2020 - KSHE Weekly COVID-19 Forum...This interactive virtual learning session aims to create a...
75
2020 - KSHE Weekly COVID-19 Forum
Transcript of 2020 - KSHE Weekly COVID-19 Forum...This interactive virtual learning session aims to create a...
2020 - KSHE Weekly COVID-19 Forum
Thank you to this week’s
sponsor
Thank you! For keeping our most important
community facilities running safely for patients, staff and visitors.
We can help.
Tom PetschkeVP [email protected]
Mike JaegerVP [email protected]
Predictable Practical Proven
WWW.CES.WORKS
502.512.1033
Online Presentations Daily Pilots Currently Available
Certified Healthcare Contractors
The only active, continuous IAQ measure forAir and Surfaces
Effective vs:• Viruses• Bacteria• VOCs• Particulate matter• Peer reviewed, lab tested and
globally deployed.
Know your Flow! Improve airflow control for: • Exhaust• Supply• Humidity • Filtration • Pressurization• Certified results
Electronic – This tech is a long way from magnets! biological and scale control without chemicals. Effective vs. LegionellaIce machines to chillers – no chemicals. A game changing technology.
All CES Systems Features Include: • Immediate efficacy• Durability • Consistency (24/7) • Cost Saving • Easily Deployed
Duct Sealing Bi-Polar Ionization Water Conditioning
Facility Level Infection Control Measures Offered:
• Environmentally Friendly • Reduce greenhouse gasses• Reduce Chemical Use• Lower Water use
• Expert Installation• Performance Guarantees • Measurement and verification• Buy, Lease or ’As a Service’ options
• Health, Wellness and Safety• Increased Productivity • Lower Risk• No Maintenance
Helping Hospitals Serve Their CommunitiesKentucky hospitals provide countless services in their communities, from high quality patient care to employment opportunities to significant economic contributions. KHA is here to support hospitals and help them be their best!
Opening Remarks
Joe Taylor, Executive Director Facilities Owensboro Health and President of
KSHE
2020 Annual Healthcare Coalition ConferenceCelebrating our Healthcare Heroes
• September 29 - October 1• Owensboro Convention Center; Hampton Inn & Suites Downtown on the
Waterfront• Sponsorship/Trade Show Reservations Now Open• Call for Presentations Now Open (Closes June 15)• Attendee Registration Opens Late May
CURRENT WORLD/US DATA
CMS Blanket Waiver – 4/31/20 Update
to adjust scheduled ITM frequencies and activities required by the LSC and HCFC. The following LSC and HCFC ITM are considered critical are not included in this waiver:• Sprinkler system monthly electric motor-driven and weekly diesel engine driven fire pump testing.• Portable fire extinguisher monthly inspection.• Elevators with firefighters’ emergency operations monthly testing.• Emergency generator 30 continuous minute monthly testing and associated transfer switch monthly testing.• Means of egress daily inspection in areas that have undergone construction, repair, alterations or additions to ensure its ability to be used instantly in case of emergency.
ASHE RESOURCES for COVID-19
(with respect to the CMS Blanket Waiver for inspection, testing and maintenance – page 23), “ASHE recommends that each organization evaluate the approved waivers and determine the appropriateness for their application at the organization. Those waivers that are determined to be appropriate should also be coordinated with the local and state authority having jurisdiction to obtain their approval.”
“Additionally, each organization should perform its own Risk Assessment(s) and document the logic associated with delaying any inspection, testing, and maintenance (ITM). The Risk Assessment must be approved by your Environment of Care (EOC) committee, documented in its minutes, and also be reviewed/approved by any local/state AHJ’s as well as all the appropriate authorities in your organization (e.g. IP, Medical Staff, Board). The Risk Assessment(s) should be reviewed frequently, and all ITM activities should be resumed as soon as the EOC deems it safe to do so.“ Joe Taylor recommendation only!!!
Moderator: Mike Canales, HFL Program Director & IHFEA Founder
KSHE callMay 7, 2020
Deb Campbell, RN-BC, MSN, CPHQ,T-CHEST, CCRN alumna
Infection Prevention Improvement Advisor
Kentucky Hospital Association
Current numbers as of 5/5
• Kentucky– Cases: New- 625* Total- 5,822 – Deaths: Total- 275– Tests: Total- 61,013 (about 18,000 since last
week)– Recovered: Total- *2,058
• US– Cases: 1,240,000– Deaths: 72, 417– Recovered 165,000
Issues Update- re-opening
• Phase 1 (April 27) – May resume non-urgent/emergent health
care services, diagnostic radiology and lab services
• Phase 2 (May 6)– Outpatient surgeries and other invasive
procedures can resume• Issues
• Public fear of returning- PSAs and letters• Testing- turnaround time (72-96 hour time frame)• Visitation- patients waiting until they can have a
family member/support person with them
Ky’s Plan for re-opening
• Phase 2 (May 6) • Provide acceptable testing for patients in
procedural and operative areas will include: – 1. Negative findings on viral testing within a
period less than 72 hours prior to any procedure.
– 2. Negative findings on viral testing within a 72 to 96 hour window prior to any procedure and patient consent to self-isolate between the period of testing and actual procedure.
– 3. Serologic testing showing immunity (IgG with no IgM) or negative IgM within 96 hours prior to procedure with self-isolation precautions as above, or 72 hours or less prior to procedure with or without self-isolation.
Ky’s Plan for re-opening
• Phase 3 (May 13)– Hospitals and care facilities can begin doing
non-emergency surgeries and procedures at 50% of their pre-COVID-19-era patient volume.• All Previous restrictions remain place
Upcoming Webinars
NIOSH Webinar on Considerations for Purchasing International RespiratorsOn Thursday, May 7 at 1:00 p.m. (ET)The Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH) is hosting a webinar on factors to consider when planning to purchase respirators from another country, including KN95 respirators from ChinaThis webinar will discuss the common pitfalls of purchasing respirators internationally to help buyers make informed procurement decisions to keep their workers safe. The considerations presented in this webinar will help to maximize the likelihood of obtaining safe and effective products.See the NIOSH webpage for more information about the webinar, including the panel of speakers.
SPECIAL SESSION: Innovative PPE Preservation StrategiesFriday, May 8, at 12:00-1:00 PM ETJoin presenters to discuss successes and challenges with implementation of Personal Protective Equipment (PPE) preservation by the individual clinician and health care organizations (hospitals and EMS). This interactive virtual learning session aims to create a peer-to-peer learning network where clinicians from the U.S. and abroad who have more experience treating patients with COVID-19 share their challenges and successes, while including a generous amount of time for participant Q & A.
Securing the Health Sector –
a Weekly Webinar Series Co-Hosted by HHS, InfraGardNCR,
and DHSUnderstanding and Mitigating Risks of Active Shooters-
Friday, May 8, at 1 pm ET.
The Department of Health and Human Services (HHS) is partnering with the Department of Homeland Security (DHS) and InfraGard National Capital Region (InfraGard NCR) on a webinar series to inform the private sector, state and local government first responders, and public healthcare professionals of potential increased threats to Healthcare and Public Health (HPH) facilities.This week’s offering, “Understanding and Mitigating Risks of Active Shooters,” will offer a strategic, introductory-level overview of active shooter incidents, including a description of applicable resources from DHS, a summary brief of the Federal Bureau of Investigation’s (FBI) recently released "Active Shooter Incidents in the United States in 2019," and a strategic perspective from the head of workplace violence and security for the largest nonprofit health system in the US.
Speakers::
•Erin Sheridan, Special Agent and Behavioral Analysis Unit Coordinator, Washington field office, FBI•Daniel Rivera, Team Lead, Active Shooter and Insider Threat Mitigation Branch, Cybersecurity and Infrastructure Security Agency, DHS•Scott Cormier, Vice President, Emergency Management, EC, and Safety, MedxcelA link to register will be posted in the chat. You must register in advance to attend the webinar. After you register, you'll receive connection details from GoToWebinar. Please send any questions [email protected].
ASPR TRACIE Webinar: COVID-19: Healthcare
System Operations Strategies and Experiences
May 11, 2020 from 2-3:30 PM ET
ASPR TRACIE, in collaboration with the HHS/FEMA Healthcare Resilience Task Force, is hosting a webinar titled COVID-19: Healthcare System Operations Strategies and Experiences. The webinar will highlight experiences and lessons learned from a few of the hardest hit hospitals in New York, New Jersey, Louisiana, and Arizona so that other healthcare systems can implement these strategies during their current response and in planning for a potential next wave. Speakers will discuss their hospital operations, logistics (space, staff, and stuff) strategies, and experiences with the current COVID-19 response.
A link to register for this webinar will beposted in the chat.
NETEC PPE Townhall
Wednesday, May 13th
12 Noon ET/11:00 AM CT.
In this NETEC town hall forum, NETEC subject matter experts will be on hand to answer frequently asked questions surrounding the use of Personal Protective Equipment in the care of COVID-19 patients
A link to register will be posted in the chat
American Society for
Health Care Engineering-
Preplanning & Immediate
Needs
Friday, May 8, at 12:00 pm ETRegistration Link will be shared in the chat
The COVID-19 pandemic is impacting the health care physical environment in ways we never imagined. Facilities have been reimagined, renovated, expanded, enlarged and underutilized simultaneously. The pandemic’s significant impact on the physical environment has offered challenges and learning experiences. This webinar series will address specific health care facility measures based on immediate, short- and long-term needs regarding preplanning, inspection, testing and maintenance, sustainability and the "new normal." The first webinar will describe preplanning for recovery and tackling immediate needs, and attendees will have the opportunity to ask questions live.
AII ROOM CONVERSION FOR COVID 19
Controlling the spread of airborne infectious diseases in health care facilities is a serious concern to patients, staff and visitors. To minimize the spread of airborne infections, certain rooms within a hospital are designed as airborne infectious isolation (AII) rooms with negative-pressure differential or protective environment (PE) rooms with a positive-pressure differential.
ROOM CONVERSIONS
128 ROOMSWhile isolation rooms must meet the general requirements for a standard medical-surgical patient room, they also have specific requirements. For instance, patient isolation rooms may only have one patient bed, should be provided with an area for gowning and storage of clean and soiled materials directly outside or inside the entry door, and should be provided with a separate toilet room with a hand-washing sink. In addition, the isolation room needs to be well-sealed to prevent excess air leakage into or out of the room. The tighter the room is constructed, the more efficiently the air pressure differential can be maintained. In most instances, an isolation room does not require an anteroom. If one is provided, it should offer enough space to don protective equipment before entering the patient room, and the doors must have self-closing devices.Photo by USG / Public domain
Air handlersChanges• The same air-handling system that serves
other standard patient rooms may be used for isolation rooms. The air-handling unit serving the isolation rooms requires minimum-efficiency reporting value (MERV) 7 pre-filters, with either MERV 14 or high-efficiency particulate air (HEPA) final filters. MERV 14 filters are adequate for AII negative pressure rooms and for PE positive pressure rooms when terminal HEPA filtration is used at the supply diffusers serving the PE room.
Isolation Fans • If the fan must be located inside, welded ductwork should be used downstream
of the exhaust fan, and a bag-in/bag-out filter housing with pre-filters and HEPA filters should be installed upstream of the exhaust fan. The exhaust fans shall be served by emergency power, and the fans should be labeled as contaminated air to meet the recommendations of the Centers for Disease Control and Prevention.
• Redundancy of the equipment also needs to be considered, and will depend on the facility’s typical census of infectious or immunocompromised patients. On larger systems serving multiple rooms, redundant fans are recommended so the failure of a single fan does not compromise the safety of patients and caregivers.
For the exhaust system serving AII rooms, the exhaust fan should be located outdoors, if possible, and be placed as far away from intakes and public areas as practical, but no less than 25 feet with discharge above the roof. For outdoor fans, all exhaust from AII rooms should be exhausted by means of a vertical exhaust stack or exhaust fan with a vertical discharge arrangement.
ALARM SET UPTIME DELAYMaintenance Technician calibrating room pressure monitor to Isolation room. All 128 The American Society of Heating, Refrigerating and Air-Conditioning Engineers' (ASHRAE's) Standard 170, Ventilation of Health Care Facilities, which is integrated into the Facility Guidelines Institute's Guidelines for Design and Construction of Health Care Facilities, requires each isolation room to have a permanently installed visual device or mechanism to constantly monitor the air pressure differential of the room when occupied by a patient who requires isolation.Permanent device can be as simple as a flutter strip or calibrated ball in tube, the most reliable way to monitor room pressure is with the use of an electronic pressure monitor. When properly selected and installed, an electronic room-pressure monitor can provide continuous confirmation of the required pressure differential across the room boundary.Most electronic monitors consist of two main components: a wall-mounted control panel and a sensor. Control panels are usually mounted on a corridor wall nearby to the entrance of the isolation room and generally displays the pressure difference in inches of water column (WC)..
CALIBRATIONIn addition to providing a continuous readout of pressure differential, the control panel should include both audible and visual alarms to warn staff when room pressurization is lost. The alarm should sound when the measured room pressurization is below the alarm setpoint. Rooms designed to maintain a pressure differential of minus 0.03-inch WC, the alarms should be programmed to activate when the pressure differential falls to minus 0.01-inch WC.Control panels also should have a programmable, built-in time delay to minimize nuisance alarms. The time delay should be set to allow staff sufficient time to routinely enter and leave the room, and typically is set between 30 and 45 seconds.
Photo by USG / Public domain
PRESSURE MONITORING DASHBOARD EXAMPLE ON BAS PAGE
Most Alarms integrated into the wall control panel include an extra identical signal that allows the pressure differential and alarm signals to be displayed at a remote location. The common location for this remote alarm is either the nurses’ station or the building automation system.
ROOM CONVERSION PLANNING
When an anteroom is provided, airflow should be from the corridor into the anteroom, and from the anteroom into the patient isolation room. To maintain the required pressure differential, the exhaust air quantity must always be higher than the supply airflow. Depending on such factors as room size and the room’s heating and cooling loads, more than 12 air changes per hour may be necessary. Typically, a minimum airflow difference of 150 to 200 cubic feet per minute (CFM) is adequate to maintain pressure differential in a well-sealed room.
AIR FLOW DESIGNNegative isolation rooms. A negative-pressure AII room is designed to isolate a patient who is suspected of, or has been diagnosed with, an airborne infectious disease. The negative-pressure isolation room therefore is designed to help prevent the spread of a disease from an infected patient to others in the hospital.
CHECKING AIR FLOW
Negative-pressure isolation rooms require a minimum of 12 air changes of exhaust per hour and must maintain a minimum 0.01-inch WC negative-pressure differential to the adjacent corridor whether or not an anteroom is utilized. Typically, a setpoint closer to minus 0.03-inch WC is used. When not required for use with an infectious patient, the negative-pressure AII room may be occupied by noninfectious patients. The negative-pressure relationship to the corridor should be upheld; however, it is not required to be maintained at the minimum of minus 0.01-inch WC.
ISOLATION ROOM CHECK
Exhaust from negative-pressure isolation rooms, associated anterooms and associated toilet rooms must be discharged directly to the outdoors without mixing with exhaust from any non-AII rooms. However, multiple AII isolation rooms may be connected to the same exhaust system. The exhaust ductwork serving AII negative isolation rooms also should be permanently labeled as contaminated air within the facility at a maximum of 20 intervals and at all wall or floor penetrations.Supply air for the room generally is located in the ceiling at the foot of the patient bed, with exhaust air taken from exhaust grilles or registers located directly above the patient bed on the ceiling or low on the wall near the head of the bed. When the head wall exhaust grilles are mounted lower than 7 feet above the floor, NFPA 90A requires that the opening be protected by a grille or screen through which a half-inch sphere cannot pass.
ANTEROOM ROOM SET UPPositive isolation rooms. A positive-pressure isolation room is designed to keep contagious diseases away from patients with compromised immune systems, such as those with cancer or transplants. These rooms require a minimum of 12 air changes per hour of supply air and must maintain a minimum 0.01-inch WC positive-pressure differential, ensuring that the patient is protected from airborne contamination regardless of whether an anteroom is used. Typically, positive-pressure rooms are designed to maintain an even stricter setpoint of positive 0.03-inch WC.Like the AII room, the PE positive room may be occupied by general patients when not in use. Similarly, the positive-pressure relationship to the corridor should be preserved; however, it is not required to be maintained at the minimum of positive 0.01-inch WC.When an anteroom is used, airflow must be from the patient room into the anteroom and from the anteroom out into the corridor. As with the AII negative room, typically a minimum airflow difference of 150 to 200 CFM is adequate to maintain pressure differential in a well-sealed room. Positive-pressure rooms are required to be supplied with HEPA-filtered air, with the filters installed at the main air-handling unit or at the supply terminals in the room.
STARC REAL WALL BARRIERS
Supply air for the room must be located in the ceiling above the patient bed, with return air taken from the ceiling near the patient room door. The supply diffuser shall be a non-aspirating, laminar-flow device and should be designed to limit the air velocity at the patient bed to reduce the possibility of patient discomfort. In addition, ASHRAE 170 requires that airflow to the PE isolation room be maintained at a constant volume to provide consistent ventilation in the room.
I would like to thank my great
stafffor stepping up
during this trying time.
AIRBORNE INFECTION ISOLATION ROOMS (AIIRS)
In health care facilities, isolation represents one of several measures that can be taken to implement infection control: the prevention of contagious diseases from being spread from a patient to other patients, health care workers, and visitors, or from outsiders to a particular patient. Protective Environment (PE) Rooms. Ventilation for PE rooms shall meet the following requirements:a. The room envelope shall be sealed to limit leakage air flow at 0.01 in. wc differential pressure across the envelope.b. Each PE room shall comply with the requirements of Tables 6-1, 6-2, and 7-l. of the FGI Protected environment rooms shall have a permanently installed. device and/or mechanism to constantly monitor the differential air pressure between the room and adjacent spaces of the room when occupied by patients requiring a protective environment. A local visual Means shall be provided to indicate whenever positive differential pressure is not maintained.
AIRBORNE INFECTION ISOLATION ROOMS (AIIRS)Airborne Infection Isolation (All) Rooms. Ventilation for AII rooms shall meet the following
requirements whenever an infectious patient occupies the room:
a. Each All roon1 shall comply with requirements of Tables 6-1, 6-2, and 7-1. AII rooms shall have a permanently installed device and/or mechanism to constantly monitor the differential air pressure between the room and adjacent spaces of the room when occupied by patients with an airborne infectious disease. A local visual means shall be provided to indicate whenever negative differential pressure is not maintained.
b. All air from the All room shall be exhausted directly to the outdoors.
Exception: All rooms that are retrofitted from standard patient rooms from which it is impractical to exhaust directly outdoors may be ventilated with recirculated
air from the room's exhaust, provided that the air first passes through a HEPA (MERV 17) filter.
c. All exhaust air from the AII rooms, associated anterooms, and associated toilet rooms shall be discharged directly to the outdoors without mixing ·with exhaust air from any other non-AII room or exhaust system.
d. Exhaust air grilles or registers in the patient room shall be located directly above the patient bed on the ceiling or on the wall near the head of the bed unless it can be demonstrated that such a location is not practical.
e. The room envelope shall be sealed to limit leakage air flow at 0.01 in. we (2.5 Pa) differential pressure across the envelope.
f. Differential pressure between All roon1s and adjacent spaces that have a different function shall be a minimum of-0.0 l in. wc .
Sanitizing vs Disinfecting
Ron Henley, CHFM, CHSP, RIAQM, LSO, CHE, SASHE
Director of Engineering, and Safety Officer
Baptist Health Paducah
The threat- A Virus
Definition of viruses -an infective agent that typically consists of a nucleic acid molecule in a protein coat, is too small to be seen by light microscopy, and is able to multiply only within the living cells of a host.
What is a coronavirus?The coronavirus COVID-19 is a member of the virus family coronaviridae, or coronaviruses. The name comes from the appearance of the virus particles under a microscope: tiny protein protrusions on their surfaces mean they appear surrounded by a halo-like corona.
What are viruses made of?
• At the core of a virus particle is the genome, the long molecule made of DNA or RNA that contains the genetic instructions for reproducing the virus. This is wrapped up in a coat made of protein molecules called a capsid, which protects the genetic material.
• Some viruses also have an outer envelope made of lipids, which are fatty organic molecules. The coronavirus that causes COVID-19 is one of these “enveloped” viruses. Soap can dissolve this fatty envelope, leading to the destruction of the whole virus particle. That’s one reason washing your hands with soap is so effective!
• Enveloped viruses like SARS-CoV-2—which rely on a protective lipid coating—are the easiest type to deactivate. In contrast with many gastrointestinal viruses like norovirus which have a tough protein shell called a capsid, viruses with this fatty wrapping are relatively vulnerable.
• “It’s much more sensitive. It’s sort of a wimpy protective shell,” says virologist Seema Lakdawala of the University of Pittsburgh.
Are viruses alive?
• Viruses rely on the cells of other organisms to survive and reproduce, because they can’t capture or store energy themselves. In other words they cannot function outside a host organism, which is why they are often regarded as non-living.
• Outside a cell, a virus it wraps itself up into an independent particle called a virion. The virion can “survive” in the environment for a certain period of time, which means it remains structurally intact and is capable of infecting a suitable organism if one comes into contact.
• Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities.
• The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05–0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.
• Germ Specificity
• Both sanitizers and disinfectants must be tested against specific germs. Chemical labels must list out each of these germs individually. One disinfectant could kill germs X and Y while another disinfectant might kill germs Y and Z. It’s important to understand that a single sanitizer or disinfectant will not kill all microorganisms, and to know which germs your products work against. Sanitizers are certified for bacteria only, while disinfectants can also be certified to kill viruses, mold, mildew, and fungi. Remember a mfg can claim to kill vs being certified.
• EPA Certification
• Sanitizers and disinfectants are regulated by the Environmental Protection Agency (EPA) and therefore, must be certified through a process that tests them to meet certain pre-defined criteria. By law, a chemical product cannot be labeled as a sanitizer or a disinfectant unless and until it is EPA certified. (A chemical company like Nyco might register a formula as both, enabling that product to be called a Disinfectant-Sanitizer.)
Time to Kill or Dwell Time
• The time it takes to kill germs is one more factor that is important when evaluating both sanitizers and disinfectants, and this must also be listed on a product’s label. Some chemical formulas kill respective germs in 5 minutes and others in just one minute or less. This is called “dwell time” and should be taken into account when choosing and using sanitizers and disinfectants for various applications.
• That's why it's critical to follow the directions on the product label for effective use.
• The main difference comes down to this: "While sanitizing reduces the amount of bacteria, viruses, and other microbes on a surface, disinfectants kill almost all of them“.
• "That's because disinfectants include chemicals like hydrogen peroxide that decontaminate a surface or object by producing destructive free radicals that attack cell components," says Stephanie Dancer, consultant microbiologist and Professor of Microbiology at Edinburgh Napier University, Scotland.
• and cleaners simply remove dirt, soils and impurities from surfaces.
• Sanitizers on the other hand, like chlorine and QUAT (quaternary ammonium compounds) based sanitizers, simply reduce the number of germs on a surface. This may not kill them, but it can still help prevent the spread of illness. Because for each disease, there's a certain number of germs — called the dose of exposure— you need to contract in order to become sick. So by lowering the total number of germs on a surface or object, sanitizers help reduce the risk of infection.
Sanitizer
• Type of antimicrobial that (according to EPA specifications) kills or irreversibly inactivates at least 99.9 percent of all bacteria, fungi, and viruses (called microbials, microbiologicals, microorganisms) present on a surface. Most sanitizers are based on toxic chemicals such as chlorine, iodine, phenol, or quaternary ammonium compounds, and which (unlike some antiseptics) may never be taken internally.
• According to the CDC, sanitizer is the process that destroys or eliminates all forms of microbial life and is carried out in health-care facilities by physical or chemical methods.
• The main difference between sanitizers and disinfectants is that sanitizers reduce the number of germs on a surface whereas disinfectants kill most of them.
• Sanitizers usually work faster than disinfectants, which can take up to 10 minutes to kill germs.
• The name hand "sanitizer" is a misnomer since its main germ-fighting ingredient is alcohol, which is a disinfectant.
• While they are powerful germ-killing agents, disinfectants can not do their jobs properly if they are used on dirty surfaces — because dirt and oil will consume the disinfectant and protect the germs
• There are a few ways to burst this flimsy shell. Alcohol-based products disintegrate the protective lipids. Quaternary ammonium disinfectants, commonly used in health-care and food-service industries, attack protein and lipid structures, thwarting the pathogen’s typical mode of infection. Bleach and other potent oxidizers swiftly break down a virus’s essential components.
• The EPA’s list of disinfectants presumed effective against SARS-CoV-2 contains several dozen antimicrobial products including ready-to-use sprays, concentrates, and wipes. Each has been shown to be effective against at least one small or large nonenveloped virus, which are considered harder to kill than the enveloped variety. And that list is likely to grow; on March 9, the EPA announced it was expediting emerging pathogen-related requests that met certain requirements.
• But consumers are unlikely to see such language on product labels any time soon. The EPA’s emerging viral pathogens program limits the places disinfectant makers can publish such a claim to off-label sources like websites, company help lines, and social media. Responding to public comments on an early draft of the program, the agency explained that this measure enables claims to be quickly removed if necessary. Product makers may also include the claims in technical literature distributed to health-care facilities, where it’s expected its recipients would have the background to put such claims in context.
• Lysol Disinfectant Max Cover Mist• Lysol Heavy-Duty Cleaner Disinfectant Concentrate• Oxycide Daily Disinfectant Cleaner• Peak Disinfectant Wipes• Peroxide Multi Surface Cleaner and Disinfectant• Peroxide Disinfectant and Glass Cleaner• Purell Professional Surface Disinfectant Wipes• Sani-Prime Germicidal Disposable Wipe• Sani-Prime Germicidal Spray
• Clorox Disinfecting Wipes
• Clorox Commercial Solutions
• Clorox Disinfecting Spray• Clorox Multi-Surface Cleaner + Bleach
• Klercide 70/30
• Lonza Formulation
• Lysol Clean & Fresh Multi-Surface Cleaner
Disinfectant • Disinfectants are chemical agents designed to inactivate or destroy microorganisms on inert
surfaces. Disinfection does not necessarily kill all microorganisms, especially resistant bacterial spores; it is less effective than sterilization, which is an extreme physical or chemical process that kills all types of life. Disinfectants are generally distinguished from other antimicrobial agents such as antibiotics, which destroy microorganisms within the body, and antiseptics, which destroy microorganisms on living tissue. Disinfectants are also different from biocides — the latter are intended to destroy all forms of life, not just microorganisms. Disinfectants work by destroying the cell wall of microbes or interfering with their metabolism.
• According to the CDC, disinfectant describes a process that eliminates many or all pathogenic microorganisms, except bacterial spores, on inanimate objects. In health-care settings, objects usually are disinfected by liquid chemicals or wet pasteurization.
Examples of..
• Alcohol• Fully Concentrated bleach
• Formaldehyde
• Isopropanol or Ethanol (Alcohol) are effective disinfectants when used at a high enough concentration. Most cleaning products that contain alcohol have at least a 70% solution, and hand sanitizers should contain at least 60% alcohol to be effective. They become less effective over time because the alcohol will evaporate.
• Quaternary Ammonium Compounds are widely used as surface disinfectants and can be found in many household cleaners including disinfectant wipes and sprays. Research has shown quaternary ammonium compounds to effectively kill most bacteria, viruses, and fungi.
• Sodium Hypochlorite (Bleach). The active ingredient in bleach is sodium hypochlorite, which can kill viruses, bacteria, and fungi. Bleach can be used on frequently touched surfaces like doorknobs and countertops but it must air dry for at least 10 minutes before wiping to effectively kill pathogens. Because bleach can irritate the skin, you should wear gloves when using it.
• Hydrogen Peroxide is not as strong as bleach but does have disinfectant properties that effectively kill viruses and bacteria. A 2018 study published in Antimicrobial Resistance and Infection Control found that hydrogen peroxide was more effective in killing some forms of bacteria than quaternary ammonium compounds. The typical 3% hydrogen peroxide concentration found in stores can be used as a disinfectant.
Quats
• Quats (quaternary ammonium compounds) are potent disinfectant chemicals commonly found in disinfectant wipes, sprays and other household cleaners that are designed to kill germs. It is often the stuff that allows a product to claim to be antibacterial, as they are certified by the EPA as pesticides.
• Downside, quats are lung irritants, must be used in correct dilution and with PPE
EPA List of Registered Disinfectants
• EPA Currently has 392 Registered Disinfectants
• Only 124 of these are specific for Human Coronavirus
• Of the 124 there are 19 common chemicals/ingredients
EPA List of Registered Disinfectants
1 Quaternary ammonium2 Hydrogen peroxide; Peroxyacetic acid3 Quaternary ammonium; Isopropanol4 Sodium hypochlorite5 Octanoic acid6 Sodium hypochlorite; Sodium carbonate7 Quaternary ammonium; Ethanol8 Quaternary ammonium; Isopropanol9 Triethylene glycol; Quaternary ammonium
10 L-Lactic Acid11 Glycolic acid12 Phenolic13 Silver ion; Citric acid14 Ethanol15 Hypochlorous acid16 1,2-Hexanediol17 Hydrogen peroxide; Ammonium carbonate; Ammonium bicarbonate18 Peroxyacetic acid19 Quaternary ammonium
392 EPA Registered products 124 specific for Human Coronavirus
EPA Approved for Human Coronavirus Common chemcials Registered disinfectants on the EPA's list
EPA LIST
Cleaning Process Reminder
• Identify high touch areas
• Re-educate cleaning crews, Proper PPE, and knowledge of dwell time!
• Frequency of cleaning dictated by location!
• Right chemical for the surface!
• For organizations reopening, advertise how safe and sanitary the building will be when opened!
Thank you –any questions?
• Ron Henley, CHFM, CHSP, RIAQM, LSO, CHE, SASHE
• Director of Engineering, and Safety Officer
• Baptist Health Paducah
Q&A
Moderator: Mike Canales, HFL Program Director & IHFEA Founder
Thank you to this week’s
sponsor
