Understanding Sanitizers and Disinfectants - Multi
Contents
1. Recommended Multi Clean Products Ful Trole 64 Microcide TB GTS Foaming Disinfectant Cleaner PHD 257 Phenolic Hospital Disinfectant Super Staph Trole 256 and or Century Q 256 ON DARY N Blood Body Fluid Spills Assemble products and equipment and post wet floor signs Put on disposable gloves goggles mask and gown Blood and body fluids must be thoroughly cleaned from surfaces and objects before application of disinfectant Absorb spill completely with absortant Pick up absorbed material with spatula and place in bio hazard bag 4 Disinfect surfaces and objects with germicide cleaner that is OSHA Blood Born Pathogen Compliant Follow instructions on label for correct contact time usually 10 minutes 5 Bag cleaning supplies contaminated with blood or body by products separate and dispose of immediately using the proper procedure for waste elimination 6 Wash hands after removing gloves with an antibacterial hand wash Recommended Multi Clean Products Microcide TB GTS Foaming Disinfecant Cleaner Super Staph Trole 256 PHD 257 Phenolic Hospital Disinfectant and or Multi Fresh Antibacterial Hand Cleaner 9 N gt Products Required e Germicidal Cleaner e Carpet Spot Cleaner Equipment Trash Can Liner e Cleaning Cloths e 36 48 Dust Mop e 24 oz wet mop e Wet floor signs e Upright vacuum cleaner with attachments e 4 6 gal mop bucket e Dust pan e Counter brush e Hand Soap paper towels toilet pa2. Moderate Cleaning ability Quat Phenolics Bleach e Effective in Hard Water General Care Areas Critical Care Area General Care Areas Not to be used of food contact surfaces ICU E R etc e Harsh on floor finishes f 1 Not effective for TB Effective against TB e Used at 2 ounce per gallon Excellent Cleaner Moderate Cleaner NO CLEANING ABILITY Must pre clean surfaces before disinfecting Bleach 5 e Bleach has no cleaning ability Pleasant Fragrance Medicinal Fragrance Strong Chlorine Odor All surfaces to be disinfected must be pre cleaned first before disinfecting or May be used on food May NOT be used on May be used on food ee preparation Surface food contact surfaces Contact Surfaces sanitizing This makes it a two step process Tested in the presence Tested in the presence Inactivated by organic Strong chlorine odor of organic soil of organic soil soil Bleach can damage some surfaces includ 16 when diluted Stable when diluted Unstable Solutions ing floor finishes Must be made up e Solutions may be inactivated by organic soil before each use and sunlight Must be made fresh each day Of Hilti Moderte cost per gal High cost per gallon Low cost per gallon Must se at 10 dilution 12 ne per gal Concentrate Concentrate Concentrate e Inexpensive concentrated Expensive in diluted state Low cost when diluted Moderate cost when High Cost when e Form 5 4 Sodium Hypochlorite Solution dilu
3. Products Required e Germicidal Cleaner e Glass Cleaner Equipment Trash Can Liner Cleaning Cloths 24 Dust Mop Nursery 1 Assemble all product and equipment items Place wet floor signs Put on disposable gloves Empty trash receptacles and damp wipe with germicidal cleaner Re line with plastic liner ONDIA V N Damp wipe sill ledges vents exterior of light fixtures furniture with cloth and germicidal cleaner Spot clean walls with cloth and germicidal cleaner Clean nursery observation windows with cloth and glass cleaner Replenish supplies as needed Dust mop floors with clean dust mop Damp mop floors with clean mop and germicidal cleaner Recommended Multi Clean Products Ful Trole 64 Microcide TB or GTS Foaming Disinfectant Cleaner Multi Shine Glass and Surface Cleaner Super Staph Trole 256 and or Century Q 256 e e e e e e e e e e e 24 oz wet mop Wet floor signs 4 6 gal mop bucket Dust pan Counter brush Auto scrubber Scrub Suit shoe covers Face Mask Hand Soap Paper Towels Toilet paper etc Disposable gloves Cleaning Procedures con t Critical Areas O R I C U Recovery Rooms For Cleaning Between Patients 1 Assemble all product and equipment items Place wet floor signs Products Required 2 paid to enter area by donning scrub suit shoe covers facemask and disposable Germicidal Cleaner 3 Scrub rooms and halls are a part of the sterile area and
4. lies in the hands of more than one person In order to sell your product you must meet the committee members that will vote for your product s approval The Infection Control Committee consists of physicians Epidemiologist Pathologist and doctors in charge of major clinical departments Infection Control Nurse Director of Nursing and the department heads of Environmental Services Pharmacy Dietary Laundry Therapy and Central Supply Your selling objective then is to identify and work with as many key members as possible before your product is brought up for discussion The more members that know of your product and its benefits the more likely there will be a favorable result of a committee vote Getting to the point where your product is considered requires a Coach This individual will have a specific interest in your disinfectant either from a user or from a technical viewpoint The Coach will guide you through the sale by giving you needed information that guarantees you not only the order but also satisfied customers and repeat business Examples of a Coach could be the Director of Environmental Services or Infection Control Nurse The Infection Control Nurse though not a direct purchaser plays an extremely important role in influencing the buying decision The Infection Control Nurse is increasingly involved in the evaluation and selection of the disinfectant For this reason it is imperative that you become fami
5. Normally done in food processing facilities Spores The reproductive element of certain microorganisms Spores are generally dormant and can survive for long periods of time sometimes years and are very difficult to kill Sterilize To kill 100 of all germs and their spores Tuberculocidal Disinfectant A disinfectant with efficacy again the mycobacterium organism TB USDA United States Department of Agriculture In charge of regulating meat and poultry processing facilities Virus A microorganism which reproduces only within other living cells 13 Disinfectant Quiz Time What does Pathogenic Organism mean a Disease causing b non disease causing What do microorganisms need to live grow and multiply a warmth b moisture c food d all of the above How often do bacteria reproduce under optimum conditions a every minute b every 15 20 minutes c every hour d every day Disinfection will kill what percent of claimed germs a 50 b 90 c 99 99 d 100 Sanitizing will kill wnat percent of claimed germs a 50 b 90 c 99 99 d 100 Bleach is a good cleaner True False Quats are excellent cleaners True False Phenolic germicides are effective against TB T F Hospital Grade Disinfectants must have efficacy claims for what three bacteria a Pseudomonas aeruginosa Staphylococcus aureus and Salmonella choleraesuis b Eschericia coli Proteus vulgaris and Candida
6. be required Itis important to know what types of germs you are concerned about and if a germicide will be able to make the claims that it will be effective against these germs If a germ is not listed on the label of a disinfectant do not assume that the product will kill that specific germ the health inspectors won t READ THE LABEL What is the proper contact time for this germicide Each germicide will state how long it must remain in contact with a surface to achieve the full efficacy of the stated claims Generally a 10 minute contact time is standard for most quat germicides Spray and wipe cleaning generally is not sufficient for full disinfecting Mopping a floor and letting it air dry generally is sufficient contact time as most floors will take about 10 minutes to dry You must read the directions or procedures section of the label to determine the proper dilution and contact time to get the full benefits of the germicide READ THE LABEL What is the proper dilution or activity level Every germicide will either be ready to use or they will be concentrated and must be diluted Proper dilution of con centrated is important to get the full benefit of the germicide By using a dilution higher that what is recommended either by intention or by accident glug glug you do not get any additional benefit It will only be more expensive as you will purchase more chemical that you really needed Know the activity level or p
7. decide and approve what disinfectants and cleaning methods are to be used for each part of their medical facilities OSHA Bloodborne Pathogen Act What is the OSHA Blood Borne Pathogen Act The Bloodborne Pathogen Act was created by OSHA Occupational Safety and Health Administration to reduce the number of cases of infectious Hepatitis B and HIV AIDS transmitted form infected blood and body fluids in the workplace It covers any employee who may be exposed to infected blood and body fluids Health care workers are particularly affected In the early 1980 s OSHA knew very little about HIV AIDS and HBV Hepatitis B Virus two relatively new bloodborne pathogens at that time However they new that thousands of health care workers were getting sick form these viruses and some were dying Due to this OSHA determined that they needed to implement a law to help protect workers from these pathogens The OSHA Bloodborne Pathogen Act was instituted on December 6 1991 Under the Act employers must 1 Develop a written exposure control plan including a The determination of which employees may be exposed b Procedures for evaluation the circumstances of an exposure c Aschedule and methods for implementing the plan 2 Provide information and training for each employee covered by the act 3 Vaccinations for infectious hepatitis must be made available to all employees covered by the Act 4 Established engineering and work practice contro
8. know the pH of the germicide and how it will affect the surface to which it is being applied pH is a unit of measure The pH scale is 0 14 and measures the amount of acidity or alkalinity in a solution Acid Germicides pH 0 6 are generally effective in restroom cleaning Acids are useful for dissolving mineral deposits hard water soap scum and rust stains in sinks shower rooms and toilet bowls etc Neutral Germicides pH 7 8 are generally used for daily cleaning of vinyl tile and terrazzo floors sealed with acrylic floor finish Neutral Cleaners will not harm the shine and leaves no residue when used properly Alkaline Germicides pH 8 14 Generally the higher the pH the better cleaning and degreasing properties a cleaner germicide will have However cleaner germicides over pH 10 can be harmful to floor finishes Battery Lemon Orange Shampoo Water Baking Laundry Ammonia Caustic Acid Juice Juice Coke Soda Detergent Soda 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Strong Acid Mildly Acidic Neutral Mildly Alkaline Strong Alkaline Bowl Shower Carpet Neutral All Purpose Germicides Floor Cleaners Cleaners Debrowners Germicides Strippers How expensive is this germicide Never choose a germicide based on the cost per gallon of concentrate Always focus on the end use cost which is calculated using this formula per gallon concentrate End use cost dilution rate Example Compare end use cost of a ounce per gallon hospital disinfectant at 2
9. of as being similar to a seed of a plant The seed or spores will not germinate until they are planted in the ground and the conditions are favorable for growth such as warmth spring sun moisture rain and food fertilizer Spores are generally not killed by most disinfectants See pages 11 12 for a list of germs and what diseases they cause Good Non Pathogenic Microorganisms vs Bad Pathogenic Microorganisms All microorganisms do not cause disease There are many helpful germs called Non Pathogenic Microorganisms In fact we could not live without non pathogenic microorganisms For example you could not digest your food without the bacteria present in your stomach Some fungi yeast help make food such as bread beer wine or spirits Bacteria break down dead organic material compost piles Molds are used to make medicines such as penicillin However many other germs can make people sick and even cause them to die These are called pathogenic germs The pathogenic germs are the ones we need to control and stop their growth before they make people sick How do germs live All microorganisms require three things to grow and multiply 1 Food Source Almost any carbon based material will suffice Food grease dirt body oils soaps dirty mop buckets solutions rotted wood damp cotton Microorganisms will eat most anything 2 Moisture High Humidity in shower rooms flood or sewer back ups solution tanks on au
10. should be cleaned with a Equipment germicidal cleaner in the same manner as the rest of the surgery areas Trash Can Liner 4 Empty all trash receptacles and clean receptacles inside and outside with germicidal 5 Cleaning Cloths cleaner Replace plastic liners e 24 Dust Mop 5 Dust mop floor using clean dust mop e Auto Scrubber or 6 Preclean soiled areas Check closely as many times there will be blood spots that 16 oz wet mop are hard to see For complete wash down dip wall mop in germicide cleaner wring Mop bucket mop dry and wipe all walls and ceilings Let air dry e Dust pan 7 Wipe lightly over table on inside and outside with germicidal cleaner Lights can be e Counter brush moved down for better cleaning e Scrub Suit 8 Using high dust tool spritzed with a germicidal cleaner clean lights vents clock e Shoe Covers light rails etc Use ladder to get light tracks and rails in ceiling e Face Mask 9 Damp wipe all ledges electrical cords light switches cabinet door tracks stools Disposable gloves stands with a germicidal cleaner and let air dry 10 Move all equipment that can t be removed to one side of the room Mop or autoscrub floor with germicidal cleaner and let air dry Move equipment to other side of room and clean the opposite sides of the floor 11 In scrub rooms thoroughly clean sinks with germicidal cleaner Clean plumbing fixtures above and below the sink with cloth and germicidal cleaner and l
11. 5 60 per gallon vs a 2 ounce per gallon hospital disinfectant at 12 30 per gallon 23 50 257 0 09 per gallon diluted 257 1 256 oz per gallon 12 30 65 0 19 per gallon diluted 65 1 64 2 oz per gallon As you can see the 1 2 oz gal disinfectant at 23 50 is more economical to use than the 2 oz gal product at 12 30 gal 0 09 vs 0 19 per gallon diluted This end use cost will tell you how much it costs every time you use the product This cost is much more important than the price per gallon of concentrate Make sure your germicidal product is EPA registered Every pesticide including disinfectants and sanitizers sold in the United States must be registered with the Environmental Protection Agency EPA The EPA registration number can be found on the label In addition each manufacturer must register each pesticide in each state that the pesticide will be sold in This registration must be renewed every year Distributors should check with the manufacturers to verify that every disinfectant they are selling is properly registered for the states they are selling into The cost of registering each disinfectant in all 50 states can be expensive so some manufacturers choose to register their disinfectants regionally or only in states where they expect to sell them READ THE LABEL Safety This is a rather broad area but is extremely important to the user Employees charged with the responsibility of using disinfec
12. A EE E T EE 1 Types and Chemistry of Germicides 00 eee cecccecceeeeeeeeeeeeeeennaeeeeeeeeenaeeeeeeeeenaaees 2 Specific Concerns in Health Care Facilities 2 0 0 0 ccecccccceccecceeeeeeeeeeeeeteteeeeeeeees 3 OSHA Blood Borne Pathogen Act sseeessssssseesssrrnessrsrnrrassrrrennneesrnennnaaatnennneseeeet 4 Whatis HBV Hepatitis AIDS ianen ara eaaa a E aai aeaa 5 Choosing the Correct Germicide 0 ee ceeeeeceeceeeeeeeeeeeeeeeeneaeeeeeteeeneaeeeeeneeeaaees 6 7 Cleaning Procedures roete EEA E EAE 8 10 Significance of Bacteria Fungi and VirUS 00 0 0 cecccccceeeeeceeeeeeeeeeeeteteeeeeees 11 12 DO TIMMONS aeaa E E E E EEEE 12 13 QuiZ TIME a a E E vedanta ec EER a 14 MAli Ciear Germicides enes ine e AEE EEEE EEA 15 How to sell Disinfectants to Hospitals cccccecceeeeeeeeeeeeeeeeeeeeeeneaaeeaeeeeeeees 16 Four common mistakes made with germicides c cceeeeeeeeeeeees Back Cover Germs What is a Germ The term Germ is a generic term used to describe microorganisms that can cause disease These microorganisms can be bacteria viruses fungus mold or mildew all single cell organisms that can only be seen with the use of a microscope See specific definitions of the different types of germs listed below Bacteria Microorganisms that do not depend on other organisms for survival They can survive on surfaces for long periods including door handles sinks mops rags countertops cooking utensils
13. Aey Jamsuy ZNO Multi Clean Germicides Ful Trole 64 Multi Purpose Cleaner Disinfectant amp Deodorizer Hospital Grade Disinfectant when used at 2 ounces per gallon of water and a Institutional Grade Disinfectant when used at 1 1 4 ounces per gallon of water Multi Purpose restroom cleaner Bactericidal Including Pseudomonas Staphylococccus Salmonella Streptococcus MRSA VRE Virucidal HIV 1 HBV HCV Fungicidal including Tricophyton and Mold and Mildew Effective in 400 ppm hardness calculated as CaCO3 in the presence of 5 Organic Serum Lemon or Floral scents pH 12 0 12 4 EPA Registration Number 10324 80 5449 Century Q 256 Disinfectant Cleaner Health Care Disinfectant A neutral pH 1 2 ounce per gallon hospital grade cleaner disinfectant Use on high gloss finished floors without dulling Broad Spectrum efficacy including HBV HCV MRSA VRE and HIV 1 AIDS VIRUS Also effective against Canine Parvo when used at 2 oz gallon See Technical Bulletin for complete list Floral fragrance EPA Registration Number 10324 141 5449 Fresh 100 Non Acid Disinfectant Bowl Cleaner Hospital grade ready to use disinfectant cleaner for restroom maintenance Its germicidal formula and clinging action makes this exceptional for toilet bowel and urinal sanitation It is effective against Pseudomonas aeruginosa Staphylococcus aureus Salmonella choleraesuis the hospital trio Streptococcus pyogenes Trichophyton interdigitale Influenza T
14. Multi Clean Technical Bulletin Understanding Sanitizers and Disinfectants A practical guide on how to select the appropriate germicide for your needs along with procedures for cleaning all types of facilities 2007 Multi Clean All rights reserved Introduction This Multi Clean Technical Bulletin is designed to be a guide and reference manual that will help educate you and your staff on the importance on what germs are and why germicidal cleaners are needed As housekeeping professionals an important part of your job is to clean areas that require a high degree of cleanliness such as restrooms classrooms hotel rooms restaurants medical facilities such as hospitals nursing homes etc The correct use of germicidal cleaners is required to achieve the desired level of cleanliness Understanding how germcides work and which one to use are critical to your success Information contained in this bulletin is designed to help you achieve your goal Topics include Types of germicides chemistry of germicides specific concerns in health care facilities what the OSHA Blood borne Pathogen Act is and how to comply with it how to choose the correct germicide as well as cleaning procedures for different types of facilities A brief description of many different microorganisms and why they are important a quiz and term definitions are also included for your convienience Good Luck Table of Contents GOMIMS E PEE E A E A
15. albicans c MRSA VRE and HBV d HIV Herpes Simplex II and Trichophyton mentagrophytes 10 11 12 13 14 15 16 Nosocomial Infections are defined as a Contracting an infection while in the hospital for something else b Contracting an infection while at home sleeping c Contracting an infection while working in a meat processing plant d Contracting an infection while in an airplane Under the Bloodborne Pathogen Act Employers are required to offer vaccinations to covered workers for what disease a HIV b Salmonella c HBV d MRSA How long should a germicide stay in on a surface for full efficacy a As long as it takes to clean the surface b Each germicide is different you must read the label c Until break time is over d Until the foam goes away What is the pH of a Neutral Germicide a 1 b 3 c 7 d 10 Alkaline Cleaners germicides are good at cleaning up hard water deposits T F Two 2 ounces per gallon is what ratio a 1 2 b 1 10 c 1 64 d 1 256 Every germicide sold in the U S must be registered with what U S government department a OSHA Occupational Safety amp Health Administration b FDA Food and Drug Administration c USDA United States Dairy Association d EPA Environmental Protection Agency A 91 9 94 Sled O EL A Zh O Lb W OL W 6 ONIL g ONIL Z as e4 9 O S A Y A E A Z V L 14
16. atory diseases It is spread from person to person Avian Infectious Bronchitis An acute rapidly spreading viral respiratory infection of chickens Canine Distemper A highly contagious disease among dogs causing fever gastrointestinal and respiratory problems Feline Leukemia Virus This virus is demonstrated in cats with lymphosarcoma It appears in the mouth of infected cats and is passed from cat to cat Feline Picornavirus Feline calicivirus is the synonym Produces a respiratory disease conjunctivitis and vesiculation in the mouth of cats Hepatitis B Virus Hepatitis B Virus HBV is a virus that attacks the liver and can cause lifelong infection cirrhosis scarring of the liver liver cancer liver failure and death Herpes Simplex Type 1 Virus causing fever blisters and canker sores caused by colds Herpes Simplex Type 2 Causes lesions on penis urethra vulva vagina and skin of buttocks Human Immunodeficiency Virus Causes severe damage to the human immune system often leading to death The virus that causes AIDS infects white blood cells and T helper cells that play key roles in body s immune system Infectious Bovine Rhinotracheitis Inflammation of the upper respiratory tract If occurs with bacterial infection may cause bronchial pneumonia May invade the placenta and fetus via maternal blood stream causing abortions or stillbirths Causes encephalitis in 2 3 month old calves also oral amp gastric necrosis in newborn
17. blood or body fluids from an infected person enters the body of a person who is not immune Sexual contact sharing needles with an infected person or from an infected mother to her baby during birth are other ways to contract HBV World wide it is estimated that there are over 350 million Hepatitis B carriers which represents 5 of the world s population HBV is responsible for killing about one million people each year It is estimated that 10 to 30 million people become infected with the virus each year HBV is very common in Asia China Philippines Africa and the Middle East In Europe and North America the incidence of known Hepatitis B carriers is about 1 in a 1000 people Infected persons can be lifelong chronic carriers of the disease There is no known cure although there are some medications to treat long lasting HBV which are effective for only 40 of infected persons The good news is that vaccinations are available for HBV Other Hepatitis Virus s Hepatitis A virus HAV is a less serious liver disease caused by the Hepatitis A virus HAV HAV can affect anyone and is spread through food or water HAV must be ingested and then is shed in the feces HAV is usually present in unsanitary conditions or when poor hygiene is used by food servers There is no known treatment of Hepatitis A It generally lasts from a few days to a few weeks and leaves the person immune to Hepatitis A Hepatitis C virus HCV can cause cirrhosis scarri
18. chemist Never ever mix a disinfectant with any other chemicals unless directed to by a disinfectant label 4 Not mixing the proper dilutions Read the label for specific dilutions for each application Adding more disinfectant than directed does not give you more effectiveness for disinfecting a surface it only will cost you more money by wasting chemical By using less disinfectant than required will not give you disinfecting properties that you are requiring which is why you are using a disinfectant in the first place For additional information contact Multi Clean Inc at 1 800 433 6816 Ask for a Chemist or for technical service Multi Clean 600 Cardigan Road Shoreview MN 55126 Phone 651 481 1900 Fax 651 481 9987 www multi clean com 1403 1 07
19. cilities While every facility has different cleaning procedures these recommendations can be used as either a starting point for developing a procedures manual for a new facility or it may be of use to compare to current cleaning procedures to determine if existing cleaning procedures are optimized or could be updated to be more efficient Classrooms 1 Assemble all product and equipment items Place wet floor signs Put on disposable gloves Empty all trash receptacles and damp wipe with cloth and germicidal cleaner Allow to air dry Replace plastic liner Erase chalk boards white boards and partitions and clean with appropriate cleaner Damp wipe ledges vents and sills if applicable with cloth and germicidal cleaner and let air dry Damp wipe top of desks and chairs if applicable with cloth and germicidal cleaner and let air dry Vacuum surfaces if applicable with back pack vacuum Dust mop floor if applicable Damp mop floor if applicable with germicidal cleaner and let air dry Spot clean carpet if applicable with carpet spot cleaner 10 Vacuum carpet if applicable Recommended Multi Clean Products Ful Trole 64 Microcide TB GTS Foaming Disinfectant Cleaner Super Staph Trole 256 or Century Q 256 Products Required Germicidal Cleaner Carpet Spot Cleaner Equipment Trash Can Liner Cleaning Cloths 24 Dust Mop 16 oz wet mop Mop bucket Dust pan Counter brush Disposable gloves COND oO A Q N Pro
20. ducts Required e Germicidal Cleaner e Glass Cleaner Restrooms 1 Evacuate toilet bowls Apply bowl cleaner to interior and under rim of toilet bowels and urinals Move to step 2 do not flush 2 Empty trash and wipe out receptacles as needed e Toilet Bowl Cleaner 3 Sweep FIORT his Acid and or Non 4 Restock supplies toilet paper towel dispenser soap dispensers sanitary napkins Acid etc 5 Clean the exterior of all dispensers hand dryers fixtures and baby changing Equipment stations etc Lightly spray surface with germicide then with a clean cloth Trash Can Liner 6 Clean sinks porcelain surfaces and chrome with germicidal cleaner Cleaning Cloths 7 Clean walls and partitions especially near stools and urinals 24 Dust mo 8 Clean mirrors with glass cleaner and a lint free cloth p 9 Return to toilets urinals and spray exterior porcelain surface and fixtures with 16 24 oz Wet mop germicidal cleaner and wipe Wet floor signs 10 Swab interior surfaces with bowl mop then flush 4 6 gal mop bucket 11 Damp mop floor with germicidal cleaner from bucket starting at rear of restroom Dust pan and working toward the exit Counter brush Hand Soap paper towels Toilet paper e Disposable gloves Recommended Multi Clean Products Fresh 100 Non Acid Bowl Cleaner 950 Bowl Cleaner 2300 Bowl Cleaner Ful Trole 64 Microcide TB GTS Foaming Disinfectant Cleaner Multi Shine Glass and Surface Cleaner and or Ful Trole 64
21. e body they destroy our tissues and emit poisons that the body absorbs These poisons cause disease Microorganisms can reproduce by doubling every 15 20 minutes or so Theoretically one germ at 8 AM can multiply to over 76 billion germs by 5 PM under optimum conditions This quick ability to multiply is why we must constantly keep cleaning and disinfecting places where these germs can live and come in contact with humans Different levels of germ control There are different levels of sanitation that are used to reduce or kill microorganisms depending on the need Sanitization Reduces germs to a safe level as judged by public health standards Sanitizing must reduce the number of germs by 99 99 While 99 99 sounds like it should be good enough it still can leave a significant number of germs on a surface There can be several billion germs on a dirty surface such as a dirty plate If you have 5 000 000 000 germs on a surface and you are able to take away 99 99 of them you are left with 500 000 germs on the surface Again sanitization reduces germs to safe levels Disinfection Kills 100 of the germs claimed on a disinfecant label when used as directed It does not kill spores Sterilization Will eliminate 100 of all germs and their spores This is accomplished by the use of autoclaves Autoclaves are equipment that use high heat and pressure to kill any germs and spores 1 Types of Germicides Germicides can come in many diff
22. edures which must be used in establishing data to be submitted the EPA for registration A O R N Association of Operating Room Nurses An association formed to streamline procedures and increase levels of sanitation in operating rooms Their publications and the association are recognized by all hospital organizations A P I C Association for Professionals in Infection Control and Epidemiology Their mission is to influence support and improve quality of healthcare through practice and management of Infection Control and the application of Epidemiology in all health care settings Asepsis The state of being free from pathogenic microorganisms Bactericidal The property of killing bacteria Bacteriostatic Inhibiting the growth of bacteria CDC Center for Disease Control A division of the Department of Health Education and Welfare web site http www cdc gov An excellent source of information on disease and heath related topics Contact Time The time a disinfectant or sanitizer must remain in contact for full efficacy of stated claims generally 10 minutes Must read label to obtain this information 12 Definitions con t Culture A growth of microorganisms in nutrient media the process of growing microorganisms Disinfection The destruction of 100 of claimed pathogenic organisms Efficacy Data The ability to destroy a specific claimed germ as tested by the A O A C Use Dilution Test for disinfectants EPA Env
23. erent forms e Ready to Use Aerosol Foaming amp Non Foaming Non Aerosol usually with a trigger sprayer e Concentrated 1 4 ounce per gallon up to 28 ounces per gallon of water e Hospital Grade Disinfectant Must have claims to kill Pseudomonas aeruginosa Staphylococcus aurous amp Salmonella choleraesuis the hospital trio as a minimum e Institutional Disinfectant schools industry hotels etc Must have claims to kill Staphylococcus aurous amp Salmonella choleraesuis as a minimum Chemistry of Germicides Quaternary Ammonium Chlorides Quat e Low level disinfection e Most common type of disinfectant and sanitizer e Many different grades of quats each with its own specific advantages claims e Can be Hospital Grade or Institutional Grade or both depending on dilutions e Pleasant odor not medicinal like phenolics Easy to formulate different fragrances into e Great Cleaner Can be formulated with detergents and builders to make disinfectants One Step Cleaner and Disinfectant e Can be used on food contact surfaces e Can be formulated into neutral acid or alkaline based cleaners disinfectants e Not effective against TB Tuberculosis by itself There is a dual quat solvent blend disinfectant on the market that is effective against TB such as Multi Clean s Microcide TB Phenolics Compare e Intermediate level disinfection e Effective against TB Quats Phenolics Bleach e Medicinal Fragrance
24. erized by severe cramping abdominal pain and diarrhea with blood and mucus Staphylococcus aureus Causes skin infections such as cellulitis boils carbuncles impetigo and postoperative wound infections Can cause food poisoning and toxic shock syndrome Both community and hospital acquired infections such as bacteremia endocarditis meningitis pneumonia and osteomyelitis Staphylococcus epidermis Causes bacteremia infective endocarditis peritonitis associated with dialysis and predominantly genitourinary tract infections Streptococcus faecalis Group D occurs in the neonatal period Anatomical defect in the central nervous system neurological intervention endocarditis urinary tract infections may lead to meningitis Streptococcus pyogenes Beta Hemolytic Group A Transmission from person to person usually from close contact by an asymptomatic carrier colonized in the nasopharynx skin angina or rectum It may be transmitted by contaminated food Causes pharyngitis tonsillitis sinusitis arthritis etc After five weeks of pharynageal infection rheumatic fever scarlet fever or impetigo may occur Significance of Specific Fungi Candida albicans A sexual budding yeast that is a normal flora of the throat Causes vaginal infections Trichophyton mentagrophytes A fungus that is the common cause of athlete s foot interdigitale 11 Significance of Specific Virus s Adenovirus Type 4 Causes less than 5 of acute respir
25. et air dry Other metal apparatus such as soap dispensers should be thoroughly cleaned with a germicidal cleaner 12 Damp wipe hamper stands in scrub area with germicidal cleaner and set in fresh hamper bag After completion of workday equipment must be wiped down with a germicidal cleaner and let air dry After disinfecting wipe dry with a clean rag and leave in surgery delivery for the next day s use Do not remove any housekeeping equipment from sterile surgery area Recommended Multi Clean Products PHD 257 Phenolic Hospital Disinfectant Emergency Rooms Out Patient Clinics 1 Assemble all product and equipment items Place wet floor signs Put on disposable gloves Empty wastebaskets and damp wipe with cloth and germicidal cleaner Replace liners Damp wipe horizontal surfaces with cloth and germicidal cleaner Spot clean vertical surfaces with cloth and germicidal cleaner Damp wipe litters wheel chairs etc with cloth and germicidal cleaner Clean bathrooms as per procedure on page 14 Replenish all disposable supplies i e toilet paper paper towels etc Clean all glass areas with cloth and germicidal cleaner Polish all stainless steel and bright metal surfaces with cloth and germicidal cleaner 9 Dust mop floors if applicable using clean dust mop 10 Damp mop floor if applicable using germicidal cleaner and let air dry 11 Spot clean carpet if applicable using carpet spot cleaner 12 Vacuum carpet if applicable
26. floors bedposts etc Common examples of bacteria include Pseudomonas Staphylococcus Salmonella hospital trio Streptococcus and E coli Viruses Microorganisms that must attach itself to another organism host to survive The do not survive on hard surfaces for long Direct contact is required for these microorganisms to survive Common examples of viruses include Influenza Herpes Simplex HIV AIDS Rabies and Canine Distemper etc Fungus Aprimitive plant that is parasitic obtains nourishment from other living organisms or saprophytic feed on dead or decaying plant or animal material Common examples of Fungus include Yeast Mushrooms Bacteria Molds and Trichophyton Athletes Foot Mold and Mildew Mold lives in the soil on plants and on dead or decaying matter Molds are a fungus and unlike plants they lack chlorophyll and must survive by digesting plant materials using plant an other organic materials for food Molds produce tiny spores to reproduce just a plants produce seeds Molds have the potential to cause health affects including alleries and asthma Mildew is a living organism that grows with warmth humidity and nutrients It is a thin black or sometimes white growth produced by mold Common Molds include Aspergillus Spores The reproductive element of certain microorganisms Spores are generally dormant and can survive for long periods of time sometimes years and are very difficult to kill Spores can be thought
27. g with a bow amp arrow and hunting with a bazooka An antibiotic is designed to enter the living body and target a specific cellular target e g a particular site in an enzyme Just one slight change a simple mutation and the germs will become resistant to the antibiotics Quat disinfectants however are nonspecific in their attack They attach to anything anionic in nature like the bacterial protein i e the amino carboxyl or phosphate groups that surrounds the bacteria The quat by surrounding the bacteria disrupts the charges on the cell wall causing a change in charge distribution disorganization denaturing This disruption causes a subsequent release of the intracellular material or autolysis to take place Thus the cell is killed Nosocomial Infections Contracting an infection ailment while in a hospital for something else Example Go into hospital to have a gall stone removed and contact a urinary tract infection Statistics show that there is a 5 10 chance of contracting a nosocomial infection when you enter a hospital Urinary Tract Surgical Wound and Lower Respiratory Infections are the most common types of infections contracted while staying in the hospital Nosocomial infections affect over 1 000 000 people each year Infection Control Committees Committees in hospitals and health care facilities made up of doctors nurses and or administrators that are responsible for controlling the spread of infections These committees
28. holerasuis not Pseudomonas aeruginosa Mold amp Mildew Forms of fungus Molds lack chlorophyll and must survive by digesting plant materials using plant and other organic materials for food Molds produce tiny spores to reproduce Mildew is a living organism that grows in warmth humidity and nutrients It is a thin black or sometimes white growth produced by mold One Step Cleaner Disinfectant A product capable of cleaning lightly soiled surfaces and disinfecting them in one step With out this claim a pre cleaning step is required No Rinse Sanitizer Sanitizer used in food processing plants not rinsed after use Non Pathogenic organism A non disease causing organism Non pathogenic bacteria can be used in carpet odor digesters trap amp drains sewage treatment plants etc Odor Causing Bacteria Bacteria that emit foul smelling waste products such as Proteus Vulgaris Pathogen A disease causing organism Phenol Carbolic Acid Phenol derivatives are used in disinfectant compounds Originally extracted from coal tar they are produced synthetically today PPM Parts per million Also can be stated as milligrams per liter Quat Shortened name for quaternary ammonium compounds These surfactants are the active ingredients used in the manufacturing of quat based disinfectants The active ingredients destroy or disrupt the cell wall of microorganisms Sanitizer A chemical which will kill 99 99 of claimed organisms
29. icemia blood poisoning Pseudomonas aeruginosa Has ability to survive and multiply in fluids water and moist environments found in hospitals Hospital acquired infections usually occur to patients having prior instrumentation or manipulative procedures such as urethral catheterizations tracheostomies and intravenous infusions of medications and fluids The most important human sources are infected wounds urine and lesions producing exudates Causes infant diarrhea ocular infections burn infections cystic fibrosis folliculitis osteomyelitis and malignant external otitis Proteus mirabilis amp vulgaris Causes urinary tract infections infant diarrhea and respiratory tract infections Salmonella choleraesuis Causes gastroenteritis septicemia bacteremia and arthritis Most common cause of bacterial diarrhea in the United States Samonella enteritidis Food poisoning salmonellosis septicemia diarrhea People can become carriers Salmonella typhi Causes typhoid enteric fever Organisms enter the body via contaminated food and water invading the intestinal tract Salmonella typhimurium Invades intestinal tissue and enters the blood stream causing enterocolitis and chronic gallbladder infections Serratia marcescens Can cause cystitis bloodstream and central nervous system infections May be associated with nosocomial and antibiotic resistant infections Shigella flexneri amp sonnei Causes bacillary dysentery charact
30. ironmental Protection Agency The federal branch of government responsible for the registration of pesticides Fungus Multi Cellular organisms including molds mildews and mushrooms Reproduction is accomplished through the formation of spores Germicide Chemical compounds which kills microorganisms i e sanitizers disinfectants and sterilants Gram Negative bacteria A classification of bacteria which due to it s cell wall composition becomes pink in color when stained according to the Gram Test Staining Procedure Gram Negative bacteria are generally pathogenic disease causing Gram Positive A classification of bacteria which due to its cell wall composition becomes purple in color when stained according to the Gram Test Staining Procedure Gram positive are generally non pathogenic does not cause disease Hard Water Water which contains high levels of calcium and magnesium Hard water can inactivate some quat disinfectants Must read labels to determine if disinfectants were tested in hard water Hospital Grade Disinfectant Disinfectants which have been proven effective against three organisms Staphylococcus aureus Salmonella choleraesuis and Pseudomonas aeruginosa the hospital trio Incubation A period of time required for microorganisms to develop as described in the A O A C use dilution test Institutional General Disinfectant A disinfectant with efficacy claims against Staphylococcus aureus and Salmonella c
31. lean mop and germicidal cleaner and let air dry Make up fresh germicidal solution after every 4 rooms or when dirty Recommended Multi Clean Products Ful Trole 64 Microcide TB or GTS Foaming Disinfectant Cleaner Super Staph Trole 256 Century Q 256 1 2 3 Whirlpool Baths Products Required e Germicidal Cleaner Equipment Trash Can Liner e Cleaning Cloths 18 Dust mop 16 24 oz Wet mop Wet floor signs 4 6 gal mop bucket Dust pan Counter brush Hand Soap paper towels Toilet paper e Disposable gloves e High Duster e Linens If the whirlpool bath has soap scum and or mineral deposit build up do the following procedure before using the disinfectant Use a phosphoric acid or similar cleaner to clean the soap scum and or mineral deposit build up Use a brush or non abrasive pad to help remove stubborn build ups Rinse with water To Disinfect Whirlpool Baths After using the whirlpool unit drain and refill with fresh water to just cover the intake valve Use appropriate amount of an approved germicidal cleaner as directed on label Start the pump to circulate the solution Wash down the unit sides seat of the chair lift and any all related equipment with a clean swab 1 2 Recommended Multi Clean Products Phos Clean Bowl and Tile Cleaner Ful Trole 64 Disinfectant Cleaner brush or sponge Treated surfaces must remain wet for 10 minutes Repeat for heavy soiled units Drain germicide solu
32. liar with the responsibilities of the Infection Control Nurse and include this important buyer as a primary prospect on every hospital sales call This individual coupled with the Environmental Services Manager will be the key resources you need to get your product considered by the Infection Control committee In addition to evaluating disinfectant products the Infection Control Committee determines all hospital policies related to infection control and provides meaningful implementation of the policies This committee usually meets monthly to identify baseline information about e Frequency and type of nosocomial infections e Provide protection for staff and patients from the development of nosocomial epidemics e Meet the requirements of JCAHO e Provide the medical and nursing staff with meaningful data concerning the level of nosocomial infections in the facility and in their area of specialty Initial call on a new hospital account When approaching a medical facility as a potential disinfectant account you must determine the level of satisfaction of the products that they are currently using You must conduct a Needs Analysis in attempt to uncover any dissatisfaction they may have with their current products This could include 1 Inefficient cleaning 4 Pricing 2 Incomplete germicidal claims 5 Service 3 Safety concerns 6 Contractual obligations Since we are selling to multiple people when selling disinfectants we a re inv
33. ls to reduce exposure to the potentially infected fluids Personal protection and equipment may also be covered Proper housekeeping including the use of appro priate disinfectants is also required Containers and equipment holding potentially infected blood or body fluids must be labeled accordingly 5 Ifan exposure incident occurs a medical evaluation and follow up must be made available to the exposed employee 6 Records must be kept for each employee covered by the Act Medical training records are required What products are approved for use by the OSHA Bloodborne Pathogen Act Originally only chlorine and tuberculocidal TB disinfectants were approved for use in disinfecting blood and body spills Quaternary based disinfectants were not approved to meet the OSHA Bloodborne Pathogen Act standards In the early 1980 s little was known about HBV and HIV They did not know how difficult it was to kill HBV and HIV Since TB was already known to be a very difficult virus to kill OSHA decided to pick it as a standard They assumed that if a disinfectant could kill TB it would also be effective against HBV or HIV This caused lots of confusion as people assumed that this standard had something to do with TB TB can only be transmitt by airborne particles from a person infected with TB who coughs and then is inhaled someone who is nearby and inhales these airborne particles deep into their lungs TB is not transmitted by blood body fluids or f
34. ng of the liver Infected persons can be lifelong chronic carriers of the disease No vaccinations are available for HCV Most cases of HCV identified recently are found in people who were infected years ago Since blood banks are screening potential donors very few new cases have been identified What is AIDS AIDS stands for Acquired Immune Deficiency Syndrome AIDS is caused by a virus called HIV Human Immunodeficiency Virus If you get infected with HIV your body will try to fight the infection It will make antibodies special molecules that are suppose to fight HIV When you get a blood test for HIV the test is really looking for these antibodies If you have these antibodies in your blood it means that you are HIV Positive Being HIV Positive is not the same as having AIDS Many people are HIV Positive but don t get sick for many years As HIV continues it slowly wears down the immune system Viruses parasites fungi and bacteria that don t usually cause problems can make you very sick when your immune system is damaged The blood vaginal fluid semen and breast milk of people infected with HIV has enough of the virus in it to infect other people You can get HIV from anyone who s infected even if they don t look sick and even if they haven t tested positive Most People get the HIV virus by having sex with an infected person sharing a needle with someone who s infected being born to an infected woman or drinking the b
35. olved in a complex sale Acomplex sale is defined as one in which several people must give their approval before the sale can take place This concept has tremendous implications because of the variety of people involved in the complex sale and the variety of conflicting decisions that theses people have to make These are some buying influences in a complex sale especially one involving disinfectants 1 Economic Buyer Screens out possible vendors When selling to the Economic Buyer keep in mind that this person gives the final yes or no It is important to find out who this person is and in most cases this buyer is the Director of Environmental Services 2 User Buyer Primarily concerned with how the sale is going to affect every day operations in their own department Examples of User Buyer would be the Director of Environmental Services supervisor cleaning staff If this Buyer is not sold you ll have a difficult time closing the sale 3 Technical Buyers Include Purchasing Agents and Infection Control Nurses When selling to Technical Buyers keep in mind that they can t say yes to your product but they can sure say No And they usually do They are the gatekeepers they get paid to say no The key to selling these people is to really know and understand your product and the tests it might have to meet in a given sales situation In order to close a complex sale you must sell all the buying influences Anyone can hinder your succe
36. oor signs e 4 6 gal mop bucket e Dust pan Recommended Multi Clean Products Ful Trole 64 Microcide TB GTS Foaming Disinfectant Cleaner Super Staph Trole 256 Century Q 256 ao fF NS NO 8 9 10 11 12 Patients Room After Discharge Assemble all product and equipment items Put on disposable gloves Remove all soiled linens if applicable from the room bed and restroom and place in the soiled linen hampers provided for that area Empty all waste receptacles and damp wipe with cloth and germicidal cleaner Replace liners Spritz high duster with germicidal cleaner Dust tops of lights doors curtains blinds etc Damp wipe ledges shelves over bed lights over bed tables inside and out bedside stands inside and out desk tops chairs telephones door frames and closets inside and out with cloth and germicidal cleaner and let air dry Spot clean walls with cloth and germicidal cleaner Using germicidal cleaner and damp cloth completely disinfect the bed and mattress working from top to bottom Apply germicidal cleaner directly into hard to reach areas including corners wheels Let air dry Remake bed with clean linens according to requirements for that particular area Place restroom linens in appropriate location Clean restroom as outlined on page 10 Dust mop floor if applicable with clean dust mop Place wet floor signs to keep traffic out of area to be damp mopped Damp mop floor if applicable with c
37. oper dilution or activity level If cleaning up blood or body fluids e Is this OSHA Blood Borne Pathogen Act compliant e Is it effective against HIV HBV and or HCV Is the germicide effective in Hard Water Is the germicide tested in the presence of Organic Soil What pH does the germicide need to be How expensive is the germicide Is the germicide registered with the EPA How about the state it is being used in READ THE LABEL What microorganisms do I need to control Do you want to control bacteria from handling raw meat or eggs or how about mold and mildew in shower rooms or HIV and HBV in medical facilities or cleaning up after a basement floods from a sewer back up or cleaning up vomit in a school or cleaning a hallway vinyl tile floor with floor finish Each of these scenarios has their own specific needs and requires a specific germicide to handle a specific problem You must know what you are trying to accomplish and then checking the germicide label to determine if it has efficacy against these germs e o o o e o o o o Efficacy is the ability to destroy a specific claimed germ All disinfectants must undergo strict laboratory tests to prove that it is effective against each germ that it has made claims for These results are then submitted to the EPA for review before the label is approved The label will also list directions for use that will include proper dilution contact time and any pre cleaning steps that may
38. per etc e Disposable gloves Products Required e Germicidal Cleaner e Absorbent Equipment e Cleaning Cloths e 24 Dust mop e Gloves gown goggles face mask e 16 24 oz Wet mop e Wet floor signs e 4 6 gal mop bucket e Dust pan e Counter brush e Bio Hazard Bags e Spatula e Absorbant e Disposable gloves ON AF WN gt Cleaning Procedures con t Patient Room Occupied Assemble all product and equipment items Put on disposable gloves Knock before entering room Empty all waste receptacles and damp wipe with cloth and germicidal cleaner Replace liners Remove soiled linens Spritz high duster with a gemicidal cleaner High dust tops of lights doors curtains blinds etc and let air dry Damp wipe ledges over bed tables bedside stands desk tops telephones charts door frames and closets with cloth and germicidal cleaner and let air dry Spot clean walls with cloth and germicidal cleaner Damp wipe bed frame and mattress with cloth and germicidal cleaner and let air dry Clean restroom as outlined on page 10 Dust mop floor with clean dust mop Place wet floor signs to keep traffic out of area to be damp mopped Damp mop floor with clean mop and germicidal cleaner let air dry Make up fresh germicidal solution every 4 rooms or when dirty Products Required e Germicidal Cleaner Equipment e Trash Can Liner e Cleaning Cloths e 18 Dust Mop e 16 24 oz wet mop e Wet fl
39. pm parts per million of active ingredients for germicidal cleaners The of active ingredients are found on the label and be translated into ppm by simply using this formula of active ingredient x 10 000 15x10 000 586 ppm 1 2 oz gal 256 1 256 dilution rate of product 256 1 oz gal 128 1 128 2 oz gal 64 1 64 Knowing the quat ppm active is important because the effectiveness can deteriorate as the quat germicidal solutions become dirty The ppm of quat in a mop bucket or spray bottle can be easily tested with test strips that are dipped into a germicide solution and then compared to a color chart on the test kit that will translate into active PPM quat READ THE LABEL Is this germicide effective in Organic Soil Some germicides are not effective on dirty surfaces Some germicides are inactivated in the presence of organic soil such as bleach All germicides should be effective in at least 5 Organic soil blood serum READ THE LABEL Is this germicide effective in Hard Water Some quat disinfectants are not effective in hard water Look at labels to determine if your quat germicide has been tested to be effective in at least 400 ppm CaCO3 READ THE LABEL Choosing the Correct Disinfectant Continued What pH does the germicide need to be Germicides come in many different pH ranges The pH of a germicide will be listed on the literature sheet and the Material Safety Data Sheet for that product It is important to
40. reast milk of an infected woman Getting a blood transfusion of blood from an infected blood donor used to be a way people got AIDS but now the blood supply is screened very carefully and the risk is very low Once infected the virus will multiply in your body for a few weeks or even months before your immune system responds During this time you won t test positive but you can infect other people When your immune system responds it starts to make antibodies When you start making antibodies you will test positive for HIV There is no cure for AIDS There are drugs that can slow down the HIV virus however there is no way to get all the HIV out of your body For more information go to the Center for Disease Control CDC web site at http www cdc gov Choosing the Correct Disinfectant Many factors must be considered when choosing the correct germicide for you applications Each disinfectant will have different properties that must be evaluated Below are some of the areas that need to be considered to make an intelligent choice Questions to ask before selecting the correct germicide These questions must be answered in order to be sure that you have selected the correct product Do need to disinfect or sanitize Dol need a disinfectant amp cleaner or a product to disinfect sanitize surfaces that have been already pre cleaned What organisms do need to control What is the proper contact time for this germicide What is the pr
41. rom any hard surfaces Since then research has shown that the HBV and HIV viruses are actually fairly easy to kill The only problem was that the only EPA approved test for HBV involved testing on chimpanzees Chimpanzees are not only an endangered species but testing for HBV on chimpanzees is costly and required that 50 chimpanzees would need to be destroyed In August 2000 the EPA approved an alternate protocol for HBV not requiring the use of any chimpanzees Since then many companies have submitted thier quaternary based disinfectants and sanitizers for testing with this new protocol Now most quaternary based disinfectants have claims to kill Hepatitis B virus HBV Hepatitis C virus HCV and HIV 1 AIDS Most quaternary based disinfectants comply with the OSHA Bloodborne Pathogen Act They are suitable for low level disinfection of surfaces contaminated with blood or bodily fluids Read the label of all disinfectants to be sure they have claims to kill HBV HCV and HIV 1 before using to clean up blood or body fluids What is HBV Hepatitis B Virus HBV is a virus that attacks the liver and can cause lifelong infection cirrhosis scarring of the liver liver cancer liver failure and death About 30 of infected persons have no signs or symptoms Symptoms are less common in children than adults and can include jaundice fatigue abdominal pain and loss of appetite nausea and vomiting and joint pain HBV is transmitted when
42. s Influenza Virus Type A HK Virus that causes the flu An acute respiratory disease that occurs in epidemic form Transmitted from person to person via aerosol route coughing and sneezing Pseudorabies Virus Causes an acute viral infection of the central nervous system in mammals primarily in swine Rabies Virus that enter the human body via animal bites Symptoms begin with partial paralysis then paralysis becomes more general hydrophobia fear of water sets in when throat muscle spasms occurs and air ducts become hypersensitive If untreated the patient will go into a coma and die Respiratory Syncytial Virus A paramyxovirus that is the principal cause of pneumonia and bronchiolitis in small children and infants Transmitted person to person by droplet and aerosol from the respiratory tract Highly contagious Rubella Virus Causes German Measles Transmissible Gastroenteritis Causes profuse diarrhea vomiting and dehydration swine High mortality in first month of newborn Outbreak generally in early Spring and Winter Vaccinia Pox virus used for vaccination of man for immunity against small pox Definitions Antimicrobial Agent Chemical with destroys or inhibits the growth of microbes Antiseptic Compounds with bactericidal properties that are designed for application on living tissue A O A C Association of Official Analytical Chemists An organization that publishes a manual which contains the approved test proc
43. ss so you must do your homework prior to beginning the sales process and you must continue to do your homework throughout the sales process To sell a disinfectant in a hospital requires you to change the way you sold before You must be prepared to dot all the i s and cross all the t s Paying attention to the little details will ensure your success Once a facility recognizes that a discrepancy exists with its existing product and decides to search for and alternative you must be prepared to go the extra mile Once the test starts you must be there to follow up and contact each buying influence to answer any questions and handle any problems You can t show up two weeks or a month later and expect to successfully close the sale You must manage the process through each step 16 Four Most Common Mistakes Made with Germicides 1 Contact Time For all Multi Clean Disinfectants the disinfectant must remain in contact with the hard surface for 10 minutes Read labels on all disinfectants for specific instructions for contact time Mopping floors and allowing to air dry or wiping a surface with a damp rag that was immersed in a bucket of containing the disinfectant and wrung out and then allowed to air dry is acceptable 2 Fresh Solutions Cross Contamination All concentrated disinfectants should be made up fresh each day or when the mop bucket solution becomes visually dirty 3 Mixing Disinfectants with other Cleaners Do not play junior
44. tant products expect and deserve products that will not be detrimental to their health If the product does have potential for health concerns i e skin irritation the proper protective equipment should be available and utilized by those using the product One of the most common safety complaints about disinfectants is the fumes given off by the product when used Typically this will be caused by three reasons 1 Mixed too strong User failed to follow the label directions and either used too much product or too little water READ THE LABEL 2 Used hot water Increasing the water temperature will cause rapid evaporation of the product fragrance and or the disinfectant ingredients causing respiration and eye irritation USE COLD OR WARM WATER 3 Aerosolize Most above the floor cleaning is done with hand held spray bottles filled with a solution of the disinfectant It is common for users to dial the nozzle to the fine spray then when the user sprays the product to clean a mirror for example the fine spray is in the user s breathing zone and this irritates the nostrils and mucous membranes In extreme cases this could lead to a serous respiratory problem USE COARSE SPRAY or use a rag bucket method Immerse the rag in the bucket containing the disinfectant and then wring out the rag prior to cleaning a surface Cleaning Procedures The following pages have recommended cleaning procedures for many different types of fa
45. ted diluted household bleach 1 2 oz 2 oz per gal 1 2 oz 2 oz per gal 12 oz per gallon 1 256 1 64 1 256 1 64 1 10 READ THE LABEL FOR PROPER DILUTIONS One exception would be Multi Clean s Microcide TB Specific Concerns in Health Care Facilities Super Germs Antibiotic resistant Super Germs are a significant concern to health care related facilities These bacteria have developed resistance against treatment with common antibiotics and are easily transmitted In some hospitals particularly in intensive care units and nursing homes where antibiotic use is often highest there is a higher prevalence of these resistant germs These Super Germs are more difficult to treat as we have fewer antibiotics with which to treat them MRSA and VRE MRSA and VRE are two common bacteria that have developed this resistance MRSA Methicillin Resistant Staphylococcus aureus VRE Vanomycin Resistant Enterococcus formerly called Streptococcus faecalis MRSA has been plaguing hospitals for years and the only effective treatment has been another antibiotic called vancomycin However in 1988 another super bug began appearing in hospitals which is resistant to vancomycin VRE are extremely communicable and have a 40 mortality rate Remember however that these germs have become resistant to antibiotics not disinfectants The difference between antibiotics and disinfectants is like the difference between huntin
46. tion Rinse 10 Significance of Specific Bacteria Acinetobacter calcoaceticus Occurs in soil water and sewage A Nosocomial infection in compromised patients leading to septicemia meningitis abscesses and urinary tract infections Bordetella bronchiseptica Normal resident of canine respiratory tracts sometimes causing kennel cough Transmitted by coughing and sneezing Chlamydia psittaci Common to domestic mammals Can cause abortions in domestic mammals Ornithosis parrot fever and psittacosis Human chlamydial infections can result from exposure to domestic mammals but they are uncommon Enterobacter aerogenes amp cloacae Can cause bacteremia urinary tract infection post surgical wound infection and other nosocomial infections Occurs in water sewage soil dairy products feces of man and animals Most strains resistant to ampicillin Escherichia coli Anosocomial infection that causes urinary tract infections terminal septicemia travelers diarrhea and infant diarrhea Fusobacterium necrophorum Causes hoof rot in cattle sheep and horses May infect man Klebsiella pneumoniae Causative agent of pneumonia Causes infant diarrhea and urinary tract infections Listeria monocyrogenes Food poisoning listeriosis meningitis and abortion Pasteurella multocida Causative agent of fowl cholera Humans become infected from dog and cat bites in which abscesses can develop around the wound and then cause sept
47. to scrubbers wet mops leaky sinks wet carpets etc 3 Warm Environment 75 F 85 F is optimum Microorganisms can survive in environments ranging from 45 F 150 F 7 65 C How do germs cause infection or disease The successful invasion and growth of germs in the tissues of a person s body is called an infection For an infection to occur a series of three steps must happen 1 Germs must be present 2 Germs must be transported to the body 3 Germs must enter the body Germs are everywhere In the air in food on the floor on surgical instruments all non sterile surfaces including peoples bodies However germs can only cause infections in one place our bodies Germs do not have the ability to move by themselves They must be transported to our bodies Germs can travel through the air on dust on animals by insects in water by other people directly or indirectly Shaking hands would be an example of direct transportation of germs An example of indirect transportation would be an infected person passing the germs to an object say a door handle and then another person touches the door handle Infections can t occur until the germs enter our bodies Germs enter our bodies through our mouth nose eyes ears or any open wound This commonly happens when germs that are on our hands get transported to the mouth eyes or nose through normal activity such as wiping a nose rubbing eyes sneezing etc When germs enter th
48. vice environments When used at 1 4 ounce per gallon 1 512 it supplies 200 ppm active quaternary and meets the USDA performance standards for D2 type products pH 6 8 EPA Registration Number 10324 63 5449 950 Bowl Cleaner Contains 9 5 Hydrochloric Acid that effectively attacks toilet bowl and urinal problems such as mineral scale rust and uric acid deposits This thickened acid bowl cleaner clings to surfaces and allows for better cleaning and Disinfection This hospital grade disinfectant has broad spectrum efficacy including MRSA VRE and HIV 1 AIDS VIRUS pH gt 1 ready to use EPA Registration Number 8155 6 5449 2300 Bowl Cleaner Contains 23 Hydrochloric Acid for maximum strength designed for stubborn problems on toilet bowls and urinals This hospital grade disinfectant has broad spectrum efficacy including MRSA VRE and HIV 1 AIDS VIRUS pH gt 1 ready to use EPA Registration Number 8155 3 5449 15 HOW TO SELL DISINFECTANTS TO HOSPITALS This Technical Bulletin provides you with substantial technical data critical to your success in disinfectant sales However this information is of no value to you if you do not have a solid understanding of the fundamental workings of the hospital product evaluation and purchasing process Infection Control Committees approve buying decisions in health care facilities especially disinfectant and skin care products This means that the decision to convert to your disinfectant s
49. ype A Herpes Simplex Type II and HIV 1 AIDS Citrus Fresh Fragrance pH 10 8 11 0 EPA Registration Number 47371 97 5449 GTS Foaming Disinfectant Cleaner An advanced foaming aerosol cleaner disinfectant This high foam formula uses unique solvents and surfactants to aggressively cleans any surface without abrasives Phenolic based OSHA Bloodborne Pathogen Act compliant ready to use aerosol lemon scent pH 12 5 13 0 EPA Registration Number 33176 6 5449 Microcide TB Restroom Disinfectant Cleaner Microcide TB is a ready to use spray cleaner that disinfects as it cleans Effective against Pseudomonas aeruginosa Staphylococcus aureus Salmonella choleraesuis the hospital trio Eschericia coli HBV HIV 1 Canine Parvovirus Trichophyton Mentagrophytes athletes foot fungus Clostridium difficile vegetative form and Mycobacterium tuberculosis BCG pH 11 5 EPA Registration Number 1839 83 5449 BQ 32 Pine Odor Disinfectant Cleaner and Deodorant Combines the clean fresh smell of pine with a highly effective quaternary to give efficient cleaning disinfecting and deodorizing Use 3 12 ounces per gallon of water depending of soil levels Effective against a wide variety of gram positive and gram negative bacteria Hospital grade disinfectant pH 7 5 7 9 EPA Registration Number 6836 169 5449 MC 10 Sanitizer High Potency Quaternary Highly effective no rinse sanitizer recommended in all phases of food processing and in food ser
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