Cleaning and Disinfection of Devices and Environmental Surfaces
Q: What is the difference between cleaning and disinfecting? When should I be cleaning and disinfecting a patient room or other areas of the practice?
A: Cleaning removes the visible dirt, dust, spills, smears, and grime, as well as some germs, from surfaces. This is accomplished by washing the surface using a cleaning product and water. Cleaning products include liquid soap, enzymatic cleaners, and detergents. High-touch surfaces should be cleaned regularly. Some examples of high-touch surfaces include tables, door handles, and keyboards.
Disinfecting kills germs on surfaces or objects. This is accomplished by cleaning an area with soap, water, or any additional detergent; then using an EPA-registered household disinfectant. Disinfectants are only for disinfecting after cleaning and are not substitutes for cleaning unless they are a combined detergent-disinfectant product. For effective use of the disinfecting product, follow the instructions on the label.
PPE should be worn while cleaning or disinfecting, such as wearing disposable gloves. Additional personal protective equipment might be required based on the cleaning/disinfectant products being used and whether there is a risk of splash.
Visit the Project Firstline Cleaning and Disinfecting Checklist to learn when certain areas/items should be cleaned and disinfected throughout your practice.
Additional information can be found in the CDC Cleaning and Disinfecting Your Facility page.
Q: What is “contact time” and why is it important?
A: Contact time is the amount of time a disinfectant needs to sit on a surface, without being wiped away or disturbed, in order to do its job of killing germs. It can be challenging in a busy health care setting, but it is important to wait for the full contact time to be sure the germs are killed. This time can vary depending on the product and can be found on the label. Combination cleaning and disinfecting products also have a minimum contact time.
Instructions about how to read a disinfectant label are available here.
Q: Can waiting room toys and activities be used in the waiting room?
A: Waiting room toys and activities can be returned to waiting rooms. However, it is recommended that toys and any other waiting room items should be cleaned and disinfected after each use and at least daily, or when a toy or equipment becomes soiled with dirt or bodily fluids, including saliva. Any waiting room toys or items that have porous surfaces such as books, stuffed animals, wood toys, etc should be removed.
Q: How do you clean a room after seeing a patient with a high probability of having an infectious disease?
A: Facility management and cleaning and disinfection should be aligned with evolving safe work practices. The Environmental Protection Agency’s (EPA’s) List “N” provides a list of disinfecting products shown to be effective against common pathogens. In addition, considerations should include waiting room management/elimination and alternate waiting and care delivery sites. Please also see additional room-related guidance in the “Ventilation” section.
Q: What PPE should be worn by practice personnel when they clean and disinfect rooms of patients with an infectious disease?
A: After patient departure, room entry for practice personnel should be delayed until sufficient time has elapsed for enough air changes to remove potentially infectious particles. After this time has elapsed, practice personnel can enter the room and should wear a face mask (for source control) along with a gown and gloves when performing terminal cleaning. Eye protection should be added if splashes or sprays during cleaning and disinfection activities are anticipated or otherwise required based on the selected cleaning products. Shoe covers are not recommended at this time.