Sanitizing high-touch objects in non-critical care areas can be broken down into products, steps and frequency. Even though labor costs will often prohibit the dwell times required to disinfect surfaces in non-critical areas, I prefer to use the appropriate EPA-registered one-step detergent disinfectant to clean by spraying and wiping HTOs with color coded microfiber cloths.

The process cleans the surface by removing the soil and germs with the microfiber cloth so the disinfectant can continue to do its job as opposed to the non-kill properties of an all-purpose cleaner. At the very least, we are sanitizing the surface by cleaning it and providing further kill in the wet or damp cloth, preventing the transfer of germs to other areas and/or surfaces.

As a BSC, it is important that the procedures be written, be site specific and state how often and what HTOs your staff will “Clean and sanitize with an EPA registered one step disinfectant” as opposed to “Clean and disinfect with an EPA registered disinfectant.” If the latter procedure is stated, then the dwell time must be allowed for as prescribed in the product’s label instructions. Another optional procedure might be “Clean HTOs daily.”

Surfaces and cleaning frequencies should be part of the scope of work as written into new contracts. According to Dan Wagner, director of facility service programs and CIMS for ISSA, “It is crucial to remember that a scope of work needs to be clear, up-to-date and does not leave anything open to interpretation. A perfect example would be if a scope of work states that a 
contractor should ‘wipe down baseboards as 
necessary’ which is likely to mean something dramatically different to two people and can cause confusion and unmet expectations.”

Let’s say the two people Dan is referring to are you and your customer, and the contract is for a multi-use building. If the contract’s scope of work does not state (and budget for) which HTOs are cleaned, how and how often, then what is your customer’s assumption? The assumption is probably a high expectation that you have this subject covered. What if there is a MRSA outbreak amongst the occupants? Questions start flying and fingers start pointing.

The best practice is to accurately define the cleaning specifications to allow the labor required to clean and sanitize all HTOs in a building. That is feasible for new contracts. For existing contracts, be proactive and review current policies and procedures. Rewrite policies if necessary, retrain employees and document the training.

Learn The Difference Between Sanitizing and Disinfecting

By Skip Seal, Trainer and consultant 

To determine the appropriate cleaning procedure, we need to look at the differences among cleaning, sanitizing and disinfecting. When deciding what surfaces to clean, sanitize or disinfect, any surface or object touched by hands or skin should be considered. However, floors are not generally considered surfaces included in those involved in the transfer of germs.

Cleaning can be defined as the removal of substances and germs from objects and surfaces. Referring back to the CDC’s statement, HTOs in non-critical care areas should be cleaned daily.

Disinfecting is defined as killing germs on objects and surfaces. Disinfecting is a normal requirement in critical care areas of healthcare facilities when there is a known outbreak of communicable disease, and is part of the cleaning process when blood or other potentially infectious material is present in the facility. Dwell times for disinfectants means increased labor hours over the course of the contract.

Sanitizing lowers the number of germs on HTOs to a safe level, as judged by public health standards or requirements. In addition, sanitizers require much shorter dwell times.

Where does sanitizing fit into this discussion? Picture this: you walk into a restaurant and while you are waiting to be seated, you observe a person with weeping mouth sores drinking iced tea. That person finishes their tea, sets the glass down and departs. As luck would have it, you are served iced tea in that same glass, however you are safe from the germs that caused the mouth sores. What did the kitchen personnel do to the glass to protect you? Disinfect? No, they cleaned and sanitized the glass. Typically, a glass is allowed to air dry after being dipped into the sanitizer.

Therefore, you might draw the conclusion that cleaning and sanitizing HTOs in non-critical care areas is an acceptable, even good practice. After all, we are not eating or drinking from push plates and door handles.

However, studies show germs contaminate and survive on objects that are frequently touched by hands. For example, MRSA can survive on hard surfaces for months. These germs are efficiently picked up by hands and transferred to the mouth or to open areas on the skin. Even after hand washing, clean hands become contaminated after touching infected surfaces.