Exposure Control: Appendix B

SPRAY-WIPE-SPRAY

Items that cannot be covered with a barrier or that are not disposable or capable of being heat sterilized must be disinfected.

A hospital level surface disinfectant should be used. Many quaternary Ammonium compounds and isopropyl alcohol are no longer acceptable. Manufacturer's directions should be followed on dilution and time required for disinfecting to kill TB. Date the preparation or mix at a regular designated time according to the specific shelf life of the product being used.

Disinfectants should not be stored in containers with gauze.

4 x 4 gauze is best for cleaning and disinfecting as they will let the disinfectants "go" whereas paper towels are made to absorb. Paper towels can be used for drying.

Wearing nitrile rubber gloves, mask and protective eye wear, spray gauze to soak with a disinf6ctant/cleaner or a cleaner. Wipe the surface. Re-spray another gauze, wipe and let surfaces sit damp the recommended time, usually 10 minutes. Do not spray switches as they should be covered with barrier materials. Do not allow excess fluid to run into switch components as it may damage the electrical system. Care should be taken to clean the holders for the handpieces and air/water syringe, however, barriers are recommended.

Clean all hard surfaces, hoses, etc. at the end of the day. Between patients clean and disinfect items and/or surfaces not covered with a barrier or that become contaminated.

Note: Bleach should be mixed daily as well as most iodophors.

Since health care workers are at the mercy of the manufacturers, you are using disinfectants that make certain claims. You can only hope these are valid claims. Some researchers say only ethanol based products should be used (i.e., Amphyl or Lysol, good disinfectants but are not good cleaners) and others say to use phenols (i.e., Perfecto Dentaphene, etc.). If items that go into the patient's mouth are sterilized and many items disposable or covered with plastic and changed between patients, there should not be any problem with the hospital level disinfectant you use. Do not however, use glutaraldehyde as a hard surface disinfectant. In most cases, chairs only need the chair arms and footrest cleaned. Disinfectants are very hard on the chair materials. The patient covers the majority of the chair. Use a small spray bottle of soap & water to clean the chair parts rather than disinfectants.
 

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