How do hospitals prevent infections through disinfection?

Sanitizer bottles to clean surfaces in the kitchen. Woman putting on protective gloves while getting ready for clean up in the background. Antiseptic, disinfection, cleanliness and healthcare

In healthcare settings effective cleaning and disinfection are crucial to prevent infections. High level disinfectants are essential for eliminating harmful pathogens from medical equipment and surfaces.

These disinfectants kill or inactivate a wide range of microorganisms including bacteria viruses and fungi helping prevent healthcare associated infections.

Proper usage is key to their effectiveness, and this article covers their correct use common types and best practices to maintain a safe and sterile environment for patients and healthcare workers.

Understanding High Level Disinfectants

High level disinfectants are chemicals used to destroy or inactivate most microorganisms on medical devices and surfaces except bacterial spores.

They are used when sterilization is not possible or necessary typically for devices that contact mucous membranes or sterile body sites.

Unlike lower level disinfectants they kill a broader range of pathogens but must be used according to instructions to prevent adverse effects like chemical burns or toxic reactions.

Types of High Level Disinfectants in Healthcare

There are several types of high level disinfectants commonly used in healthcare settings. Each has its unique characteristics and effectiveness against specific types of microorganisms. Below are some of the most widely used high level disinfectants

Glutaraldehyde

Glutaraldehyde is a common high-level disinfectant used in healthcare effective against bacteria viruses and fungi.

It disinfects medical devices like endoscopes and surgical instruments, with its effectiveness depending on concentration and contact time.

However it can irritate the skin eyes and respiratory system so proper PPE like gloves, goggles and masks are necessary.

It should be used in well ventilated areas following the manufacturer’s guidelines for exposure time and dilution.

Hydrogen Peroxide

Hydrogen peroxide is a common high-level disinfectant in healthcare acting as an oxidizing agent to break down microorganisms.

It is used in vapor form for large areas or non-immersible equipment. While safer than other disinfectants it can damage rubber and metals so it’s important to follow manufacturer guidelines on concentration and exposure times to ensure effectiveness and prevent damage.

Peracetic Acid

Peracetic acid is a fast acting highly effective disinfectant that combines acetic acid and hydrogen peroxide. 

It rapidly inactivates a wide range of pathogens including bacteria viruses and fungi and is commonly used in healthcare to disinfect medical equipment and surfaces. 

A key benefit of peracetic acid is that it leaves no harmful residues making it ideal for sensitive environments. 

However it is a potent substance that can cause irritation or burns so proper personal protective equipment (PPE) is necessary when handling it.

Chlorine Dioxide

Chlorine dioxide is a powerful disinfectant effective against a wide range of microorganisms including viruses bacteria and fungi.

It is commonly used in water treatment and for disinfecting surfaces in healthcare settings particularly for controlling infections like Clostridium difficile.

However due to its potential for irritation chlorine dioxide requires careful handling and should only be used by trained personnel familiar with its properties and risks.

The Proper Way to Use a High Level Disinfectant

Using high level disinfectants properly is essential to ensure their effectiveness in eliminating harmful microorganisms and preventing the spread of infections. Below are the key steps for using high level disinfectants in healthcare settings

Read and Follow Manufacturer Instructions

Each high level disinfectant has specific usage instructions including recommended dilution ratios contact times and storage guidelines. 

It is essential to read and follow these instructions carefully to ensure the disinfectant works as intended. 

Failure to adhere to the manufacturer’s guidelines could lead to ineffective disinfection and in some cases damage to medical equipment.

Use Appropriate PPE

High level disinfectants can be hazardous to health if they come into direct contact with the skin eyes or respiratory system. 

Personal protective equipment such as gloves goggles face shields and masks should always be worn when handling disinfectants. 

For additional protection it is recommended to use chemical resistant aprons or gowns especially when working with concentrated solutions.

Clean Surfaces Before Disinfecting

Disinfectants are most effective when used on clean surfaces. Before applying a high-level disinfectant, surfaces or medical equipment as well as office areas should be cleaned to remove dirt, debris, and organic matter. 

Residual organic material can shield microorganisms from the disinfectant and reduce its effectiveness. 

Office cleaners should be used to maintain a clean environment before disinfection to ensure thorough microbial inactivation.

Ensure Proper Contact Time

Each disinfectant requires a specific contact time to effectively kill microorganisms. This duration varies depending on the disinfectant and the pathogen targeted. Following the recommended contact time is essential to ensure proper disinfection.

Rinse

Some high level disinfectants, such as glutaraldehyde and hydrogen peroxide, may require rinsing after use to remove any residual chemicals. 

It is important to follow the manufacturer’s instructions regarding whether rinsing is necessary and if so the proper procedure for rinsing.

Proper Disposal

High level disinfectants should be disposed of according to local regulations and safety guidelines. 

Many of these chemicals are hazardous so it is important to follow the proper disposal protocols to avoid environmental contamination or harm to healthcare workers.

What Type of Disinfectant is Most Commonly Used in Healthcare Environments?

In healthcare settings intermediate level disinfectants are most commonly used as they are effective against a wider range of pathogens than low level disinfectants but are less potent than high level disinfectants. 

High level disinfectants like glutaraldehyde hydrogen peroxide and peracetic acid are still necessary for more thorough disinfection particularly when sterilization is not an option. 

For general surface cleaning, intermediate level disinfectants such as quaternary ammonium compounds or chlorine based disinfectants are typically used while high-level disinfectants are essential for high risk areas or specialized equipment.

Conclusion

High level disinfectants are an indispensable tool in healthcare settings, offering an effective means of combating infections and maintaining a safe environment for patients and staff. 

Proper use of these disinfectants is crucial to ensure their effectiveness in preventing the spread of harmful microorganisms. 

By understanding the types of high level disinfectants available, following recommended procedures and taking the necessary safety precautions healthcare professionals can safeguard the health of those in their care while minimizing the risk of chemical exposure.

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