4 Common Mistakes in Surface Disinfection to Prevent Cross-Contamination

Environmental hygiene in healthcare facilities is significantly correlated with hospital-acquired infections. The environmental surface has been described as a patient's "second skin," highlighting the importance of surface cleanliness in infection prevention. Surface disinfection can be performed through wiping or spraying methods. For high-touch environmental surfaces, wiping is the primary method, as it utilizes mechanical action to effectively remove dirt and pathogens from surfaces.

What are the common mistakes in disinfection wiping?

Mistake 1

Using a single cloth to wipe multiple areas or using the same side of a cloth repeatedly to wipe multiple surfaces compromises disinfection effectiveness. The correct wiping method involves "clean unit" operation, using "S" or "Z" shaped motions from side to side or up and down. The wiping tool should be immediately replaced when it becomes contaminated or when no disinfectant residue remains on the surface.

Figure 1. Correct cleaning motion

Mistake 2

The "repeated dipping" phenomenon occurs when contaminated cloths are repeatedly dipped into clean water/cleaning solution/disinfectant during the wiping process. Once used, the cloth becomes contaminated; repeated dipping will contaminate the cleaning solution/disinfectant, reducing or nullifying its effectiveness and potentially causing cross-contamination. When wiping, prepare cleaning cloths by pre-soaking them in disinfectant and wringing them out. Change each cloth after use and collect them for centralized cleaning and disinfection.

Mistake 3

Studies have shown that cleaning tools stored in damp conditions become breeding grounds for microorganisms, which can spread during wiping. Using contaminated cloths not only contaminates the operator's hands but also causes secondary contamination of equipment and environmental surfaces. After use, cleaning tools should first be washed clean, then soaked in 250-500mg/L chlorine-containing disinfectant for 30 minutes, rinsed to remove disinfectant residue, and hung to dry before next use.

Mistake 4

The choice of disinfectant depends on microbial resistance. Disinfectants should be selected based on pathogen characteristics, while considering patient factors and compatibility between surfaces and disinfectants.

Sterilization Protocol

Eliminates all microorganisms including bacterial spores, achieving sterility assurance level. 

From weakest to strongest resistance (No.1<No.7) :

1. Lipophilic viruses (HIV, HBV, HCV, COVID-19 virus)

2. Vegetative bacteria

3. Fungi

4. Hydrophilic viruses (Polio, Hepatitis A, Hand-foot-mouth disease)

5. Mycobacteria

6. Bacterial spores

7. Prions

Low-level disinfection: Eliminates vegetative bacteria and lipophilic viruses. Includes mechanical methods like ventilation and rinsing. Examples: quaternary ammonium compounds, chlorhexidine.

Intermediate-level disinfection: Eliminates all pathogens except bacterial spores, including mycobacteria. Examples: iodine compounds, alcohols and chlorhexidine compounds, alcohol and quaternary ammonium compound combinations.

High-level disinfection: Eliminates all vegetative bacteria and most bacterial spores. Examples: chlorine compounds, chlorine dioxide, ortho-phthalaldehyde, peracetic acid, ozone, tincture of iodine.

Sterilization methods

Physical: Heat sterilization, radiation sterilization 

Chemical: Ethylene oxide, hydrogen peroxide, formaldehyde, glutaraldehyde, peracetic acid

Wiping products

Generally industrial or cleanroom wipes made of knitted or non-woven materials, impregnated with disinfectant or disinfectant plus surfactant, releasing disinfecting agents during wiping. These disinfectant wipes achieve cleaning and disinfection in one step, are disposable to prevent cross-contamination, and can be conveniently placed beside beds or on treatment carts for easy access.

Tags：Surface Disinfection