Do We Manage Dwell Time Requirements for Disinfectant Solutions?
For the next two weeks, we will feature a two-part series on Dwell Time Management from Tru-D’s Director of Program Management, Cathy Campbell. If you’re at APIC this week, June 14-16, be sure to stop by Tru-D’s booth #808 to ask Cathy any questions you have.
The relationship between cleaning and hospital-acquired infections (HAIs) is a fact we cannot ignore. Pressure to turn rooms quickly introduces inherent elements of human error when disinfecting the environment by manual cleaning, both in efficiency and assurance of the efficacy of the disinfectant we use in our health care facilities.
As Environmental Service (ES) Professionals and technicians manage the cleaning of patient care areas, too often they feel the pinch to meet a system of metrics— how fast do we clean the room, how clean is the room and how satisfied is the patient?
What are Dwell Times?
Adding to the pressure of moving quickly through the patient room is the requirement to adhere to disinfectant solution “contact times” or what some may refer to as “dwell times.”
“Dwell” is referring to the required time that the disinfectant must remain wet on a surface to meet the detailed kill claims on the label for specific pathogens. Many pathogens are killed immediately, but for others, the solution must remain wet for the required timeframe or the efficacy of the product is questionable. Unfortunately, living in the reality of reduced manpower, coupled with the pressure to meet national standards, an ES Technician does not always count the number of known minutes a surface must remain wet. How many ES Technicians do you see watching the clock to ensure surfaces stay wet for a required timeframe? Does the ES Technician use several disposable wipes to ensure surfaces are saturated? In some cases, when restrooms are adjoining the patient room, does the ES Technician even stay in the room long enough to observe the dwell time of a solution on surfaces? How often does a ES Professional observe the Technician cleaning the room to ensure dwell times are sufficient?
Additionally, “numerous studies have demonstrated that current strategies for terminal room disinfection are inadequate. In fact, 50% or more hospital surfaces may go untouched and uncleaned following terminal room disinfection” (Anderson, et al, CDC Prevention Epicenters Program. 2013). Decontamination of Targeted Pathogens from Patient Rooms Using an Automated Ultraviolet-C-Emitting Device. Infection Control and Hospital Epidemiology, 34(5), 466-471.). This reality, combined with disinfectant solutions that dry prior to being effective, leaves colonies of unseen, harmful organisms on surfaces for weeks, and sometimes months and longer.
In the health care industry, ES Professionals and Infection Preventionists always have their ears to the ground hoping for a new and improved disinfectant that is proven to have a shorter dwell time. Shorter dwell times might support a more efficient protocol for cleaning the room, but we still have to manage people who manage the dwell time.
Stay tuned for part 2 of this series on how a measured dose of UV light can ensure total room disinfection.