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Thursday, September 6, 2012

Slippery When Wet – Proper Cloth Saturation is Key for Adequate Disinfection

This past spring I read an interesting abstract authored by Cynthia J. Larson, Aaron Freeberg and Wendolyn Slattery titled “The Effect of Proper Cloth Saturation on Disinfection of High Touch Surfaces”. Although I sadly didn’t get an opportunity to attend their abstract presentation during this year’s APIC Conference in San Antonio, the abstract presents a straightforward account of their study and the impact cloth saturation can have on the effectiveness of cleaning practices. 

As Nicole and I have lamented time and time again, contact time is important when using disinfectants! If the contact time is not complied with, it’s likely that disinfection is simply not being achieved. Selecting a disinfectant with a rapid and realistic contact time will most certainly make this an easier goal to achieve however, we will still need to use or apply the disinfectant in such a way that its contact time is easily complied with. Not surprisingly, the saturation level of the cloth or wipe used to apply the disinfectant will play a major role in ensuring adequate coverage of the surface. But, when was the last time you incorporated a discussion on cloth saturation into your cleaning and disinfection training? I’ll admit, even I’m guilty of glossing over that detail when I’m assisting with such training sessions. 

The Larson et al. study found that improving the saturation of disinfectant on the cleaning cloths in conjunction with some education on effective cleaning processes did improve environmental monitoring scores by 24% initially and with continued feedback improved them by 55% overall. But, what is the appropriate amount of saturation?? In my opinion, the cloth should be wet with the solution, but not so wet that it is dripping everywhere. It should be sufficiently saturated to provide consistent and even coverage of the surface but not pose any risk to the user because it’s “sloshing” everywhere. The study found that utilizing a cloth and bucket process provided superior saturation when compared with their prior method of pouring the disinfectant solution onto the cloth prior to wiping the surface. We too have found this in practice and will often recommend this application method when feasible. 

What about pre-saturated disinfectant wipes? How do we ensure they are sufficiently saturated? More correctly the question should be: How do we ensure that the disinfectant wipes stay sufficiently saturated? Disinfectant wipe manufacturers have determined exactly how much solution is required to fully saturate their wipe substrate and will manufacture the product with this in mind. With that being said, end-users need to ensure that the wipes remain wet by keeping the canister closed when not in-use. If the canister is left open, the first wipe or two may slowly dry out in which case they should be discarded in favour of a fully saturated wipe when the cleaning and disinfection task is at hand. Likewise, common sense should play into the equation when using disinfectant wipes to clean and disinfect larger surfaces.  A single 6”x7” disinfectant wipe is unlikely to distribute enough solution onto a 4’x8’ table for instance.  In other words, multiple wipes may be required to complete some tasks.

To summarize, a nearly dry cloth or wipe is unlikely to help us effectively clean and disinfect high touch surfaces.  End-users should ensure that their cloth is sufficiently saturated, yet not dripping wet, when cleaning and disinfection in order to provide them with the most likely chance for success.

So, are you going to include mention of cloth saturation in your next environmental cleaning training session? 

Hasta la vista

Lee – The Germinator

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