If you work in a medical clinic, you probably have well-developed routines and habits for surface decontamination. But the outbreak of COVID-19 gave healthcare providers a brutal reminder of how easily microorganisms can spread and the consequences when they do. This article reviews best practices for decontaminating surfaces in your medical clinic.
Surface contamination has consequences
In training, you learned that the healthcare environment has many surfaces constantly being contaminated with microorganisms.
When an infected patient coughs in an exam room, respiratory drops land on surfaces and can infect the next patient who touches them. Disease-carrying droplets can contaminate the healthcare professionals handling the equipment or travel on the HCP’s skin or gloves. In addition to hand-washing and PPE, regularly cleaning surfaces and medical equipment is one of the best ways to prevent diseases from spreading in a hospital or clinic.
Surface contamination is simple, but it can be easy to forget the consequences. Of course, the risk to healthcare professionals is substantial, but patients are also affected.
Even before the SARS-CoV-2 outbreak, nosocomial or healthcare-associated infections (HCAIs) created substantial harm. For example:
- On any given day, about one in 31 hospital patients has at least one healthcare-associated infection (HCAI).
- Nearly 1.7 million hospitalized patients each year acquire HCAIs while receiving care at US hospitals.
- Each year, 98,000 patients (one in 17) that get an HCAI die from these infections.
According to one analysis, the most common sources of infectious agents causing HAIs are (in order): the patient, medical equipment and devices, the hospital environment, health care personnel, and contaminated drugs/food/patient care equipment. So the message is clear: decontaminating medical clinic surfaces and medical equipment or devices is one of the best ways to ensure your patients don’t leave with more problems than when they arrived.
Of course, some HCAIs decreased when hospitals and clinics improved hand hygiene and PPE practices during the COVID-19 outbreak. But as the pandemic gets under control, let’s remember that surface decontamination saves lives.
Surface decontamination best practices for medical clinics
In its simplest form, decontaminating a surface involves cleaning it before applying a chemical disinfectant. Using disinfectants is simple: after cleaning, use a clean cloth or paper towel to apply a chlorine-releasing agent or alcohol-based product that destroys the remaining microorganisms.
But the details matter. Let’s look at four surface decontamination best practices for anyone working in a medical clinic:
- Make sure to CLEAN and disinfect
- Prioritize high-risk areas
- Decontaminate surfaces often
- Use the right products
Make sure to CLEAN and disinfect
Remember that cleaning and disinfecting aren’t the same thing. Cleaning is physically removing germs, dirt, or other impurities from a surface. Disinfection, on the other hand, reduces the remaining microorganisms (left on “clean” surfaces”) to a level that’s no longer harmful.
A clean clinic isn’t just good for patient health, of course. It’s also good for business. So make sure to dust surfaces, keep exam rooms and bathrooms clean, and declutter the reception area. Regular cleaning will make disinfecting easier and sends a message to patients that their safety is your top priority.
You should only disinfect a surface after cleaning it. While there are products that clean and disinfect simultaneously, it’s most effective to do these separately.
Prioritize high-risk areas
Ideally, medical clinics would decontaminate all surfaces regularly throughout the day. But your team has to face the practical reality of operating a busy clinic.
Think through the areas of your clinic that get the most traffic and produce the highest risk of infection. Specialty rooms used for X-rays or invasive procedures are obvious candidates, but you should also focus on anything patients and staff touch often throughout the day.
According to CDC guidelines, highly touched surfaces include counters, tabletops, doorknobs, bathroom fixtures, keyboards, tablets, and bedside tables.
Revisit your clinic’s cleaning plan and ensure that staff decontaminate high-risk surfaces frequently.
Decontaminate surfaces often
You probably have a cleaning team come to your clinic after hours. But for which surfaces is daily disinfection sufficient, and which should clinic staff decontaminate throughout the day?
Here’s a brief overview of how often to decontaminate healthcare surfaces:
At least twice daily, decontaminate all:
- Handrails & light switches
- Countertops & tables
- Desk phones, keyboards, touch screens
- Pens & clipboards
At least three times per day, decontaminate:
- Toilet and washroom surfaces (including door handles and light switches)
- Other high-touch surfaces
Between each patient visit, decontaminate:
- Exam room surfaces, including chairs, tables, and anything patients could cough on
- All equipment used with patients
Pay special attention to smartphones and other electronic equipment, often used frequently but forgotten as clinical tools. One study found that many health care workers use phones as often as once every 15 minutes.
Use the right products
There are five critical criteria to consider when choosing disinfectants and cleaning products for your medical clinic. Disinfectants used in medical clinics should be:
- Effective at killing the most prevalent pathogens. Ensure the disinfectants you choose are EPA registered as effective against the most common pathogens that might affect your clinic. For example, vegetative bacteria (like S. aureus or Escherichia coli) cause the vast majority of HAIs (~80%).
- Fast enough acting. Make sure that contact times are greater than or equal to kill times. This means the product will kill pathogens before it can dry.
- Responsible and safe. Consider toxicity, flammability, and compatibility with PPE and other equipment. Choose products with the lowest toxicity rating that are less likely to harm users, staff, or patients.
- Easy to use. The easier a product is to use, the more likely staff will use it correctly. Ensure disinfectants and cleaning products are stored in durable containers and easily accessible to cleaners.
- Affordable. When calculating or comparing product costs, also consider time and laundering costs. When in doubt, use the safest products most likely to reduce HAIs.
Keep in mind that decontamination is never fully effective. Even if your team follows protocols perfectly, some microorganisms will survive. As you review your medical clinic’s protocols for surface decontamination, remember to wash your hands often and use PPE effectively.
If you have more questions about what products to use or how to implement effective surface decontamination in your medical clinic, refer to CDC guidelines.
Alternative surface decontamination methods
More healthcare facilities are implementing non-standard disinfection methods like UV light and engineered antimicrobial surfaces.
For example, ultraviolet light C (or “UVC”) is helping hospitals cut transmission of multi-drug resistant organisms that linger in healthcare settings. One study found that machines emitting UV light can cut the transmission of pathogens by 30%.
Engineered antimicrobial surfaces are another relatively new method hospitals and clinics use to reduce HCAIs. Medical equipment manufactured with antimicrobial technology contains silver, zinc, or copper that inhibits the growth of bacteria, viruses, and fungi.
One example is Mobius Clinic’s Conveyor USB, a medical dictation device that allows doctors to connect their smartphone and instantly dictate on any computer. Since doctors use Mobius in clinical settings, the Conveyor USB is made with a MicroBan silver alloy additive that inhibits microorganisms.
In addition to using standard disinfection strategies to keep your clinic safe, consider purchasing medical devices that reduce the spread of disease-causing microorganisms.