfacesare cleaned and disinfected using a combination one-step procedure combining acleaner disinfectant.

Attention to detail is probably the single most important step to maintainingsurfaces that are clean and disinfected. Some important techniques to considerare:

• Contaminated cleaning tools can be a common cause of poor results with germicides and sanitizers. Clean tools not only must be free of visible soil, they must be free of bacteria. Always use freshly laundered and thoroughly dried mops for cleaning floors. Mop buckets should never have a dirty layer of soil left in them and should always be returned to storage cleaner than when they were taken out. Trigger sprayers always should be labeled and function properly without leaking. For general surface cleaning, disposable cloths or paper towels provide the best means of cleaning surfaces while reducing the opportunity for cross contamination.

• It is vitally important that each employee using mops clean and thoroughly wring them out at the end of their shift. Never leave mops in a pail for re-use the following day. Regular laundering is critical to get the longest life from a mop head. Always launder mops in mesh bags to prevent tangling. Better yet, mops manufactured with end stitching provide the best tangle-free performance. Always dry mops after laundering to prevent souring.

• The most efficient method to clean large surfaces such as hallways is through the use of an autoscrubber. These machines dispense fresh cleaner/disinfectant solution, combine mechanical and chemical action to thoroughly clean surfaces, and practically dry the floor via the squeegee and wet vacuum. These machines are efficient for use in large areas and hallways, and can be paid for in labor savings alone.

An additional method for properly treating large areas is through the use ofa pump-up sprayer to apply fresh disinfectant solution followed by mopping usinga pail of the same disinfectant solution to rinse out the soil removed.Additionally, double-bucket mopping is still utilized in many healthcarefacilities. These methods of disinfectant application help assure that freshsolution is always applied to the floor surface. Soil and germs are picked up inthe mop and rinsed and wrung out in a bucket of disinfectant. These applicationtypes can usually be found in the critical care areas of a healthcare facility.

• Whether using an autoscrubber, mop, or simply wiping table and bed frame surfaces, mechanical action (elbow grease) always helps to clean surfaces and is as important as the cleaner/disinfectant used to assure both soil removal and germ kill. Wiping surfaces in one direction while folding the wiper will not only remove soils, but will trap them in the cloth for rinsing out prior to proceeding to other areas. Without mechanical action, vinyl composition floor tile can actually become stained from regular use of quaternary disinfectants when a process of only damp mopping is utilized. Without thorough wetting, the quaternary active can build up on the floor and cause stickiness and even discoloration.

• Germicidal solutions should be changed regularly. Optimum performance from cleaners and disinfectant solutions is obtained from the use of fresh solutions. A typical hospital disinfectant costs between 6 and 10 cents per in-use gallon. With increased concern regarding hospital-acquired infections many facilities are requiring solutions be changed at regular intervals regardless of the solution appearance. In general-patient areas many facilities have mop solutions changed after every three rooms or more frequently if soil conditions warrant. Typically, solutions prepared and dispensed from trigger bottles should be changed on a daily use basis. The cost of changing the disinfectant solutions frequently is far cheaper than the cost of dealing with a nosocomial infection outbreak.

• The use of precision dilution systems provides the ultimate in safety, economy, and reliability. These systems accurately dilute and dispense cleaners and disinfectants by the flow of water past a metering tip port. The size of the hole in the metering tip dictates the dilution being dispensed. The advantage of such a system is the fact that proper solution is always prepared fresh and without possible error of either too much or too little product being added. These systems are usually proprietary and are designed to only accept the manufacturers' product containers in a locked cabinet that prevents overuse. Less handling of the product concentrates provides for safer employee handling of cleaner/disinfecting products--a user benefit all around.

Employeeswho are properly trained in their job responsibilities and are assigned specificcleaning duties within specific departments maintain integrity within the group.Training also provides recognition of the importance of the environmentalservices department. Some employers even offer employee training in the Englishlanguage. This type of investment goes a long way toward developingprofessionalism and job satisfaction. Both add to career longevity that canresult in career advancement.

The entire discussion referred to in this article involves the process ofchemical management. If a manufacturer received a call from a distributor or enduser 10 years ago inquiring about chemical management, the immediate responsewould be to provide the cost per in-use gallon review vs. theircompetition. Chemical management goes well beyond in-use cost. With workersafety, right-to-know issues, bloodborne pathogens and standard precautions,chemical management involves as much with safety as it does with economics. Theless environmental service employees handle cleaners, wax strippers, anddisinfectants, the better.

Chemical management involves many departments, including purchasing,infection control, health and safety, and environmental services, to name a few.It's not just dumping some product in a bucket and mopping floors any more.Product manufacturers can be an invaluable resource when assembling all the MSDS',procedures, and technical information needed to be compliant with both internaland regulatory requirements.

Tom Bach is the senior technical service manager for Reckitt BenckiserProfessional in Wayne, NJ.