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INFECTION PREVENTION THROUGH EDUCATION
5 mistakes that can compromise disinfection and increase the risk of transmission of infections
From protocol theory to field reality: where cleaning and disinfection rules actually break down and how human or logistical errors can be avoided.
In day-to-day operations, even when a suitable product is used, vulnerabilities can arise in the cleaning and disinfection process.
Some relate to how the product is used. Others relate to space organization, materials used, or how the procedure is followed.
The five situations addressed here are:
Insufficient contact time
The contact time is not being respected.
Apply the product and wipe it off immediately. Or, in the case of instruments disinfected by immersion, remove them from the solution before the required time has elapsed.
In these situations, the product is not used under the conditions for which its biocidal action was evaluated. Contact time is one of the conditions that contributes to the demonstrated efficacy of a disinfectant, along with factors such as concentration and, depending on the test method, temperature or organic load.
How to do it correctly
- Check the contact time indicated in the instructions for use.
- Organize the application so that the surface remains wet for the intended duration.
- For immersion disinfection, keep the instruments completely covered by the solution for the entire indicated duration.
Faster does not mean equally efficient.
Concentration deviations
The dilution is estimated by eye.
“I'll add a little more, just to be sure.” Or: “It doesn’t need to be quite that much.”
Both replace the concentration established by the manufacturer with an estimate. And the deviation can go in both directions: a concentration that is too low may not provide the conditions for which the product was evaluated, while a higher concentration does not automatically mean better biocidal action.
A study published in 2024, conducted in 10 hospitals, identified problems in 9 of them: of the 107 automated dosing systems evaluated, 29 provided lower concentrations than expected, and in 15 cases, no disinfectant was detected.
9 OUT OF 10Hospitals have experienced issues
29 OF 107Systems provided lower concentrations than expected
15The systems did not provide detectable disinfectant.
How to do it correctly
- Respect the concentration indicated by the manufacturer, without approximations.
- Use appropriate dosing systems or graduated containers, in accordance with the procedure.
- Opt for ready-to-use (RTU) products when they are suitable for the respective application.
Source: Cadnum JL, et al. Dilution dysfunction: evaluation of automated disinfectant dispenser systems in 10 hospitals demonstrates a need for improved monitoring to ensure that correct disinfectant concentrations are delivered. Infect Control Hosp Epidemiol. 2024. doi:10.1017/ice.2024.148.
Mechanical recontamination
The same cloth goes from one surface to another
A cloth or wipe used on a contaminated surface can transfer microorganisms to a clean surface when used successively.
An experimental study showed that disinfectant-impregnated wipes were able to transfer Clostridioides difficile spores from contaminated surfaces to initially uncontaminated areas.
Another study showed the recontamination of surfaces with E. coli, S. aureus, and E. faecalis when the same cloth was reused for successive wipes, even in the presence of a biocide.
These results highlight the importance of how the wiping material is used, rather than a lack of efficacy of the disinfectant itself.
ALLThe tested surfaces were recontaminated on the second pass.
1 CLOTHPer surface to prevent pathogen transfer
How to do it correctly
- Observe the established cleaning method for the area and surface type.
- Change the cleaning material according to the procedure and whenever it can no longer be used properly.
- Avoid going back over processed surfaces with already contaminated material.
The goal is to prevent the transfer of microorganisms and eliminate the risk of cross-contamination between surfaces.
Nkemngong CA, Chaggar GK, Li X, Teska PJ, Oliver HF. Disinfectant wipes transfer Clostridioides difficile spores from contaminated surfaces to uncontaminated surfaces during the disinfection process. Antimicrob Resist Infect Control. 2020;9:176. doi:10.1186/s13756-020-00844-0.
Edwards NWM, Best EL, Goswami P, Wilcox MH, Russell SJ. Recontamination of Healthcare Surfaces by Repeated Wiping with Biocide-Loaded Wipes: „One Wipe, One Surface, One Direction, Dispose” as Best Practice in the Clinical Environment. Int J Mol Sci. 2020;21(24):9659. doi:10.3390/ijms21249659.
Inefficient logistics flow
The product is not available at the place of use.
A procedure may be correct on paper, but difficult to apply if the necessary products and materials are not available where the activity takes place.
The distance to the product, its absence, or the need to search for it elsewhere can make it difficult to integrate the procedure into the actual workflow.
Availability is, therefore, also a matter of organization: products must be accessible at the points where they are needed, in accordance with internal procedures and applicable requirements.
How to do it correctly
- Identify the points where products and materials are needed in the workflow.
- Ensure their availability at the points of use.
- Periodically check stock and placement to prevent shortages.
Degradation of procedural routine
Lack of continuous training and auditing
A procedure explained at the beginning does not mean it will be followed correctly over time. Without monitoring and feedback, deviations can go unnoticed and become part of the daily routine.
An AHRQ analysis of cleaning improvement interventions in medical facilities highlighted the importance of continuous education, direct feedback, and monitoring. In a study conducted across 36 hospitals, and subsequently monitored for sustainability in 8 of them, cleaning performance declined by approximately 10–20% within 6–18 months after the last feedback session.
10–20%Compliance degradation over time
6–18 monthsSince the last feedback session
How to do it correctly
- Plan refresh sessions for procedures based on identified needs.
- Periodically monitor compliance with procedures using methods appropriate to the context.
- Provide feedback to the team and use the results to correct deviations.
Training, monitoring, and feedback are a continuous process, not just an initial stage.
Leas BF, Sullivan N, Han JH, Pegues DA, Kaczmarek JL, Umscheid CA. Environmental Cleaning for the Prevention of Healthcare-Associated Infections. AHRQ Technical Brief No. 22. Agency for Healthcare Research and Quality; 2015.
Carling PC, Parry MM, Rupp ME, Po JL, Dick B, Von Beheren S. Improving cleaning of the environment surrounding patients in 36 acute care hospitals. Infect Control Hosp Epidemiol. 2008;29(11):1035–1041. doi:10.1086/591940.
ESSENTIAL DELIMITATIONS
What relates to the product and what relates to the procedure
Choosing the product can simplify certain stages of the process, but it cannot replace the procedure.
A ready-to-use product can eliminate the dilution step.
A suitable format can facilitate the application of the product at the point of use.
The right wiping materials can support a procedure that limits the transfer of contamination.
But the contact time must be respected, the wiping material must be used correctly, the product must be available where it is needed, and staff must be trained and monitored.
The product is part of the process. It does not replace the process.
What customers say
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Frequently Asked Questions
What are the offices asking us?
Why must the contact time of a disinfectant be respected?
The contact time of a disinfectant is the period during which the product must remain under the conditions specified in the instructions for use for the claimed efficacy to be supported. A shorter time cannot be considered equivalent unless there is efficacy data to support it.
What happens if the disinfectant is diluted incorrectly?
An incorrect dilution of the disinfectant means that the product is no longer being used at the concentration specified in the instructions for use. The demonstrated efficacy of the product cannot be automatically extrapolated to a different concentration.
Why is it not recommended to use the same cloth on multiple surfaces?
Using the same cloth on multiple surfaces can transfer microorganisms from a contaminated surface to one that was initially uncontaminated. Experimental studies have demonstrated this phenomenon even in the case of wiping materials impregnated with biocide.
Can disinfectant wipes transfer microorganisms?
Disinfectant wipes can remove microorganisms from a surface, but under certain experimental conditions, they can also transfer some of the contamination to other areas if used successively. This does not mean that disinfectant wipes are ineffective, but rather that the method of use and changing the wiping material are important.
Is it enough to choose an effective disinfectant?
Choosing an effective disinfectant is important, but not sufficient for a correct disinfection process. The result also depends on application in accordance with the instructions for use, concentration, contact time, material compatibility, and adherence to the procedure.
Why does the placement of the disinfection product matter?
The placement of the disinfectant product can influence how easily a procedure can be followed during work. If the product is not available at the point where it is needed, applying the procedure can become more difficult. Organization and supply must, therefore, take into account the actual workflow.
Is the training provided at the start of the activity sufficient?
Training provided at the beginning of an activity does not guarantee the maintenance of correct practices over time. Studies on environmental cleaning in healthcare facilities have shown that improvements gained through training and feedback can decline over time in the absence of continuous monitoring and feedback.
Why is simple disinfectant spraying not sufficient on surfaces?
Direct spraying without mechanical action may leave uncovered areas and does not remove organic load or biofilm. Wiping ensures uniform product distribution and helps physically remove microorganisms from the surface.
Can a ready-to-use product reduce the risk of error?
A ready-to-use product eliminates the preparation stage involving dilution and, consequently, the risk of error associated with this step. However, it does not eliminate other process requirements, such as correct application and adherence to the contact time.
What is the role of monitoring cleaning and disinfection procedures?
Monitoring cleaning and disinfection procedures helps identify deviations and maintain correct practices over time. Providing feedback to staff can help sustain the results achieved through training.
⚠️ Klintensiv disinfectants are approved by the Ministry of Health through the National Commission for Biocidal Products, and technical documentation is available upon request. Use biocides responsibly. Always read the label and product information before application. Follow the manufacturer's instructions to ensure effective disinfection and safe use.
Romanian company specializing in the production and commercialization of disinfectants, cleaning products, and personal hygiene solutions, tailored for both professional sectors (B2B & B2G) and individual consumers (B2C).
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